Health Information for International Travel 1996-97
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CDCCENTERS FOR DISEASE CONTROL AND PREVENTION Health Information for International Travel 1996-97 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service This document was created with FrameMaker 4.0.4 ATTENTION READERS It is impossible for an annual publication on international travel to remain absolutely current given the nature of disease transmission in the world today. For readers of this text to be the most up-to-date on travel-related diseases and recommendations, this text must be used in conjunction with the other services provided by the Travelers’ Health Section of the Centers for Disease Control and Prevention (CDC). Changes such as vaccine requirements, disease outbreaks, drug availability, or emerging infections will be posted promptly on these services. For these and other changes, please consult either our Voice or Fax Information Service at 404-332-4559 or our Internet address on the World Wide Web Server at http://www.cdc.gov or the File Transfer Protocol server at ftp.cdc.gov . Because certain countries require vaccination against yellow fever only if a traveler arrives from a country currently infected with this disease, it is essential that up-to-date information regarding infected areas be maintained for reference. The CDC publishes a biweekly "Summary of Health Information for Interna- tional Travel" (Blue Sheet) which lists yellow fever infected areas. Subscriptions to the Blue Sheet are available to health departments, physicians, travel agencies, international airlines, shipping companies, travel clinics, and other private and public agencies that advise international travelers concerning health risks they may encounter when visiting other countries. The Blue Sheet is also available by dialing our fax information service at (404) 332–4565 and requesting document number 220022#. For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, D.C. 20402, (202) 512–1800. Health Information for International Travel 1996-97 December 1996 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH SERVICE Centers for Disease Control and Prevention National Center for Infectious Diseases Division of Quarantine Atlanta, Georgia 30333 ___________________ All material in this publication is in the public domain and may be used and reprinted without special permission; citation as to source, however, is appreciated. Suggested Citation: CDC, Health Information for International Travel 1996-97, DHHS, Atlanta, GA. 1997. ___________________ PREFACE One of the important responsibilities of the Centers for Disease Control and Prevention is to provide up-to-date and comprehensive information on immunization requirements and recommendations for international travelers. Readers are invited to send comments and suggestions regarding this book to: CENTERS FOR DISEASE CONTROL AND PREVENTION National Center for Infectious Diseases Division of Quarantine (E-03) Attention: Travelers' Health Section Atlanta, Georgia 30333 CENTERS FOR DISEASE CONTROL AND PREVENTION David Satcher, M.D., Ph.D. Director National Center for Infectious Diseases James M. Hughes, M.D. Director Division of Quarantine Robert B. Wainwright, M.D. Director Rosamond R. Dewart, B.A. Chief, Travelers' Health Section The Travelers’ Health Section gratefully acknowledges the considerable contributions and assistance of the staff of the National Center for HIV, STD and TB Prevention, the National Center for Infectious Diseases, the National Immunization Program, and the National Center for Environmental Health. iii This document was created with FrameMaker 4.0.4 CONTENTS CHANGES SINCE 1995 EDITION . .ix INTRODUCTION . 1 REFERENCES . 2 VACCINATION INFORMATION . 5 List of Countries by Region . .5 Exemption from Vaccination . .9 Unvaccinated Persons . .9 Travel on Military Orders . .9 Persons Authorized to Vaccinate and to Validate International Certificate of Vaccination . .9 Persons Authorized to Sign Certificate . .9 Model of a Correctly Completed Certificate . .10 VACCINATION CERTIFICATE REQUIREMENTS . 11 Summary of Vaccinations that may be Required by International Health Regulations (WHO) . 11 Vaccination Certificate Requirements for Direct Travel from the United States to Other Countries . .12 Return to the United States . .12 How to Use This Book to Determine Vaccinations Required or Recommended . .13 Vaccinations Required and Information on Malaria Risk and Prophylaxis, by Country . .17 UNITED STATES PUBLIC HEALTH SERVICE RECOMMENDATIONS . 81 Introduction . .81 General Recommendations on Human Immunodeficiency Virus (HIV) Infection and the Acquired Immunodeficiency Syndrome (AIDS) . .82 General Recommendations on Vaccination and Prophylaxis . .82 Age at Which Immunobiologics are Administered . .84 Spacing of Immunobiologics . .84 Multiple Doses of Same Antigen . .84 Simultaneous Administration . .84 Recommended Childhood Immunization Schedule, United States, July-December 1996 . .85 Recommended Immunization Schedule for Infants and Children Less Than 7 years of Age Who Start the Series Late . .86 Recommended Immunization Schedule for Persons 7 years of Age or Older . 87 Minimum Age for Initial Vaccination and Minimum Interval Between Vaccine Doses. .88 Non-Simultaneous Administration . .89 v Immune Globulin. 89 Hypersensitivity to Vaccine Components . 90 Altered Immunocompetence . 91 Vaccination of Persons with Acute Illnesses . 92 Vaccination During Pregnancy . 92 Breast-feeding . 93 Immunization Schedule Modifications for International Travel for Infants and Inadequately Immunized Young Children <2 Years of Age . 95 Routine Childhood Vaccine Preventable Diseases . 95 Other Vaccines and Immune Globulin . 97 Adverse Events Following Immunization: Reporting . 99 Communicable Diseases in Disasters . 99 SPECIFIC RECOMMENDATIONS FOR VACCINATION AND PROPHYLAXIS . 101 Acquired Immunodeficiency Syndrome (AIDS) . 103 African Sleeping Sickness (Trypanosomiasis) . 105 Amebiasis . 105 American Trypanosomiasis (Chagas' Disease) . 105 Cholera . 106 Cryptosporidiosis . 107 Cyclospora . 107 Dengue Fever . 107 Diphtheria, Tetanus, and Pertussis . 110 Encephalitis, Japanese . 112 Encephalitis, Tickborne . 116 Filiariasis, Lymphatic . 117 Giardiasis . 117 Haemophilus Influenzae, Type b Meningitis & Invasive Systemic Disease . 118 Hepatitis, Viral, Type A . 119 Hepatitis, Viral, Type B . 124 Lassa Fever . 127 Leishmaniasis . 127 Malaria . 128 Measles . 137 Meningococcal Disease . ..