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.
Editors in Chief
Gary W. Brunette, MD, MS and Jeffrey B. Nemhauser, MD
CHIEF MEDICAL EDITOR
Phyllis E. Kozarsky, MD
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
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
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ISBN 978–0–19–006597–3 (hbk.)
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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.
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.
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Arguin, Paul M.
Baggett, Henry C.
Ballesteros, Michael F.
Barton Behravesh, Casey
Beckman, Michele G.
Blaney, David D.
Brogdon, William G.
Brooks, John T.
Brown, Clive M.
Brunette, Gary W.
Cantey, Paul T.
Cardemil, Cristina V.
Chiller, Tom M.
Choi, Mary Joung
Clemmons, Nakia S.
Czarkowski, Alan G.
Duong, Krista Kornylo
Erskine, Stefanie K.
Esposito, Douglas H.
Francois Watkins, Louise K.
Friedman, Cindy R.
Galland, G. Gale
Galloway, Renee L.
Gastañaduy, Paul A.
Gee, Jay E.
Geissler, Aimee L.
Gerber, Susan I.
Gershman, Mark D.
Goodson, James L.
Green, Michael D.
Griffin, Patricia M.
Hall, Aron J.
Hawley, William A.
Hendricks Walters, Kate
Herwaldt, Barbara L.
Hills, Susan L.
Hlavsa, Michele C.
Hunter, Jennifer C.
Jentes, Emily S.
Jones, Jeffrey L.
Jungerman, Robynne M.
Kersh, Gilbert J.
Kharod, Grishma A.
Kozarsky, Phyllis E.
Kroger, Andrew T.
Lessa, Fernanda C.
Lopez, Adriana S.
Maloney, Susan A.
Marlow, Mariel A.
Marston, Chung K.
Martin, Diana L.
McCollum, Andrea M.
McCotter, Orion Z.
Mead, Paul S.
Meyer, Sarah A.
Mintz, Eric D.
Montiel, Sonia H.
Morof, Diane F.
Mullan, Robert J.
Negron, Maria E.
Nelson, Christina A.
Nelson, Noele P.
Nicholson, William L.
Paddock, Christopher D.
Peters, Philip J.
Peterson, Brett W.
Powers, Ann M.
Raczniak, Gregory A.
Reef, Susan E.
Reyes, Nimia L.
Rollin, Pierre E.
Santelli, Ana Carolina
Sauber-Schatz, Erin K.
Schafer, Ilana J.
Schmid, D. Scott
Sharp, Tyler M.
Skoff, Tami H.
Sleet, David A.
Sotir, Mark J.
Staples, J. Erin
Stoddard, Robyn A
Stoney, Rhett J
Tan, Kathrine R.
Tiwari, Tejpratap S. P.
Villarino, Margarita E.
Walker, Allison Taylor
Wallace, Ryan M.
Wassilak, Steven G. F.
Waterman, Stephen H.
Watson, John T.
Weinberg, Michelle S.
Wong, Karen K.
|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