Travel preparation is crucial, even for healthy people. Proper preparations are inexpensive relative to the costs of getting sick or injured while away from home.
Prior to travel, people and their medical providers should review planned itineraries and relevant medical histories, recommended vaccinations, measures to prevent infections such as malaria and traveler's diarrhea, and advice about avoiding injury. For older travelers, the most common causes of death are heart attack and stroke; for other travelers, the most common cause of death is road traffic crashes.
Travel Medical Kits
Travel medical kits are useful for minor injuries and illnesses. Useful contents include:
First-aid supplies (such as bandages, tape, elastic wrap)
Antacids
Antibiotics
Travelers should carry their travel medical kit, prescription medications, extra eyeglasses or other corrective lenses (as well as a current written prescription for either), and hearing-aid batteries in a carry-on bag in case their checked baggage is delayed, lost, or stolen. People with specific dietary and medical needs should plan carefully and carry their own food and supplies. Major problems can often be prevented with common-sense precautions.
The U.S. Transportation Safety Administration (TSA) forbids carrying containers with more than 90 mL (3 ounces) of liquid or gel on a commercial flight, but the TSA allows larger amounts of medically necessary liquids, gels, and aerosols in reasonable quantities for the trip. These items must be declared to TSA officers at the checkpoint for inspection (see tsa.gov).
Travel Health Insurance
Health insurance is important for travelers. Even with domestic travel, some plans limit coverage for health care away from home. Thus, travelers should know the limitations of their policies.
Coverage is more often a problem for international travel. Some domestic insurance plans limit coverage for vaccinations and preventive medications for international travel, even though some vaccinations are required for entry into certain countries. Likewise, Medicare and many commercial health insurance plans are not valid in foreign countries and do not cover the cost of any treatment given outside the United States. In addition, a cash deposit or payment in full may be required in international hospitals before care is provided.
To avoid high costs or inability to obtain care, travelers should determine in advance what international coverage, if any, their health plan offers, how to seek prior authorization for international care, and how to make a claim after an emergency. Travel health insurance, including insurance for emergency evacuation, is available through many commercial agencies, travel services, and some major credit card companies. Travelers may want to purchase insurance for services such as
Emergency care (about 1 in 30 people traveling abroad requires emergency care)
Transportation, with accompanying medical personnel, equipment, and care, within foreign countries or back to the United States
Dental care
Prenatal or postnatal care
Lost or stolen prescription medications
Medical translators
The International Association for Medical Assistance to Travellers (IAMAT—www.iamat.org), a nonprofit organization, maintains a list of English-speaking doctors in cities around the world. Other directories listing English-speaking doctors in foreign countries are available from several organizations and web sites. United States consulates may help travelers identify and secure emergency medical services.
Useful Contacts for People Traveling Abroad
Organization | Phone Numbers | Web Site |
|---|---|---|
International Association for Medical Assistance to Travellers (IAMAT) | United States: (716) 754-4883 Canada: (416) 652-0137 | |
Centers for Disease Control and Prevention (CDC) | United States: Toll-free (800) CDC-INFO (800-232-4636) TTY (teletypewriter): (888) 232-6348 | |
CDC Malaria Information | United States: Toll-free (800) CDC-INFO (800-232-4636) TTY (teletypewriter): (888) 232-6348 | |
CDC Zika Pregnancy Information | United States: (866) 626-6847 | |
U.S. Department of State, Overseas Citizens Services | From United States & Canada: (888) 407-4747 From Overseas: (202) 501-4444 | |
World Health Organization (WHO) | International: (+41 22) 791-2111 Americas: (202) 974-3000 |
Vaccinations for Travel
Vaccinations are important for travel to most developing countries and are required by some countries for entry. Ideally, travelers should visit their usual health care professionals at least 6 to 8 weeks before their travels to get any necessary vaccinations and ensure that they are current on all their routine immunizations, including for COVID-19. An International Certificate of Vaccination is the best place to document the names and dates of all vaccinations. The certificate is easy to carry and can be obtained from many travel clinics or from the Superintendent of Documents at the U.S. Government Printing Office.
The Centers for Disease Control and Prevention (CDC) website provides general travel and up-to-date immunization information and malaria prevention recommendations (also available from the CDC's malaria hotline: 855-856-4713). (See also Malaria.)
