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About the Yellow Book: Front Matter

The front matter from the printed edition of CDC Health Information for International Travel 2010, pages i-xii, is included here.

Publishing Reference

Managing Editor

Gary W. Brunette, MD, MS

Medical Editors

Phyllis E. Kozarsky, MD
Alan J. Magill, MD
David R. Shlim, MD

Associate Editor

Amanda D. Whatley, MPH

Public Health Service
Centers for Disease Control and Prevention
National Center for Preparedness, Detection, and Control of Infectious Diseases
Division of Global Migration and Quarantine
Atlanta, Georgia

For Elsevier
Commissioning Editor: Sue Hodgson
Development Editor: Joanne Scott
Editorial Assistant: Rachael Harrison
Project Manager: Susan Stuart
Design: Stewart Larking
Marketing Managers (UK/USA): Clara Toombs, Courtney Ingram
Production: Helius

MOSBY is an imprint of Elsevier Inc.
© 2009, Elsevier Inc. All rights reserved.
ISBN: 978-0-7020-3481-7

Elsevier 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 2010. Atlanta: U.S. Department of Health and Human Services, Public Health Service, 2009.

Readers are invited to send comments and suggestions regarding this publication to Gary W. Brunette, Managing Editor, Centers for Disease Control and Prevention, Division of Global Migration and Quarantine (E-03), Geographic Medicine and Health Promotion Branch, 1600 Clifton Road NE, Atlanta, Georgia 30333, USA.


Both generic and trade names 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 U.S. Department of Health and Human Services, the Public Health Service, or the Centers for Disease Control and Prevention.

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


Medical knowledge is constantly changing. Standard safety precautions must be followed, but as new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current product information provided by the manufacturer of each drug to be administered to verify the recommended dose, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Neither the publisher nor the authors assume any liability for any injury and/or damage to persons or property arising from this publication.  The Publisher

For additional copies, please contact Elsevier Inc. Order online at [[forward label=([]) link=([])]].

British Library Cataloguing in Publication Data

CDC health information for international travel 2010.
1. Travel—Health aspects.
I. Health information for international travel 2010
II. Yellow book
III. Brunette, Gary W.
IV. Centers for Disease Control and Prevention
ISBN-13: 9780702034817

Library of Congress Cataloging in Publication Data

A catalog record for this book is available from the Library of Congress.

Printed in Spain


The CDC Health Information for International Travel 2010 has been extensively revised for this latest edition in an effort to stay on the cutting edge of travel health information. The book is meant to be a guide to the practice of travel medicine, as well as the authoritative source of U.S. government recommendations for immunizations and prophylaxis for foreign travel. International travel is becoming more and more commonplace, and thus 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 the practitioner and public to find the answers to their travel-related questions, whether before travel, during travel, or post-travel.


Rima Khabbaz, MD, Director


Martin S. Cetron, MD, Director
Nina Marano, DVM, MPH, Chief, Geographic Medicine and Health Promotion Branch
Phyllis E. Kozarsky, MD, Expert Consultant, Travelers’ Health
Gary W. Brunette, MD, MS, Medical Epidemiologist
Amanda D. Whatley, MPH, CHES, Health Communications Specialist


CDC Contributors

Adjemian, Jennifer
Alexander, James P.
Alexander, Nicole T.
Anderson, Alicia
Ansari, Armin
Arguin, Paul M.
Ari, Mary D.
Atkinson, William
Bair-Brake, Heather
Balaban, Victor
Barskey, Albert E., IV
Barzilay, Ezra J.
Batts, Dahna
Beach, Michael
Benzekri, Noelle A.
Bern, Caryn
Boore, Amy L.
Brooks, John T.
Brown, Clive M.
Brunette, Gary W.
Cano, Maria V.
Chaves, Sandra S.
Chiller, Tom
Chosewood, L. Casey
Cohn, Amanda
Collins, Blanche C.
Dasch, Gregory A.
Davis, Xiaohong Mao
De, Barun K.
Deming, Michael
Dorell, Christina
Dunne, Eileen F.
Dykewicz, Clare A.
Eremeeva, Marina E.
Fagan, Ryan P.
Farnon, Eileen C.
Fischer, Marc
Fox, LeAnne M.
Gallagher, Kathleen M.
Gallagher, Nancy M.
Galland, G. Gale
Gee, Jay E.

