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General Medical Practice

TRAVEL ADVISORY BY IHI

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Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel

Disease

Medications/Precautions

Malaria

Areas of Afghanistan with Malaria: April–December in all areas <2,000m (<6,561ft)

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine)

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Afghanistan and should not be taken to prevent malaria in this region.

wwwnc.cdc.gov/travel/destinations/afghanistan.htm
Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel
Tick-borne encephalitis 3 months before travel
wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Cholera 2 weeks before travel

Yellow Fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel

Other Diseases/Precautions

-All travellers are advised to ensure that tetanus and polio vaccinations are kept up to date.

-Dengue, filariasis, leishmaniasis are other diseases carried by insects that also occur in parts of this region. Protecting yourself against from insect bites will help to prevent these diseases.

-Schistosomiasis, a parasitic infection, is found in fresh water in the region, especially in the Nile Delta and Valley; it is found focally in other countries. Do not swim in fresh water (except in well-chlorinated swimming pools).

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Meningococcal Meningitis 2-3 weeks before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination or exemption from vaccination required**

10 days before travel

Disease

Medications/Precautions

Malaria

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine)

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Angola and should not be taken to prevent malaria in this region.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 daysbefore travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel

Other diseases/Precautions

-Dengue epidemics have occurred on many of the Caribbean islands. Most islands are infested with Aedes aegypti, so these places are at risk for introduction of dengue. Protecting yourself against insect bites will help to prevent this disease.

-All travellers are advised to ensure that tetanus and polio vaccinations are kept up to date.

-Endemic foci of histoplasmosis are found on many Caribbean islands, and outbreaks have occurred in travelers.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel

Yellow fever (in some areas)

10 days before travel

Disease

Medications/Precautions

Malaria

Areas of Argentina with Malaria: Rural areas of northern Salta Province (along Bolivian border). Rare cases reported in the city of Puerto Iguazú in Misiones Province. No transmission at Iguassu Falls.

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel
wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:
Tick-borne encephalitis 3 months before travel
wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatits A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel

Disease

Medications/Precautions

Malaria

Areas of Azerbaijan with Malaria: May–October in rural areas <1,500 m (4,921 ft). None in Baku.

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:
Hepatitis A 2 weeks before travel
Hepatitis B At least 2 months before travel
wwwnc.cdc.gov/travel/destinations/azores.ht

Disease: When to get the vaccination:
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel

Other diseases/Precautions

-Dengue epidemics have occurred on many of the Caribbean islands. Most islands are infested with Aedes aegypti, so these places are at risk for introduction of dengue. Protecting yourself against insect bites will help to prevent this disease.

-All travellers are advised to ensure that tetanus and polio vaccinations are kept up to date.

-Endemic foci of histoplasmosis are found on many Caribbean islands, and outbreaks have occurred in travelers.

wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel
Japanese encephalitis 1 month before travel

Disease

Medications/Precautions

Malaria

Areas of Bangladesh with Malaria: All areas, except in the city of Dhaka.

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Bangladesh and should not be taken to prevent malaria in this region.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel

Other diseases/Precautions

-Dengue epidemics have occurred on many of the Caribbean islands. Most islands are infested with Aedes aegypti, so these places are at risk for introduction of dengue. Protecting yourself against insect bites will help to prevent this disease.

-All travellers are advised to ensure that tetanus and polio vaccinations are kept up to date.

-Endemic foci of histoplasmosis are found on many Caribbean islands, and outbreaks have occurred in travelers.

wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Tick-borne encephalitis 3 months before travel
wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel

Other diseases/Precautions

-Dengue epidemics have occurred on many of the Caribbean islands. Most islands are infested with Aedes aegypti, so these places are at risk for introduction of dengue. Protecting yourself against insect bites will help to prevent this disease.

-All travellers are advised to ensure that tetanus and polio vaccinations are kept up to date.