Vaccines for International Travel*,†
Infection | Regions Where the Vaccine is Recommended | Comments |
|---|---|---|
Africa, India, Pakistan, Nepal, Guam, Southeast Asia, New Guinea, China, Mexico, South and Central America, islands in the Caribbean, Indian, and Pacific Oceans, and limited areas of Europe | One dose recommended for individuals 18 years of age or older who are at increased risk of exposure to chikungunya virus See also Chikungunya Vaccine | |
Worldwide | Updated COVID-19 vaccine recommended for people 6 months of age and older; people ≥ 65 years who received 1 dose of any updated COVID-19 vaccine (Moderna, Pfizer-BioNTech or Novavax) should receive 1 additional dose of an updated COVID-19 vaccine at least 4 months after the previous updated dose See also COVID-19 Vaccine | |
All low- and middle-income countries | Two doses are given at least 6 months apart.‡ See also Hepatitis A Vaccine. | |
All low- and middle-income countries (hepatitis B is particularly common in China) | This vaccine is recommended for extended-stay travelers and all health care workers.‡ See also Hepatitis B Vaccine. | |
Worldwide | Seasonality in northern hemisphere: September through May Seasonality in southern hemisphere: April through September In the tropics, influenza is transmitted throughout the year. Sometimes slightly different influenza vaccines are used in the northern and southern hemisphere. | |
Japanese encephalitis | Rural areas throughout most of Asia and South Asia, particularly in areas with rice and pig farming | Two doses are given 28 days apart. Adults aged 18 to 65 years can get the second dose as early as 7 days after the first dose. The last dose should be given at least 1 week before travel. This vaccine is not recommended for pregnant women. This vaccine is usually not advised for those spending less than one month in an endemic area. |
Northern Sub-Saharan Africa from Mali to Ethiopia (the meningitis belt) Throughout the world, especially in crowded living situations (such as dormitories) | A single dose of quadrivalent vaccine is effective. Risk of infection in the meningitis belt is higher during the dry season (December through June). This vaccine is required for entry into Saudi Arabia during Hajj or Umrah. See also Meningococcal Vaccine. | |
All countries, including the United States | This vaccine is recommended for travelers at risk of animal bites, including rural campers, veterinarians, people living in remote areas, and field workers. It does not eliminate the need for additional vaccinations after an animal bite (for added protection). This vaccine is given during pregnancy only if the risk of infection is high. See also Rabies Prevention. | |
All low-income countries, especially in South Asia (including India) | Two forms of the vaccine are available. Single injection form: It protects for 2 years and is thought to be safer for pregnant women than the pill form of the vaccine. Pill form: One pill is taken every other day for a total of 4 pills. This form protects for 5 years and is not safe for pregnant women. See also Typhoid Fever Prevention. | |
Tropical South America and tropical Africa | The disease is rare, but many countries require proof of vaccination for entry.§ This vaccine is not safe for pregnant women. This vaccine has an increased risk of side effects in older people.§ One dose is protective for life for most travelers. See also Yellow Fever Prevention. | |
* In addition to the listed vaccinations, travelers should be up to date on their routine vaccinations, including influenza, measles, mumps, rubella, tetanus, diphtheria, polio, pneumococcal disease, and varicella. | ||
† All recommendations are subject to change. For the latest recommendations, consult the Centers for Disease Control and Prevention (www.cdc.gov or 800-CDC-INFO [800-232-4636]). See also Overview of Immunization. | ||
‡ There is also a combination hepatitis A and hepatitis B vaccine available, which doctors give on either a three-dose or four-dose schedule. (See Hepatitis A Vaccine and Hepatitis B Vaccine.). | ||
§ For travelers over age 60, doctors may consider completing the waiver section of the Yellow Card (International Certificate of Vaccination), instead of administering yellow fever vaccine. Those travelers should then be particularly diligent regarding personal protection measures against insects. | ||
Preparations For Travelers With Medical Conditions
Traveling with a medical condition requires special preparation. People with a medical condition should visit their doctor before departure to ensure that their condition is stable and to determine whether any changes in medications are needed. Detailed written medical information may be the most valuable thing a person can have in a medical emergency, including information about
Vaccinations
Medications
Results of major diagnostic tests
Types and dates of treatments
People should consider asking their doctor to prepare such information in a letter. Medical identification bracelets or necklaces are essential for people with conditions that can cause rapid, life-threatening symptoms, confusion, or unconsciousness (such as diabetes, seizures, and severe allergic reactions). Travelers with heart disorders should travel with a copy of a recent electrocardiogram (ECG). Travelers should also carry proof of medical insurance.
Medications
Medications should remain in their original bottles so that the precise names of the medications and the instructions for taking them can be reviewed in an emergency. The generic name of a medication is more useful than its brand name because brand names differ among countries.
Travelers should also pack an extra supply of medications in carry-on bags in case checked bags get lost, stolen, or delayed in transit or the return trip is delayed. Because opioids, syringes, and large amounts of any medication are likely to raise the suspicions of security or customs officers, travelers should have a doctor’s note explaining the medical need for the supplies. In addition, syringes should be packed together with the medications that are dispensed in them. Travelers should also check with airports, airlines, or embassies to determine what additional documentation is helpful in making travel with these supplies go smoothly. See also United States Transportation Security Administration (TSA) regulations.
More Information
The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of the resources.