Gershman, Mark
Gould, L. Hannah
Green, Michael D.
Griggs, Anne
Guerra, Marta A.
Hall, Aron J.
Herwaldt, Barbara L.
Hicks, Lauri A.
Hlavsa, Michele C.
Holmberg, Scott
Illig, Petra A.
Jackson, Michael L.
Jentes, Emily S.
Johnston, Stephanie P.
Jones, Jeffrey L.
Joyce, M. Patricia
Kozarsky, Phyllis E.
Kroger, Andrew
Kutty, Preeta K.
Lawson, Carl
LoBue, Philip
Lynch, Michael
Mali, Sonja
Malilay, Josephine
Maloney, Susan
Marano, Nina
Marienau, Karen J.
McCarron, Margaret
McQuiston, Jennifer
Mead, Paul S.
Miller, Charles W.
Mintz, Eric
Mitruka, Kiren
Montgomery, Susan
Moore, Anne
Moro, Pedro L.
Mullan, Robert J.
Nasci, Roger S.
Naughton, Mary P.
Nuorti, J. Pekka
Ortega, Luis S.
Park, Benjamin

Parker, Amy A.
Powers, Ann M.
Reed, Christie M.
Reef, Susan E.
Reynolds, Mary G.
Rollin, Pierre E.
Roy, Sharon
Rupprecht, Charles E.
Schantz, Peter M.
Schilling, Katharine
Schroeder, Betsy
Shadomy, Sean V.
Shay, David K.
Shealy, Katherine
Skoff, Tami H.
Sleet, David A.
Smith, Theresa L.
Sommers, Theresa
Staples, J. Erin
Steele, Stefanie F.
Stoddard, Robyn
Sutton, Madeline
Tan, Kathrine R.
Teo, Chong-Gee
Thomas, Cynthia G.
Tiwari, Tejpratap S. P.
Tomashek, Kay M.
Uzicanin, Amra
Viray, Melissa
Wallace, L. J. David
Warnock, Eli W., III
Wassilak, Steven
Watson, John C.
Weber, Ingrid B.
Weinberg, Michelle
Weinberg, Nicholas
Whatley, Amanda D.
Widdowson, Marc-Alain
Wiersma, Steven T.
Wirtz, Robert A.
Workowski, Kimberly
Yanni, Emad
Zielinski-Gutierrez, Emily

External Contributors

Acosta, Rebecca W., Traveler’s Medical Service of New York, New York, NY
Ansdell, Vernon E., University of Hawaii, Honolulu, HI
Backer, Howard D., California Department of Public Health, Richmond, 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, Hong Kong, China
Carroll, I. Dale, The Pregnant Traveler, Spring Lake, MI
Chavez, Gilberto F., California Department of Public Health, Sacramento, CA
Connor, Bradley A., Weill Medical College of Cornell University, New York, NY
Franco-Paredes, Carlos, Emory University, Atlanta, GA
Freedman, David O. University of Alabama, Birmingham, AL
Guerrant, Richard L., University of Virginia School of Medicine, Charlottesville, VA
Gushulak, Brian D., Migration Health Consultants, Cheltenham, Canada
Hackett, Peter H., Institute for Altitude Medicine, Telluride, CO
Harriman, Kathleen H., California Department of Public Health, Richmond, CA
Hidron, Alicia I., Emory University, Atlanta, GA
Howard, Cynthia R., University of Minnesota, Minneapolis, MN
John, Chandy C., University of Minnesota, Minneapolis, MN
Jong, Elaine C., University of Washington, Seattle, WA
Kain, Kevin C., University of Toronto, Toronto, Canada
Keystone, Jay S., University of Toronto, Toronto, Canada
LaRocque, Regina C., Massachusetts General Hospital and Harvard University, Boston, MA
Mackell, Sheila M., Mountain View Pediatrics, Flagstaff, AZ
Magill, Alan J., Walter Reed Army Institute of Research, Silver Spring, MD
McCarthy, Anne E., University of Ottawa, Ottawa, Canada
Nord, Daniel A., Divers Alert Network, Durham, NC
Ostroff, Stephen M., Pennsylvania Department of Health, Harrisburg, PA
Pawlowski, Sean W., University of Virginia School of Medicine, Charlottesville, VA
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
Walker, Patricia F., HealthPartners, Center for International Health, St. Paul, MN
Wilson, Mary Elizabeth, Harvard Medical School and Harvard School of Public Health, 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 2010 editorial team gratefully acknowledges all the authors and reviewers for their commitment to this new edition. We extend sincere thanks to the following individuals and groups for their contributions to the production of this book:

  • Kevin Liske, Jeffery Henry, and Robert Neurath (Geospatial Research, Analysis and Services Program of the Agency for Toxic Substances and Disease Registry) for creating all the maps contained in this publication;
  • Tiffany Bailey, Amanda Crowell, Linda Frank, Shannon Omisore, Jacqui Read, and Cathy Young in CDC’s Writer–Editor Services Branch;
  • Kelly Holton, Theresa Sommers, Heather Bair-Brake, Katherine Mues, Laurie Dieterich, and Tricia Schwartz for their additional assistance in preparing the text for publication; and
  • Elise Beltrami, Clive Brown, Mark Gershman, Emily Jentes, Katherine Johnson, Nina Marano, and Ava Navin for their extensive review of the text.