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About the 2014 Yellow Book: Front Matter

The front matter from the printed edition of CDC Health Information for International Travel 2014, pages i-xxv, is included here.

Publishing Reference

Editor in Chief

Gary W. Brunette, MD, MS

Chief Medical Editor

Phyllis E. Kozarsky, MD

Medical Editors

Nicole J. Cohen, MD, MS
Mark D. Gershman, MD
Alan J. Magill, MD
Stephen M. Ostroff, MD
Edward T. Ryan, MD
David R. Shlim, MD
Michelle Weinberg, MD, MPH
Mary Elizabeth Wilson, MD

Managing Editor

Amanda Whatley Lee, MPH

Public Health Service
Centers for Disease Control and Prevention
National Center for Emerging and Zoonotic Infectious Diseases

Division of Global Migration and Quarantine
Atlanta, Georgia

Oxford University Press

Oxford University Press is a department of the University of Oxford.
It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide.

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© Oxford University Press 2014

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by license, or under terms agreed with the appropriate reproduction rights organization. Inquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above.

You must not circulate this work in any other form and you must impose this same condition on any acquirer.

ISSN 0095-3539
ISBN 978–0–19–994849–9

Oxford University Press is proud to pay a portion of its sales for this book to the CDC Foundation. Chartered by Congress, the CDC Foundation began operations in 1995 as an independent, nonprofit organization fostering support for CDC through public-private partnerships. Further information about the CDC Foundation can be found at The CDC Foundation did not prepare any portion of this book and is not responsible for its contents.

All CDC material in this publication is in the public domain and may be used and reprinted without special permission; however, citation of the source is appreciated.

Suggested Citation

Centers for Disease Control and Prevention. CDC Health Information for International Travel 2014. New York: Oxford University Press; 2014.

Readers are invited to send comments and suggestions regarding this publication to Gary W. Brunette, Editor in Chief, Centers for Disease Control and Prevention, Division of Global Migration and Quarantine (E-03), Travelers’ Health Branch (proposed), 1600 Clifton Road NE, Atlanta, GA 30333, USA.


Both generic and trade names (without trademark symbols) are used in this text. In all cases, the decision to use one or the other was made based on recognition factors and was done for the convenience of the intended audience. Therefore, the use of trade names and commercial sources in this publication is for identification only and does not imply endorsement by the US Department of Health and Human Services, the Public Health Service, or CDC.

References to non-CDC Internet sites are provided as a service to readers and do not constitute or imply endorsement of these organizations or their programs by the US Department of Health and Human Services, the Public Health Service, or CDC. CDC is not responsible for the content of these sites. URL addresses were current as of the date of publication.


This material is not intended to be, and should not be considered, a substitute for medical or other professional advice. Treatment for the conditions described in this material is highly dependent on the individual circumstances. While this material is designed to offer accurate information with respect to the subject matter covered and to be current as of the time it was written, research and knowledge about medical and health issues are constantly evolving, and dose schedules for medications and vaccines are being revised continually, with new side effects recognized and accounted for regularly. Readers must, therefore, always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulation. Oxford University Press and the authors make no representations or warranties to readers, express or implied, as to the accuracy or completeness of this material, including without limitation that they make no representations or warranties as to the accuracy or efficacy of the drug dosages mentioned in the material. The authors and the publishers do not accept, and expressly disclaim, any responsibility for any liability, loss, or risk that may be claimed or incurred as a consequence of the use and/or application of any of the contents of this material.

The Publisher is responsible for author selection and the Publisher and the Author(s) make all editorial decisions, including decisions regarding content. The Publisher and the Author(s) are not responsible for any product information added to this publication by companies purchasing copies of it for distribution to clinicians.

