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Masks Strongly Recommended but Not Required in Maryland, Starting Immediately

Due to the downward trend in respiratory viruses in Maryland, masking is no longer required but remains strongly recommended in Johns Hopkins Medicine clinical locations in Maryland. Read more .

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Traveler's First-Aid Kit

What should a traveler's first aid kit include.

The American College of Emergency Physicians and the CDC encourage travelers to pack a first aid kit or a travel health kit for common medical emergencies. Pack the following items in your carry-on bag and keep it with you at all times:

Medicines you take on a regular basis at home. Take enough medicine for the planned trip plus extra in case your return home is delayed. Carry all medicine in their original containers with clear labels that identify your name and dosing schedule. If you have a chronic condition, such as diabetes, seizures, or allergies, consider wearing a medical alert bracelet.

Acetaminophen, ibuprofen, or aspirin to relieve headaches, pain, fever, and simple sprains or strains

Antihistamines to relieve allergies 

Antacid medicine for upset stomach

Anti-nausea or motion sickness medicine. You may also want to include medicine for altitude sickness if traveling to high altitudes.

Antibacterial hand wipes or an alcohol-based hand cleaner (should contain 60% alcohol or more) 

Masks, disposable or cloth

Bandages of assorted sizes to cover minor cuts and scrapes

Bandage closures, such as butterfly bandages, to tape edges of minor cuts together

Triangular bandage to wrap injuries and make an arm sling

Elastic wraps to wrap wrist, ankle, knee, and elbow injuries

Gauze in rolls, as well as 2-inch and 4-inch pads, to dress larger cuts and scrapes

Adhesive tape to keep gauze in place

Scissors with rounded tips to cut tape, gauze, or clothes, if necessary. Note that this may not be allowed in your carry-on bag if traveling by air.

Safety pins to fasten splints and bandages

Antiseptic wipes to disinfect wounds or clean hands and tweezers, scissors, or other utensils. Some of these items may not be allowed in your carry-on bag if traveling by air.

Antibiotic ointment to prevent infection in cuts, scrapes, and burns

Hydrogen peroxide to clean and disinfect wounds

Disposable, instant-activating cold packs to cool injuries and burns, as well as for use in strains and sprains

Tweezers to remove small splinters, foreign objects, bee stingers, and ticks from the skin. Note that this may not be allowed in your carry-on bag if traveling by air.

Disposable rubber gloves to protect hands and reduce the risk for infection when treating wounds

Thermometer (no mercury and no glass) to take temperatures in case of illness

Calamine lotion to relieve itching and irritation from insect bites and poison ivy

Hydrocortisone cream to relieve irritation from rashes

Sunscreen of SPF 15 or higher

Aloe gel for sunburns

Insect repellent. Those appropriate for use on children should contain 10% to 30% DEET. Those for adults should contain 30% to 50% DEET or up to 20% of picaridin. The chemical can cause harm when absorbed through the skin. Don't use insect repellant on infants 2 months of age or younger. Don't use products that combine DEET with sunscreen.

Medicine to prevent malaria, if needed where you are traveling

Over-the-counter medicine for diarrhea. Talk with your healthcare provider about a prescription for an antibiotic you can take in case of diarrhea.

Cough and cold medicines

Epinephrine auto-injector for people with severe allergies

List of prescription medicines and generic names

Latex condoms

Water purification tablets

Extra pair of contact lenses or prescription glasses

Follow the same safety measures with the medicines in your first aid kit as you do with all medicines, and use only as recommended by your healthcare provider. Make sure children can't get into the first aid bag. Use child safety caps whenever possible. Also be aware of volume limits in carry-on bags. Some of these items may need to be packed in your checked luggage while flying. Check expiration dates and discard medicine that is out-of-date. If someone has a life-threatening allergy, carry the appropriate medicine with you at all times.

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#PrepYourHealth: Tips for Holiday Travel

Holiday travel often includes visiting loved ones or taking a vacation. Whether you’re seeking a winter wonderland or an escape from subzero temperatures, follow these travel tips to stay healthy and safe during the holiday travel season.

Before Your Trip

No matter where you plan to travel, check CDC’s destination pages for travel health information . These pages include information about

• vaccines and medicines you may need, and
• diseases or health risks that are a concern at your destination.

Get up to date with your COVID-19 vaccines and seasonal flu vaccine. CDC recommends getting the  flu  vaccine every year.

Get up to date on routine vaccines. Routine vaccinations protect you from infectious diseases such as measles that can spread quickly in groups of unvaccinated people. Many diseases prevented by routine vaccination are uncommon in the United States but common in other countries.

Prepare a  travel health kit that includes personal needs, especially those items that may be difficult to find at your destination. Take enough of your prescription and over-the-counter medicines to last your entire trip, plus extra in case of travel delays. You may also want to pack  insect repellent ,  sunscreen  (SPF 15 or higher), aloe, alcohol-based hand sanitizer, water disinfection tablets, and important paperwork like your health insurance card.

Make sure you have a plan for  getting health care during travel . Find out if your health insurance covers medical care abroad. Travelers are usually responsible for paying hospital and other medical expenses out of pocket at most destinations. Consider buying  additional insurance  that covers health care and emergency evacuation, especially if you will travel to remote areas.