-Endemic foci of histoplasmosis are found on many Caribbean islands, and outbreaks have occurred in travelers.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Meningococcal meningitis 2-3 weeks before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination or exemption from vaccination required**

10 days before travel

Disease

Medications/Precautions

Malaria

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Benin and should not be taken to prevent malaria in this region.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel

Other diseases/Precautions

-Dengue epidemics have occurred on many of the Caribbean islands. Most islands are infested with Aedes aegypti, so these places are at risk for introduction of dengue. Protecting yourself against insect bites will help to prevent this disease.

-All travellers are advised to ensure that tetanus and polio vaccinations are kept up to date.

-Endemic foci of histoplasmosis are found on many Caribbean islands, and outbreaks have occurred in travelers.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel
Japanese encephalitis 1 month before travel

Disease

Medications/Precautions

Malaria

Areas of Bhutan with Malaria: Rural areas <1,700 m (5,577 ft) of the southern belt districts along the border with India: Chirang, Geylegphug, Jongkhar, Samchi, Samdrup, and Shemgang.

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Bhutan and should not be taken to prevent malaria in this region.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Yellow fever 10 days before travel

Disease

Medications/Precautions

Malaria

Areas of Bolivia with Malaria: All areas <2,500 m (8,202 ft).None in the city of La Paz.

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Bolivia and should not be taken to prevent malaria in this region.

wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Tick-borne encephalitis 3 months before travel
wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel

Disease

Medications/Precautions

Malaria

Areas of Botswana with Malaria: Present in the following districts: Central, Chobe, Ghanzi, Northeast, and Northwest. None in the cities of Francistown and Gaborone.

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-.proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Botswana and should not be taken to prevent malaria in this region.

Other Diseases/Precautions

-All travellers are advised to ensure that tetanus and polio vaccinations are kept up to date.

-Dengue, filariasis, leishmaniasis, onchocerciasis (river blindness), African tick bite fever, and African trypanosomiasis (transmitted by the tetse fly) are other diseases carried by insects that also occur in Southern African countries, mostly in rural areas. Protecting yourself against from insect bites will help to prevent these diseases.

-Schistosomiasis, a parasitic infection, is found in Southern African countries. Do not swim in fresh water (except inwell-chlorinatedswimming pools) in Southern African countries.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B At least 2 months before travel
Rabies 1 month before travel
Yellow fever 10 days before travel

Disease

Medications/Precautions

Malaria

Areas of Brazil with Malaria: States of Acre, Amapá, Amazonas, Mato Grosso, Para, Rondonia, Roraima, Tocantins, and the western part of Maranhaõ. Also present in urban areas, including cities such as Boa Vista, Macapa, Manaus, Maraba, Porto Velho, and Santarem. Rare cases in Belem. No transmission at Iguassu Falls.

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-.proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.**

Other Diseases/Precautions

-Dengue, filariasis, leishmaniasis, onchocerciasis, and American trypanosomiasis (Chagas disease) are other diseases carried by insects that also occur in this region. Epidemics of viral encephalitis and dengue fever occur in some countries in this area. Bartonellosis, or Oroya fever (a sand fly-borne disease), occurs in arid river valleys on the western slopes of the Andes up to 3,000 meters (9,842 feet). Protecting yourself against insect bites will help to prevent these diseases.

-Schistosomiasis, a parasitic infection that can be contracted in fresh water in South America, is found in Brazil, Suriname, and north-central Venezuela. Do not swim in fresh water (except in well-chlorinated swimming pools) in these countries.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel
Japanese encephalitis 1 month before travel

Other Diseases/Precautions

-Dengue, chikungunva, filariasis, Japanese encephalitis, and plague are diseases carried by insects that also occur in this region. Protecting yourself against insect bites will help to prevent these diseases.

-Do not swim in fresh water (except in well-chlorinated swimming pools) to avoid infection with schistosomiasis. Leptospirosis, a bacterial infection often contracted through recreational water activities in contaminated water, such as kayaking, is common in tropical areas of Southeast Asia. An outbreak was reported in Borneo among expedition travelers in 2000.

wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Tick-borne encephalitis 3 months before travel
wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Meningococcal meningitis 2-3 weeks before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination or exemption from vaccination required**

10 days before travel

Disease

Medications/Precautions

Malaria

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-.proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Burkina Faso and should not be taken to prevent malaria in this region.