For additional copies, please contact Oxford University Press. Order online at

Editorial Staff

Editor in Chief: Gary W. Brunette
Chief Medical Editor: Phyllis E. Kozarsky
Medical Editors: Nicole J. Cohen, Mark D. Gershman, Alan J. Magill, Stephen M. Ostroff, Edward T. Ryan, David R. Shlim, Michelle Weinberg, and Mary Elizabeth Wilson
Managing Editor: Amanda Whatley Lee
Design and Production Editor: Kelly Holton
Technical Writer-Editors: Ronnie Henry and Ava W. Navin
Editorial Assistant: Julie Ephgrave
Cartographer: Kevin Liske

CDC Contributors

Alexander, James P.
Allen, Jessica
Anderson, Alicia
Ansari, Armin
Arguin, Paul M.
Averhoff, Francisco
Bair-Brake, Heather
Balaban, Victor
Ballesteros, Michael F.
Barskey IV, Albert E.
Barzilay, Ezra J.
Batts, Dahna
Benenson, Gabrielle A.
Bern, Caryn
Bhan, Ashika Devi
Bialek, Stephanie R.
Blaney, David D.
Bowen, Anna
Bresee, Joseph
Brogdon, William G.
Brooks, John T.
Brown, Clive M.
Brunette, Gary W.
Brunkard, Joan M.
Buff, Ann M.
Cantey, Paul T.
Chai, Shua J.
Chiller, Tom M.
Ciesielski, Carol
Cohen, Nicole J.
Cohn, Amanda
Czarkowski, Alan G.
Dasch, Gregory A.
De, Barun K.
Dhara, V. Ramana
Dunne, Eileen F.
Dykewicz, Clare A.
Eidex, Rachel B.
Erskine, Stefanie
Fagan, Ryan P.
Fiebelkorn, Amy Parker
Fischer, Marc
Fox, LeAnne M.
Gaines, Joanna
Gallagher, Nancy M.
Galland, G. Gale
Gargano, Julia Warner
Garrison, Laurel E.
Gee, Jay E.
Gershman, Mark D.
Goodson, James L.
Gould, L. Hannah
Grant, Althea
Green, Michael D.

Greenbaum, Adena
Griffin, Patricia M.
Grosse, Scott
Guerra, Marta A.
Hall, Aron J.
Heiman, Katherine E.
Henry, Ronnie
Herwaldt, Barbara L.
Hicks, Lauri A.
Hills, Susan L.
Hlavsa, Michele C.
Holtzman, Deborah
Iademarco, Michael F.
Illig, Petra A.
Imanishi, Maho
Jentes, Emily S.
Johnson, Katherine J.
Jones, Jeffrey L.
Kapella, Bryan K.
Khan, Ali S.
Kidd, Sarah
Knust, Barbara
Kozarsky, Phyllis E.
Kroger, Andrew T.
Kutty, Preeta K.
Lankau, Emily W.
Lee, Amanda Whatley
Lee, C. Virginia
Liang, Jennifer L.
LoBue, Philip
Lopman, Ben
MacNeil, Jessica R.
Mahon, Barbara E.
Malilay, Josephine
Maloney, Susan A.
Marano, Nina
Margolis, Harold S.
Marienau, Karen J.
Marin, Mona
Markowitz, Lauri
Marston, Chung K.
Mathieu, Els
McLean, Huong Q.
McQuiston, Jennifer
Mead, Paul S.
Meites, Elissa
Miller, Charles W.
Mintz, Eric
Mitruka, Kiren
Mody, Rajal
Montgomery, Susan
Moore, Anne
Moro, Pedro L.
Mullan, Robert J.

