HEALTH INFORMATION for INTERNATIONAL TRAVEL - Centers for Disease ...

HEALTH INFORMATION for INTERNATIONAL TRAVEL

INCLUDING - UNITED STATES DESIGNATED YELLOW FEVER VACCINATION CENTERS

PUBLISHED AS A SUPPLEMENT TO

T f t o n / U d jt u ,

= VOL.

H 23

1 WEEKLY

| REPORT

= September

= 1974

U.S. D E P A R T M E N T O F H E A L T H , E D U C A T IO N , A N D W E LFA R E PUBLIC H EA LTH SERVIC E

C E N T E R F O R O IS E A S E C O N T R O L A T L A N T A . G E O R G IA 30333

A

HEALTH INFORMATION FOR

INTERNATIONAL TRAVEL

1974

S u p p le m e n t to the

Morbidity and Mortality Weekly Report

U.S. D E P A R T M E N T OF H E A L T H , E D U C A T IO N , A N D W ELFA RE PUBLIC HEALTH SERVICE

CENTER FOR DISEASE CONTROL BUREAU OF EPIDEMIOLOGY ATLANTA, GEORGIA 30333

DHEW Publication No. (CDC) 75-8280 (formerly 74-8128 and 73-82H?

PREFACE

One o f the m ost im portant responsibilities o f the Center for Disease C ontrol is th a t o f providing health inform ation, including recomm ended and required vaccinations, for world travelers. Such inform ation m ust be as up-to-date and as com prehensive as possible. It is hoped th at this pam phlet w hich has been extensively revised and replaces the previous supplem ent to the Morbidity and Morbidity Weekly Report entitled "V accination Certificate Requirem ents for International Travel" will substantially m eet the need for this kind o f inform ation. Com ments, suggestions, and criticisms from readers are m ost welcome and should be addressed to:

Center for Disease C ontrol A ttention: D irector, Q uarantine Division

Bureau o f Epidemiology A tlanta, Georgia 30333

The following CDC staff com m ittee participated in the preparation o f this pam plet:

John A. Bryan, M.D., Chairman William H. Barker, M.D. Philip S. Brachman, M.D. H. Bruce Dull, M.D. Eugene J. Gangarosa, M.D. Joseph F. G iordano, M.S. M ichael B. Gregg, M.D. D eborah L. Jones, B.S. R obert L. Kaiser, M.D. J. Michael Lane, M.D. Elizabeth H. Paz, B.B.A. M yron G. Schultz, M.D.

TABLE OF CONTENTS

I. In troduction 1

II. Sources 1

III. Definitions 3

IV. V accination Inform ation 3 A. Introduction 3 B. How to Use this Pam phlet to D eterm ine V accinations R equired 3 C. Exemption from Vaccination 3 D. Unvaccinated Persons 3 E. Persons Authorized to Vaccinate and Validate Certificates 4 F. Persons A uthorized to Sign Certificates 4 G. Model o f a Correctly Completed Certificate 4 H. Travel on Military Orders 4

V. Vaccination Certificate Requirements 4 A. Summary of Requirem ents for United States Travelers to Countries Most Frequently Visited 4 1. E urope 4 2. Canada and Mexico 4 3. The Caribbean 5 4. Return to the United States 5

B. Travel from the U nited States To and Betw een O ther C ountries 5 1. R eference list o f countries w hich com prise Africa, the Am ericas, including the C aribbean, Asia, Europe, and Oceania 5 2. Index of countries 7 3. Vaccination requirements and recommendations, by country 9 4. Yellow fever endemic zones 50

VI. United States Public Health Service Recom m endations 52 A. Introduction 52

B. Im m unizations and Prophylaxis 52 1. In tro d u c tio n 52 2. Summary o f imm unizations and prophylaxis 52 3. Specific recom m endations 53 a) Smallpox 53 b) Cholera 54 c) Yellow fever 54 d) T yphoid fever 55 e) Poliom yelitis 55 f) Plague 55 g) Typhus fever 55 h) Immune serum globulin for protection against viral hepatitis, Type A 55 i) Malaria prophylaxis 56 4. Simultaneous adm inistration of certain vaccines 65

