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About the 2016 Yellow Book: Front Matter

The front matter from the printed edition of CDC Health Information for International Travel 2016, 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

Megan Crawley O’Sullivan, MPH

Technical Editor

Ronnie Henry

US Department of Health and Human Services
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

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Copyright © 2016 by Oxford University Press

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.

ISBN 978–0–19–937915–6 1 2 3 4 5 6 7 8 9

Printed in the United States of America on acid-free paper 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 2016. New York: Oxford University Press; 2016.

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, 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: Megan Crawley O’Sullivan
Technical Editor: Ronnie Henry
Design and Production Editor: Kelly Holton
Editorial Assistant: Julie Ephgrave
Cartographer: R. Ryan Lash
Assistant Cartographer: C. Virginia Lee


CDC Contributors

Alexander, James P.
Anderson, Alicia
Ansari, Armin
Arguin, Paul M.
Armstrong, Gregory L.
Averhoff, Francisco
Bair-Brake, Heather
Ballesteros, Michael F.
Barbre, Kira A.
Beavers, Suzanne
Benenson, Gabrielle A.
Benoit, Tina J.
Bialek, Stephanie R.
Blaney, David D.
Bowen, Anna
Bresee, Joseph
Brogdon, William G.
Brooks, John T.
Brown, Clive M.
Brunette, Gary W.
Buff, Ann M.
Burke, Heather
Cantey, Paul T.
Chen, Tai-Ho
Chiller, Tom M.
Cohen, Nicole J.
Czarkowski, Alan G.
Dhara, V. Ramana
Dubray, Christine
Duong, Krista Kornylo
Dykewicz, Clare A.
Ederer, David J.
Epperson, Scott
Erskine, Stefanie K.
Fiebelkorn, Amy Parker
Fischer, Marc
Flannery, Brendan
Fox, LeAnne M.
Gaines, Joanna
Galloway, Renee L.
Galland, G. Gale
Gargano, Julia Warner
Garrison, Laurel E.
Gastañaduy, Paul A.
Gee, Jay E.
Geissler, Aimee L.
Gerber, Susan I.
Gershman, Mark D.
Goodson, James L.
Gould, L. Hannah
Grant, Althea M.
Green, Michael D.
Griffin, Patricia M.
Grosse, Scott D.
Guerra, Marta A.
Hall, Aron J.
Han, Pauline V.
Hanlon, Cathleen A.
Henry, Ronnie
Herwaldt, Barbara L.
Hills, Susan L.
Hlavsa, Michele C.
Holtzman, Deborah
Illig, Petra A.
Iwamoto, Martha
Jentes, Emily S.
Jones, Jeffrey L.
Kharod, Grishma A.
Kidd, Sarah E.
Kile, James C.
Knust, Barbara
Kozarsky, Phyllis E.
Kroger, Andrew T.
Kutty, Preeta K.
Lebo, Emmaculate J.
Lee, Amanda W.
Liang, Jennifer L.
Lippold, Susan A.
LoBue, Philip
Lopman, Ben
Lyss, Sheryl
MacNeil, Jessica R.
Mahon, Barbara E.
Malilay, Josephine
Maloney, Susan A.
Marano, Nina
Margolis, Harold S.
Marienau, Karen J.
Marin, Mona
Marston, Chung K.
Martin, Diana L.
McQuiston, Jennifer
Mead, Paul S.
Meites, Elissa
Meyer, Sarah A.
Mintz, Eric
Mitruka, Kiren
Mody, Rajal
Montgomery, Susan
Montiel, Sonia H.
Morgan, Oliver W
Moro, Pedro L.
Morof, Diane F.
Mullan, Robert J.
Murphy, Trudy V.
Nasci, Roger S.
Nelson, Christina A.
Nelson, Noele P.
Newton, Anna E.
Nguyen, Duc B., Olson, Christine K.
O’Reilly, Ciara E.
Powers, Ann M.
Rabe, Ingrid B.
Reef, Susan E.
Reyes, Nimia L.
Reynolds, Mary G.
Rollin, Pierre E.
Routh, Janell A.
Roy, Sharon L.
Schmid, D. Scott Shadomy, Sean V.
Sharp, Tyler M.,
Shealy, Katherine R.
Skoff, Tami H.
Sleet, David A.
Sobel, Jeremy
Sotir, Mark J.
Spruit-McGoff, Kathryn E.
Staples, J. Erin
Steele, Stefanie F.
Stoddard, Robyn A.
Stoney, Rhett J.
Strikas, Raymond A.
Tan, Kathrine R.
Teo, Chong-Gee
Tiller, Rebekah
Tiwari, Tejpratap S. P.
Tomashek, Kay M.
Traxler, Rita M.
Villarino, Margarita E.
Wallace, Gregory S.
Warren, Dora
Wassilak, Steven G. F.
Waterman, Stephen H.
Watson, John C.
Watson, John T.
Weinberg, Michelle
Weinberg, Nicholas
Wilson, Todd W.
Wirtz, Robert A.
Wolkin, Amy F.
Woodhall, Dana M.
Workowski, Kimberly
Xiao, Lihua Yoder, Jonathan S.

