About the 2020 Yellow Book: Front Matter

The front matter from the printed edition of CDC Yellow Book 2020: Health Information for International Travel, pages iii-xxvii, is included here.

Publishing Reference

Editors in Chief

Gary W. Brunette, MD, MS and Jeffrey B. Nemhauser, MD


Phyllis E. Kozarsky, MD

Medical Editors

Kristina M. Angelo, DO, MPH&TM
Nicole J. Cohen, MD, MS
Douglas H. Esposito, MD, MPH
Stephen M. Ostroff, MD
Edward T. Ryan, MD
David R. Shlim, MD
Richard W. Steketee, MD, MPH
Michelle Weinberg, MD, MPH
Mary Elizabeth Wilson, MD


Jenique Meekins


Ronnie Henry


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. Oxford is a registered trademark of Oxford University Press in the UK and certain other countries.

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© Oxford University Press 2019

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CIP data is on file at the Library of Congress
ISBN 978–0–19–092893–3 (pbk.)
ISBN 978–0–19–006597–3 (hbk.)
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Paperback and Hardback printed by LSC Communications, United States of America

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 www.cdcfoundation.org. 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 Yellow Book 2020: Health Information for International Travel. New York: Oxford University Press; 2017.

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), Travelers’ Health Branch (proposed), 1600 Clifton Road NE, Mail Stop E-28, 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.

Descriptions of drugs, biologics, or medical products used for an indication not in the approved labeling or packaging (“off-label” uses) do not constitute official HHS approval or endorsement of those products or uses. The uses described in this publication have been identified by subject-matter experts on the basis of published evidence and clinical experience. Clinicians who use a product for an off-label use should be well informed about the product, base its use on firm scientific rationale and sound medical evidence, and maintain records of the product’s use and effects.

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.

Boundaries and labels shown on maps are not necessarily authoritative.


This material is not intended to be, and should not be considered, a substitute for medical, legal, 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, legal, 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. Therefore, readers must 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 www.oup.com/us.