Other Diseases/Precautions

-All travellers are advised to ensure that tetanus and polio vaccinations are kept up to date.

-Dengue, filariasis, leishmaniasis, onchocerciasis (river blindness) are other diseases carried by insects that also occur in West Africa. Protecting yourself against from insect bites will help to prevent these diseases.

-Schistosomiasis, a parasitic infection, is found in fresh water in this region. Do not swim in fresh water (except in well-chlorinated swimming pools) in these countries.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel
Japanese encephalitis 1 month before travel

Disease

Medications/Precautions

Malaria

Areas of Burma with Malaria: Rural areas throughout the country at altitudes <1000 m (<3,281 ft). None in the cities of Mandalay and Rangoon (Yangon).

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-.proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Meningococcal meningitis 2-3 weeks before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination or exemption from vaccination required**

10 days before travel

Disease

Medications/Precautions

Malaria

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-.proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Burundi and should not be taken to prevent malaria in this region.

Other Diseases/Precautions

-All travellers are advised to ensure that tetanus and polio vaccinations are kept up to date.

-Dengue, filariasis, leishmaniasis, onchocerciasis (river blindness) are other diseases carried by insects that also occur in West Africa. Protecting yourself against from insect bites will help to prevent these diseases.

-Schistosomiasis, a parasitic infection, is found in fresh water in this region. Do not swim in fresh water (except in well-chlorinated swimming pools) in these countries.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 months before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel
Japanese encephalitis 1 month before travel

Disease

Medications/Precautions

Malaria

Areas of Cambodia with Malaria: Present throughout the country, except none at the temple complex at Angkor Wat, Phnom Penh, and around Lake Tonle Sap.

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-.proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

Other Diseases/Precautions

-Dengue, chikungunva, filariasis, Japanese encephalitis, and plague are diseases carried by insects that also occur in this region. Protecting yourself against insect bites will help to prevent these diseases.

-Do not swim in fresh water (except in well-chlorinated swimming pools) to avoid infection with schistosomiasis. Leptospirosis, a bacterial infection often contracted through recreational water activities in contaminated water, such as kayaking, is common in tropical areas of Southeast Asia. An outbreak was reported in Borneo among expedition travelers in 2000.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel

Yellow fever

**Certificate of vaccination or exemption from vaccination required**

10 days before travel

Disease

Medications/Precautions

Malaria

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-.proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Cameroon and should not be taken to prevent malaria in this region.

Other Diseases/Precautions

-Dengue, chikungunva, filariasis, African trypanosomiasis, and plague are diseases carried by insects that also occur in this region. Protecting yourself against insect bites will help to prevent these diseases.

-Dengue, filariasis, leishmaniasis, onchocerciasis (river blindness) are other diseases carried by insects that also occur in West Africa. Protecting yourself against from insect bites will help to prevent these diseases.

-Schistosomiasis, a parasitic infection, is found in fresh water in this region. Do not swim in fresh water (except in well-chlorinated swimming pools) in these countries.

wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:
Rabies (those who come in direct contact with bats, carnivores, and other mammals) 1 month before travel
wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:
Hepatitis A 2 weeks before travel
wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 day before travel

Disease

Medications/Precautions

Malaria

Areas of Cape Verde with Malaria: Limited cases in Saõ Tiago Island.