External Contributors

Adler, Tina Westata National Center for Complementary and Integrative Health Clearinghouse, Rockville, MD
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
Benenson, Michael W. Armed Forces Research Institute of the Medical Sciences, Bangkok, Thailand (retired)
Borwein, Sarah T. TravelSafe Medical Centre, Hong Kong, China
Bowron, Christopher S. University of Minnesota, Minneapolis, MN
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
Ejike-King, Lacreisha Office of Minority Health, US Department of Health and Human Services, Rockville, MD
Fairley, Jessica K. Emory University School of Medicine, Atlanta, GA
Freedman, David O. Shoreland, Inc., Milwaukee, WI
Gracia, J. Nadine Office of Minority Health, US Department of Health and Human Services, Rockville, 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
Hamer, Davidson H. Center for Global Health and Development Boston University; Department of Global Health, Boston University School of Public Health and Section of Infectious Diseases, Boston Medical Center, Boston, MA
Hochberg, Natasha S. Section of Infectious Diseases, Boston University School of Medicine, Boston, MA
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
Law, Catherine National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD
Libman, Michael McGill University, Centre for Tropical Disease, Montreal, Canada
Ludwig, Grant US Department of State
Maalim, Salahudin M. University of Minnesota, Minneapolis, MN
Magill, Alan J. Walter Reed Army Institute of Research, Experimental Therapeutics, Silver Spring, MD
Neumann, Karl Weill Medical College of Cornell University and New York Presbyterian Hospital/ Cornell Medical Center, New York, NY
Nilles, Eric J. Division of Health Securities and Emergencies, World Health Organization, Suva, Fiji
Nord, Daniel A. Divers Alert Network, Durham, NC
Offit, Paul The Children’s Hospital of Philadelphia, Philadelphia, PA
Ostroff, Stephen M. Food and Drug Administration, Silver Spring, MD
Pedone, Bettina N. Arthur Ashe Student Health & Wellness Center, University of California, Los Angeles, CA
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
Staat, Mary Allen International Adoption Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
Stauffer, William M. University of Minnesota, Minneapolis, MN, and CDC, Atlanta, GA
Thigpen, Michael C. National Institutes of Health, Rockville, MD
Valk, Thomas H. VEI Inc., Marshall, VA
Wangu, Zoon Division of Pediatric Infectious Diseases, UMass Memorial Children's Medical Center, Worcester, MA
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 2016 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, Clive Brown, and Scott Santibanez for their extensive review of the text.
  • Amanda W. Lee, Laurie Dieterich, and Crystal Polite for their assistance in preparing the text for publication.
  • Stephanie Brantman for freely lending her graphic design expertise to help refine the cartographic styles used throughout the book.
  • Michael Johansson for his assistance in procuring and evaluating the data utilized to produce all dengue disease maps.


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 find 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
Phyllis E. Kozarsky, MD, Expert Consultant, Travelers’ Health Branch
Megan Crawley O’Sullivan, Health Communications Specialist, Travelers’ Health Branch

Photography Credits

Cover Images: Rio de Janeiro, Brazil

Photos by Julia Raposo

Banner Images for Select Destinations

East Africa: Safaris (p. 423): Michelle Russell/Personal Collection

South Africa (p. 427): Kelly Holton/Personal Collection

Tanzania: Kilimanjaro (p. 430): Kevin Kain/Personal Collection

Brazil (p. 434): Julia Raposo/Personal Collection

Dominican Republic (p. 439): Jeffrey Wages/Personal Collection

Haiti (p. 443): Amethyst Auza/Personal Collection

Mexico (p. 447): Natalia Castells-Esquivel/Personal Collection

Peru: Cusco–Machu Picchu (p. 452): Kelly Holton/Personal Collection

Cambodia (p. 456): Emily Jentes/Personal Collection

China (p. 461): Marco Obando/Personal Collection

India (p. 467): Tiffany Eberhard/Personal Collection

Nepal (p. 472): David R. Shlim/Personal Collection

Thailand (p. 476): Michelle Russell/Personal Collection

Vietnam (p. 481): BK Kapella/Personal Collection

Egypt & Nile River Cruises (p. 486): Geoff Boyer/Personal Collection

Saudi Arabia: Hajj Pilgrimage (p. 490): Ziad A. Memish/Personal Collection