Nasci, Roger S.
Naughton, Mary P.
Navin, Ava W.
Nelson, Christina A.
Newton, Anna E.
Novak, Ryan T.
Olson, Christine K.
O’Reilly, Ciara Ortega, Luis S.
O’Sullivan, Megan Crawley
Powers, Ann M.
Reef, Susan E.
Reyes, Nimia
Reynolds, Mary G.
Roehler, Douglas R.
Rollin, Pierre E.
Roy, Sharon L.
Rupprecht, Charles E.
Schneider, Eileen
Shadomy, Sean V.
Sharapov, Umid M.
Shealy, Katherine
Skoff, Tami H.
Slaten, Douglas D.
Sleet, David A.
Smith, Nicole M.
Smith, Theresa L.
Sommers, Theresa E.
Sotir, Mark J.
Spruit-McGoff, Kathryn
Staples, J. Erin Steele, Stefanie F.
Stoddard, Robyn A.
Strikas, Raymond M. A.
Tan, Kathrine R.
Teo, Chong-Gee
Teshale, Eyasu H.
Tiwari, Tejpratap S. P.
Tomashek, Kay M.
Wallace, Gregory S.
Wassilak, Steven G. F.
Waterman, Stephen H.
Watson, John C.
Weber, Ingrid B.
Weinberg, Michelle
Weinberg, Nicholas
Wilson, Todd W.
Wirtz, Robert A.
Workowski, Kimberly
Yanni, Emad A.
Yendell, Stephanie J.
Yoder, Jonathan S.
Zielinski-Gutierrez, Emily

External Contributors

Ahmed, Qanta State University of New York, Stony Brook, NY; Glasgow Caledonian University School of Public Health, Scotland, UK; and Templeton-Cambridge Journalism Fellow, England, UK
Ansdell, Vernon E

University of Hawaii, Honolulu, HI

Backer, Howard D. California Emergency Medical Services Authority, Sacramento, CA
Barbeau, Deborah Nicolls Tulane University, New Orleans, LA
Barnett, Elizabeth D. Boston University School of Medicine and Boston Medical Center, Boston, MA
Borwein, Sarah T. TravelSafe Medical Centre, Hong Kong, China
Brownstein, John S. Boston Children’s Hospital Informatics Program at the Harvard-MIT Division of Health Sciences and Technology; Division of Emergency Medicine, Boston Children’s Hospital; and Department of Pediatrics, Harvard Medical School, Boston, MA
Carroll, I. Dale The Pregnant Traveler, Spring Lake, MI
Chen, Lin H. Mount Auburn Hospital—Travel Medicine Center, Cambridge, MA, and Harvard Medical School, Boston, MA
Connor, Bradley A. Weill Medical College of Cornell University, New York, NY
DeRomana, Ines University of California System, Education Abroad Program, Santa Barbara, CA
Dupont, Herbert L. University of Texas Health Science Center, School of Public Health, Houston, TX
Ebner, Jodi Chapman University, Center for Global Education, Orange, CA
Eremeeva, Marina E. Georgia Southern University, Statesboro, GA
Fairley, Jessica K. Emory University School of Medicine, Atlanta, GA
Forgione, Michael A. Keesler Medical Center—Infectious Diseases Consultant to the Surgeon General, Keesler Air Force Base, MS
Freedman, David O. University of Alabama at Birmingham, Birmingham, AL
Freifeld, Clark C. Boston Children’s Hospital Informatics Program at the Harvard-MIT Division of Health Sciences and Technology; Division of Emergency Medicine, Boston Children’s Hospital; and Department of Biomedical Engineering, Boston University, Boston, MA
Fukuda, Mark M. Armed Forces Health Surveillance Center—Global Emerging Infections Malaria Program, Silver Spring, MD
Gushulak, Brian D. Migration Health Consultants, Cheltenham, Canada
Hackett, Peter H. Institute for Altitude Medicine, Telluride, CO, and Altitude Research Center, University of Colorado Denver School of Medicine, Denver, CO
Hansen, Amy L. Sonricker Boston Children’s Hospital Informatics Program at the Harvard-MIT Division of Health Sciences and Technology and Division of Emergency Medicine, Boston Children’s Hospital, Boston, MA, and Department of Epidemiology and Biostatistics, State University of New York, Albany, NY
Howard, Cynthia R. University of Minnesota, Minneapolis, MN
John, Chandy C. University of Minnesota, Minneapolis, MN
Kain, Kevin C. University of Toronto, Toronto, Canada
Keystone, Jay S. University of Toronto, Toronto, Canada
Kotton, Camille Nelson Massachusetts General Hospital and Harvard University, Boston, MA
LaRocque, Regina C. Massachusetts General Hospital and Harvard Medical School, Boston, MA
Libassi, Lisa Swedish Medical Center, Seattle, WA
Libman, Michael McGill University, Centre for Tropical Disease, Montreal, Canada
Mackell, Sheila M. Mountain View Pediatrics, Flagstaff, AZ
Magill, Alan J. Walter Reed Army Institute of Research, Experimental Therapeutics, Silver Spring, MD
Maguire, Jason D. Naval Medical Center Portsmouth—Infectious Diseases Division and Travelers’ Health Clinic, Portsmouth, VA
McCarthy, Anne E. Ottawa Hospital and University of Ottawa, Ottawa, Canada
Neumann, Karl Weill Medical College of Cornell University and New York Presbyterian Hospital/ Cornell Medical Center, New York, NY
Nord, Daniel A. Divers Alert Network, Durham, NC
Offit, Paul The Children’s Hospital of Philadelphia, Philadelphia, PA
Ostroff, Stephen M. Pennsylvania Department of Health, Harrisburg, PA
Reisenauer, Amy K. Hawaii Permanente Medical Group, Wailuku, HI
Rhodes, Gary Center for Global Education, University of California, Los Angeles, CA
Rosselot, Gail Travel Well of Westchester, Inc., Briarcliff Manor, NY
Ryan, Edward T. Massachusetts General Hospital and Harvard University, Boston, MA
Shlim, David R. Jackson Hole Travel and Tropical Medicine, Jackson Hole, WY
Stauffer, William M. University of Minnesota, Minneapolis, MN, and CDC, Atlanta, GA
Valk, Thomas H. VEI Inc., Marshall, VA
Walker, Patricia F. University of Minnesota, Minneapolis, MN, and HealthPartners, Center for International Health and Travel and Tropical Medicine Center, St. Paul, MN
Wilson, Mary Elizabeth Harvard School of Public Health, Boston, MA
Wu, Henry M. Emory University, Department of Medicine, Atlanta, GA
Youngster, Ilan Children’s Hospital Boston and Harvard University, Boston, MA