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-.proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Meningococcal meningitis 2-3 weeks before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination or exemption from vaccination required**

10 days before travel

Disease

Medications/Precautions

Malaria

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Central African Republic and should not be taken to prevent malaria in this region.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Meningococcal meningitis 2-3 weeks before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination or exemption from vaccination required**

10 days before travel

Disease

Medications/Precautions

Malaria

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Chad and should not be taken to prevent malaria in this region.

wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B At least 2 months before travel
Rabies 1 month before travel
Yellow fever 10 days before travel
wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Japanese encephalitis 1 month before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination or exemption from vaccination required**

10 days before travel

Disease

Medications/Precautions

Malaria

Areas of China with Malaria: Rural parts of Anhui, Guizhou, Hainan, Henan, Hubei, and Yunnan Provinces. Rare cases occur in other rural parts of the country <1,500 m (4,921 ft) May–December. None in urban areas. Some major river cruises may go through malaria-endemic areas in Anhui and Hubei Provinces.

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Yellow fever 10 days before travel

Disease

Medications/Precautions

Malaria

Areas of Colombia with Malaria: All areas <1,700 m (5,577 ft). None in Bogotá and Cartagena.

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Colombia and should not be taken to prevent malaria in this region.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Cholera 2 weeks before travel

Disease

Medications/Precautions

Malaria

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-.proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug Comoros and should not be taken to prevent malaria in this region.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Meningococcal meningitis 2-3 weeks before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination or exemption from vaccination required**

10 days before travel

Disease

Medications/Precautions

Malaria

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-.proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Congo and should not be taken to prevent malaria in this region.

wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel

Yellow fever

**Certificate of vaccination required if arriving from an infected area**

10 days before travel

Disease

Medications/Precautions

Malaria

Areas of Costa Rica with Malaria: Limón Province, but not in Limón City (Puerto Limón). Rare cases in other parts of the country.

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-.proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.**

wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Tick-borne encephalitis 3 months before travel
wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 daysbefore travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel

Other diseases/Precautions

-Dengue epidemics have occurred on many of the Caribbean islands. Most islands are infested with Aedes aegypti, so these places are at risk for introduction of dengue. Protecting yourself against insect bites will help to prevent this disease.

-All travellers are advised to ensure that tetanus and polio vaccinations are kept up to date.

-Endemic foci of histoplasmosis are found on many Caribbean islands, and outbreaks have occurred in travelers

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Hepatitis A 2 weeks before travel

wwwnc.cdc.gov/travel/destinations/list.htm
Disease: When to get the vaccination:
Hepatitis A 2 weeks before travel
Tick-borne encephalitis 3 months before travel
wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Meningococcal meningitis 2-3 weeks before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination or exemption from vaccination required**

10 days before travel

Disease

Medications/Precautions

Malaria

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-.proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Congo and should not be taken to prevent malaria in this region.

wwwnc.cdc.gov/travel/destinations/list.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 months before travel
Cholera 2 weeks before travel
Yellow fever 10 days before travel
Japanese encephalitis 1 month before travel

Disease

Medications/Precautions

Malaria

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine)

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in India and should not be taken to prevent malaria in this region.

http://wwwnc.cdc.gov/travel/destinations/india.htm

Disease: When to get the vaccination:
Typhoid 10 days before travel
Hepatitis A 2 weeks before travel
Diphtheria 3 months before travel
Tuberculosis 3 months before travel
Hepatitis B 2 months before travel
Rabies 1 month before travel
Meningococcal meningitis 2-3 weeks before travel
Cholera 2 weeks before travel

Yellow fever

**Certificate of vaccination or exemption from vaccination required**

10 days before travel

Disease

Medications/Precautions

Malaria

- Take antimalarial medication daily starting 1 week before, during, and 1 week after the traveling. (Atovaquone-.proguanil, Doxycycline, Hydroxychloroquine sulfate, Mefloquine, or Pimaquine).

- Use insect repellent and wear long pants and sleeves to prevent mosquito bites.

- Sleep in air-conditioned or well-screened rooms or use bed nets.

**All people who take Primaquine should have a documented normal G6PD level before starting the medication.

**Chloroquine is NOT an effective antimalarial drug in Côte d'Ivoire and should not be taken to prevent malaria in this region.

wwwnc.cdc.gov/travel/destinations/list.htm

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