VII. Health Hints for the Traveler 66

VIII. U nited States Designated Yellow Fever V accination C enters 67

HEALTH INFORMATION FOR INTERNATIONAL TRAVEL

I. Introduction

This pam phlet is published annually as a supplem ent to th e Morbidity and Mortality Weekly Report (MMWR) by the Bureau o f Epidemiology, Center for Disease Control (CDC). It is intended to provide, for those w ho must advise international travelers on measures for health protection, the necessary inform ation on required vaccinations, U.S. Public H ealth Service recom m enda tions, International Certificates o f V accination, and health hints so th at transmission o f internationally quarantinable diseases can be prevented and interna tional travel facilitated.

The pam phlet is organized into these prim ary sections:

Sources -- This section gives the sources o f d ata used to prepare and update this pam phlet so that the reader will have a b etter understanding o f how it should be used.

Definitions -- This section clarifies key words, terms, and phrases used throughout the pam phlet.

V accination Inform ation -- This section provides practical inform ation about the reasons for International Certificates o f V accination, use o f this pam phlet, valida tion o f Certificates, and exceptions to regulations.

Vaccination Certificate Requirem ents for Interna tional Travel -- This section gives inform ation on the vaccinations required by each country; these require m ents have been assembled by the World H ealth O rganization (WHO).

U.S. Public H ealth Service (USPHS) Recom m enda tions -- This section gives vaccinations and prophylactic measures recom m ended by the U.S. Public H ealth Service (USPHS) b u t n o t required by the U nited States or any other country.

H ealth H ints fo r th e Traveler -- This section gives practical suggestions for avoiding illness while traveling.

U.S. Designated Yellow Fever V accination Centers -- This section gives inform ation on the C enters designated to adm inister yellow fever vaccine in the United States.

This pam p hlet supersedes Vaccination Certificate Requirements fo r International Travel, S upplem ent to the MMWR, Vol. 22, No. 17, April 18, 1973, and the chart " Immunizations and Prophylaxis Recommended by the Public H ealth Service" revised May 10, 1973. The prior publications Health Information for International Travel, PHS P ublication N o. 2 045, A pril 1970, and

Immunization Information fo r International Travel, PHS Publication No. 384, July 1967, are also obsolete. In addition, this pam phlet contains an up-to-date listing o f Yellow Fever V accination Centers, previously published separately, and thus supersedes United States Designated Yellow Fever Vaccination Centers, S upplem ent to the MMWR, Vol. 22, No. 32, August 11, 1973.

Because the situation w ith regard to quarantinable diseases (smallpox, cholera, yellow fever, and plague) and vaccinations required by various countries may change frequently, CDC distributes weekly a sheet entitled " Countries w ith Areas Infected w ith Quarantinable Diseases" w hich lists countries currently reporting cases o f smallpox, cholera, yellow fever, and plague. Because it is always printed on blue paper, it has come to be know n as the " Blue Sheet." In addition, changes in vaccination requirem ents reported by WHO are published at the b o tto m o f the " Blue Sheet" and also in the MMWR under " International Notes -- Q u a ra n tin e Measures." Changes in vaccination requirem ents should be entered in the "V accination Requirem ents" section o f this pam phlet so th at individuals advising travelers can keep inform ation on vaccination requirem ents current.

Occasionally, the Bureau o f Epidemiology, CDC, issues an " Advisory M em orandum " which reports and describes newly identified health problems associated w ith some international travel.

II. Sources

This pam phlet has been prepared from inform ation included in the following docum ents:

1. International Health Regulations (1 9 6 9 ) F irst A nnotated Edition, World H ealth O rganization, Geneva, 1971

2. Vaccination Certificate Requirements fo r Interna tional Travel -- situation as o f 1 Jan u ary 1974. World Health Organization, Geneva, 1974

3. Weekly Epidemiological Record. W orld H ealth Organization, Geneva

4. Collected Recommendations o f the Public Health Service Advisory Committee on Immunization Practices (ACIP), Supplem ent to the MMWR, Vol. 21, No. 25, 24 June 1972

For purposes of identification, the docum ents re ferred to above are depicted on page 2.

1

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