All contributors have signed a statement indicating that they have no conflicts of interest with the subject matter or materials discussed in the document(s) that they have written or reviewed for this book and that the information that they have written or reviewed for this book is objective and free from bias.


The CDC Health Information for International Travel 2014 editorial team gratefully acknowledges all the authors and reviewers for their commitment to this new edition. We extend sincere thanks to the following people for their contributions to the production of this book:

  • Elise Beltrami and Clive Brown for their extensive review of the text.
  • Stefanie Erskine, Nomana Khan, C. Virginia Lee, Megan Crawley O’Sullivan, Crystal Polite, and Kate Spruit-McGoff for their assistance in preparing the text for publication.


To stay on the cutting edge of travel health information, this latest edition of CDC Health Information for International Travel has been extensively revised. The book serves as a guide to the practice of travel medicine, as well as the authoritative source of US government recommendations for immunizations and prophylaxis for foreign travel. As international travel continues to become more common in the lives of US residents, having at least a basic understanding of the medical problems that travelers face has become a necessary aspect of practicing medicine. The goal of this book is to be a comprehensive resource for clinicians to fi nd the answers to their travel health–related questions.

Thomas R. Frieden, MD, MPH, Director

Beth P. Bell, MD, MPH, Director

Martin S. Cetron, MD, Director
Gary W. Brunette, MD, MS, Chief, Travelers’ Health Branch (proposed)
Phyllis E. Kozarsky, MD, Expert Consultant, Travelers’ Health Branch (proposed)
Amanda Whatley Lee, MPH, MCHES, Health Communications Specialist, Travelers’ Health Branch (proposed)