CDC Contributors

Abe, Karon
Acosta, Anna
Ali, Ibne
Alvarado-Ramy, Francisco
Angelo, Kristina
Ansari, Armin
Anstey, Erica
Appiah, Grace
Arboleda, Nelson
Arguin, Paul M.
Baggett, Henry C.
Ballesteros, Michael F.
Barton Behravesh, Casey
Beavers, Suzanne
Beckman, Michele G.
Benedict, Katherine
Benowitz, Isaac
Biggs, Holly
Blaney, David D.
Bonilla, Luis
Brogdon, William G.
Brooks, John T.
Brown, Clive M.
Bruce, Beau
Brunette, Gary W.
Cantey, Paul T.
Cardemil, Cristina V.
Chatham-Stevens, Kevin
Chiller, Tom M.
Choi, Mary Joung
Clemmons, Nakia S.
Cooley, Laura
Cope, Jennifer
Czarkowski, Alan G.
Dionne-Odom, Jodie
Dubray, Christine
Duong, Krista Kornylo
Edelson, Paul
Eichwald, John
Erskine, Stefanie K.
Esposito, Douglas H.
Estivariz, Concepcion
Fischer, Marc
Francois Watkins, Louise K.
Friedman, Cindy R.
Fry, Alicia
Gaines, Joanna
Galland, G. Gale
Galloway, Renee L.
Gastañaduy, Paul A.
Gee, Jay E.
Geissler, Aimee L.
Gerber, Susan I.
Gershman, Mark D.
Goodson, James L.
Goswami, Neela
Gould, Carolyn
Green, Michael D.
Griffin, Patricia M.
Hall, Aron J.
Hall, Rebecca
Ham, David
Harris, Aaron
Harvey, Pauline
Hawley, William A.
Healy, Jessica
Hendricks Walters, Kate
Henry, Ronnie
Herwaldt, Barbara L.
Hill, Vincent
Hills, Susan L.
Hinton, Cindy
Hlavsa, Michele C.
Hughes, Mike
Hunter, Jennifer C.
Jackson, Brendan
Jentes, Emily S.
Jones, Jeffrey L.
Jungerman, Robynne M.
Kersh, Gilbert J.
Kharod, Grishma A.
Knust, Barbara
Kozarsky, Phyllis E.
Kroger, Andrew T.
Lanzieri, Tatianna
Laughlin, Mark
Lee, Keun
Lessa, Fernanda C.
Lindsey, Nichole
LoBue, Philip
Lopez, Adriana S.
Lutgring, Joseph
MacArthur, John
Maloney, Susan A.
Marano, Nina
Marin, Mona
Marlow, Mariel A.
Marston, Chung K.
Martin, Diana L.
Martin, Stacey
McCollum, Andrea M.
McCotter, Orion Z.
McFarland, Jeffrey
McNamara, Lucy
Mead, Paul S.
Meyer, Sarah A.
Mintz, Eric D.
Montgomery, Susan
Montiel, Sonia H.
Moore, Matt
Morales, Michelle
Morof, Diane F.
Moser, Kathleen
Mott, Joshua
Mounts, Anthony
Mullan, Robert J.
Mutebi, John-Paul
Ncho, Hammad
Negron, Maria E.
Nelson, Christina A.
Nelson, Noele P.
Nicholson, William L.
Paddock, Christopher D.
Park, Benjamin
Patel, Manisha
Patimeteeporn, Calvin
Perez-Padilla, Janice
Peters, Philip J.
Peterson, Brett W.
Powers, Ann M.
Rabold, Elizabeth
Raczniak, Gregory A.
Reef, Susan E.
Reyes, Nimia L.
Robinson, Candice
Roellig, Dawn
Roguski, Katherine
Rollin, Pierre E.
Routh, Janell
Roy, Sharon
Russell, Michelle
Santelli, Ana Carolina
Sauber-Schatz, Erin K.
Schafer, Ilana J.
Schmid, D. Scott
Sharp, Tyler M.
Shoemaker, Trevor
Skoff, Tami H.
Sleet, David A.
Sotir, Mark J.
Spradling, Phil
Staples, J. Erin
Stauffer, Kendra
Stoddard, Robyn A
Stoney, Rhett J
Straily, Anne
Tan, Kathrine R.
Tardivel, Kara
Teshale, Eyasu
Tiller, Rebekah
Tiwari, Tejpratap S. P.
Uribe, Carolina
Vieira, Antonio
Villarino, Margarita E.
Walker, Allison Taylor
Wallace, Ryan M.
Wassilak, Steven G. F.
Waterman, Stephen H.
Watson, John T.
Weinberg, Michelle S.
White, Stephanie
Wien, Simone
Winstead, Allison
Wong, Karen K.
Workowski, Kimberly

