CDC Updates Health Guide for International Travelers

The Centers for Disease Control and Prevention (CDC) recently updated its comprehensive travel guide, CDC Health Information for International Travel 2020 (The Yellow Book). The revised Yellow Book offers guidance to people traveling abroad on a range of topics, from tips on how to avoid becoming ill while abroad to specific cautions for a number of popular destinations to when to seek care or have a check-up with a healthcare practitioner after returning from overseas.

First published in 1967, the Yellow Book has been an important travel tool for over 50 years, with the number of topics and details covered greatly expanding over the years. The book contains 11 chapters as well as several maps, tables and other resources. Before, during and after a trip, travelers can access the extensive guide, which has sections covering, for example:

• Pre-travel consultations
• Vaccinations
• Food and Water Precautions
• Traveler’s Diarrhea
• Environmental Hazards
• Health Care Abroad

Some examples of new topics covered by the updated version include:

• Telemedicine—this section includes recommendations for healthcare practitioners to provide travel health care for their patients remotely.
• Cutting-edge rapid diagnostic tests for infectious diseases—travelers may be tested for infections with rapid tests performed at the point of care. These include tests for malaria, dengue fever and Chikungunya and Zika viruses, to name a few.
• Antimicrobial resistance—international travelers may be at greater risk of contracting infections caused by microbes that are resistant to standard treatments. This section includes recommendations for treating these infections as the incidence of antimicrobial resistance increases globally.

Though the Yellow Book has information for all types of travelers, including families, military personnel and healthcare and humanitarian aid workers, the timing of the update may be particularly helpful for the growing number of U.S. students who are heading overseas to study abroad at this time of year. According to a study published in the Journal of Travel Medicine, the number of American youths studying overseas has more than tripled in the last 20 years. As study-abroad programs expand and offer more diverse destinations, more students are heading to locations in resource-poor areas where they may be at higher risk for traveler-associated diseases, including infectious diseases that are not common in their home countries.

The study looked at the experiences of students from 2007 to 2017 who became ill after traveling internationally and who sought medical care at a health facility supported by the CDC and International Society of Travel Medicine. More than 400 students were included in the study. They ranged in age from 17 to 24 years old, and more than half were women. The median length of stay abroad was 40 days (ranging from one day to more than a year). The most common region where students’ illnesses occurred was sub-Saharan Africa, and the top five countries where students experienced the most illnesses were India, Ecuador, Ghana, China and Peru. By far, the most common illnesses were gastrointestinal and of those, acute diarrhea was the most common complaint. Other illnesses included, for example, skin problems (e.g., insect bites, rashes), conditions that cause fevers (e.g., viral infections, malaria) and respiratory infections.

In addition to a thorough pre-trip consultation with their healthcare practitioners, students and other international travelers may consider using the Yellow Book as another resource to enhance their education about their destinations and help safeguard their health from related travel risks. Full content of the Yellow Book is available online at the CDC website, where there is also information on how to obtain a printed or electronic copy (ebook).