External Contributors

Ansdell, Vernon E. University of Hawaii, Honolulu, HI
Atkinson, Gregory Teesside University, Middlesbrough, UK
Backer, Howard D. California Emergency Medical Services Authority, Sacramento, CA
Barbeau, Deborah Nicolls Tulane University, New Orleans, LA
Barkati, Sapha McGill University, Centre for Tropical Disease, Montreal, Canada
Barnett, Elizabeth D. Boston University School of Medicine and Boston Medical Center, Boston, MA
Batterham, Alan M. Teesside University, Middlesbrough, UK
Boggild, Andrea K. University of Toronto, Toronto, Canada
Borwein, Sarah T. TravelSafe Medical Centre, Hong Kong, China
Bozkurt, Taylan JMS Burn Centers, Inc., Augusta, GA
Bunn, Bill Medical University of South Carolina; Navistar International Corporation
Carroll, I. Dale The Pregnant Traveler, Spring Lake, MI
Changizi, Roohollah United Family Hospital, subsidiary of United Family Healthcare, Beijing, China
Chen, Lin H. Mount Auburn Hospital—Travel Medicine Center, Cambridge, MA, and Harvard Medical School, Boston, MA
Chimiak, James M. Divers Alert Network, Durham, NC
Connor, Bradley A. Weill Medical College of Cornell University, New York, NY
DeRomaña, Inés University of California System, Education Abroad Program, Santa Barbara, CA
Ejike-King, Lacreisha US Food and Drug Administration, US Department of Health and Human Services, Rockville, MD
Fairley, Jessica K. Emory University School of Medicine, Atlanta, GA
Florez-Arango, Jose F. Biomedical Informatics, College of Medicine, Texas A&M Health Science Center, College Station, TX
Forgione, Michael Keesler Medical Center, Keesler AFB, Mississippi
Franco-Paredes, Carlos Division of Infectious Diseases, University of Colorado at Denver, School of Medicine, Aurora, CO; Hospital Infantil de México Federico Gómez, Mexico City, Mexico
Freedman, David O. Shoreland, Inc., Milwaukee, WI
Gracia, J. Nadine Office of Minority Health, US Department of Health and Human Services, Rockville, MD
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
Henao-Martinez, Andres Division of Infectious Diseases, University of Colorado at Denver, School of Medicine, Aurora, CO
Henderson, John United Nations consultant, Burma
Hochberg, Natasha S. Section of Infectious Diseases, Boston University School of Medicine, Boston, MA
Javed, Uzma Office of American Citizens Services
Kain, Kevin C. University of Toronto, Toronto, Canada
Kayden, Stephanie Harvard Humanitarian Initiative, Cambridge, MA; Harvard Medical School, Boston, MA; Brigham and Women’s Hospital, Boston, MA
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
Levi, Matt CHI Franciscan Health, Tacoma, WA
Libman, Michael McGill University, Centre for Tropical Disease, Montreal, Canada
McDevitt, Sue Ann New York, NY
Neumann, Karl Weill Medical College of Cornell University and New York Presbyterian Hospital/ Cornell Medical Center, New York, NY
Nilles, Eric J. Harvard Humanitarian Initiative, Cambridge, MA; Harvard Medical School, Boston, MA; Brigham and Women’s Hospital, Boston, MA
Nord, Daniel A. Divers Alert Network, Durham, NC
Norton, Scott Children’s National Medical Center, Washington, DC
Parker, Salim Dee Bee Medical Centre, Cape Town; South African Society of Travel Medicine, Johannesburg, South Africa
Pogemiller, Hope University of Minnesota Medical School, Minneapolis, MN
Rhodes, Gary Center for Global Education, University of California, Los Angeles, CA
Riddle, Mark S. Naval Medical Research Center, Silver Spring, MD
Rosselot, Gail A. Travel Well of Westchester, Briarcliff Manor, NY
Ryan, Edward T. Massachusetts General Hospital and Harvard University, Boston, MA
Sampson, Dana M. Office of Minority Health, US Department of Health and Human Services, Rockville, MD
Shlim, David R. Jackson Hole Travel and Tropical Medicine, Jackson Hole, WY
Shurtleff, David National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD
Staat, Mary Allen International Adoption Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
Taggart, Linda R. University of Toronto, Toronto, Canada
Thompson, Andrew University of Liverpool, Liverpool, UK
Valk, Thomas H. VEI Inc., Marshall, VA
Van Tilburg, Christopher Providence Hood River Memorial Hospital, Hood River, OR
Waggoner, Jesse Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA
Wanat, Karolyn Medical College of Wisconsin, Milwaukee, WI
Wangu, Zoon Department of Pediatric Infectious Diseases, Boston Medical Center, Boston, MA
Weinberg, Nicholas Geisel School of Medicine, Dartmouth College, Hanover, NH
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


The CDC Yellow Book 2020: Health Information for International Travel 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:

  • Kelly M. Winter for serving in the role of managing editor and guiding this edition through the first half of production.
  • Elise Beltrami, Nicole Cohen, Rachel Eidex, and Scott Santibanez for their extensive review of the text.
  • Maeghan Dessecker, Johanzynn Gatewood, and Calvin Patimeteeporn for their assistance in preparing the text for publication.


To stay on the cutting edge of travel health information, this latest edition of the CDC Yellow Book 2020: 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.

Centers for Disease Control and Prevention

Robert R. Redfield, MD, Director

National Center for Emerging and Zoonotic Infectious Diseases

Rima Khabbaz, MD, Director

Division of Global Migration and Quarantine

Martin S. Cetron, MD, Director
Gary W. Brunette, MD, MS, Chief, Travelers’ Health Branch
Jeffrey B. Nemhauser, MD, Chief Medical Officer, Travelers’ Health Branch
Jenique Meekins, Health Communications Specialist, Travelers’ Health Branch