During Your Trip

Choose safe transportation. Always wear your seat belt. If you are traveling with children ages 12 and younger, make sure they are properly buckled in a car seat, booster seat, or seat belt—whichever is appropriate for their age, weight, and height—in the back seat.

Motor vehicle crashes are the leading cause of death among healthy travelers. Be alert when crossing the street, especially in countries where people drive on the left side of the road.  Find out other steps  you can take to stay safe on the roads.

Protect yourself from the sun. Apply sunscreen with SPF 15 or higher when traveling.  Protecting yourself from the sun  isn’t just for tropical beaches. You can sunburn even if it’s cloudy or cold. You are at the highest risk for ultraviolet light exposure during summer months, near the equator, at high altitudes, and between 10 a.m. to 4 p.m.

Stay alert in crowded areas. Does your holiday travel involve markets, festivals, or other activities that involve a large number of people at the same place (mass gathering)? If so, learn some tips to stay safe at a mass gathering.

Considerations for cold weather travel

Wear warm clothing in several loose layers when traveling in cold weather or climates. Learn practical skills and lessons like how to prevent hypothermia and frostbite .

Considerations for warm weather travel

If you are traveling in hot weather or to a hot climate, wear loose, lightweight, light-colored clothing.

Your chances of getting heat stroke, heat exhaustion, or other heat-related illness during travel depend on your destination, activities, level of hydration, and age. The more active you are in high temperatures, the more likely you are to get a heat-related illness. Learn how to prevent  heat-related illness .

Use   insect repellent  and take steps to avoid bug bites. Bugs, including mosquitoes, ticks, and flies, can spread diseases such as Zika, dengue, Lyme, and others. These bugs are typically more active during warm weather. Check your destination’s  page to determine what you need to do to protect yourself from diseases spread through bug bites, including medications or vaccines when recommended.

After Your Trip

If you recently traveled and feel sick , particularly if you have a fever, talk to a healthcare professional. Tell them about your travel. Be prepared to answer questions about your vaccination history, destination(s), reasons for traveling, itinerary, and other aspects of your trip.

• Travelers’ Health | CDC
• Traveler Advice | Travelers’ Health | CDC
• COVID-19: International Travel to and from the United States | CDC
• Cruise Ship Travel During COVID-19| CDC

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

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Security Alert May 17, 2024

Worldwide caution, update may 10, 2024, information for u.s. citizens in the middle east.

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Get Help with a Medical Emergency Abroad

If you or a U.S. citizen loved one become seriously ill or injured abroad, we can:

• Help locate appropriate medical services.
• Inform your family or friends, with your permission.
• Help  transfer funds  to U.S. citizens overseas.

The U.S. government does not pay overseas medical bills. The patient must pay all hospital and other expenses.

You can find lists of doctors and hospitals in the country you are visiting. Check the  website of the U.S. embassy in the country you are visiting. 

Check Your Health Insurance – Are You Covered Abroad?

Understand what medical services your health insurance will cover overseas before traveling. Carry your insurance card and a claim form if your policy covers you outside the United States. 

Medicare does not cover medical care when you travel the United States. Visit  Medicare.gov  for more information.

Some health insurance companies pay for “customary and reasonable” hospital costs abroad. Very few pay for your medical evacuation back to the United States. The cost may exceed $250,000, depending on your location and medical condition. Consider buying medical evacuation insurance. For more information, visit our webpage on Insurance Coverage Overseas . 

Traveling with Prescription Medications

• Check with the foreign embassy of the country you are visiting or passing through. Check to make sure your medications are allowed, particularly prescriptions for medical marijuana. You may need an import license or permit to travel with certain medications.
• Bring plenty of medicine for your trip. If possible, bring a few extra days’ worth in case of delays. You might not be able to get the same medication abroad.
• Carry a letter from the doctor. It should describe your medical condition. It should also list any prescription drugs and their generic names.
• Keep medications in their original, labeled containers.
• Entering a country with a prescription medication, even if legally obtained in the United States, could be illegal and result in your detention or arrest overseas.

Medical Tourism Abroad

Between 150,000 and 320,000 U.S. citizens travel abroad for medical care each year. Medical tourism includes cosmetic surgery, dentistry, and other surgical procedures. 

If you are a U.S. citizen considering travel abroad for medical care, you should:

• Verify the doctor’s training, qualifications, and reputation. 
• Visit the U.S. Centers for Disease Control and Prevention (CDC) Medical Tourism website for more information on medical tourism. 
• Check country information  for more information.

Inform Yourself About Vaccinations

Some Countries Require Vaccinations

Before you travel, check country information . You may need to carry an International Certificate of Vaccination, also called a Yellow Card. You may also need to show proof of other inoculations or medical tests. Check also current requirements directly with the foreign embassies of the countries you are visiting.

Recommended Vaccinations and Malaria Prevention

Check the  U.S. Centers for Disease Control (CDC)  and World Health Organization (WHO)  websites for recommended vaccinations and malaria prevention for your destination. Review the CDC’s webpage on Choosing a Drug to Prevent Malaria .

Travel Smartly with Prescription Medications

• Bring an ample supply of medication to cover you for your trip, and if possible, a few extra days in case there are delays.
• Carry a letter from the attending physician that describes your medical condition and any prescription medications, including the generic name of prescribed drugs.
• Check with the foreign embassy of the country you are visiting or transiting to make sure your medications are permitted in that country. Some countries require an import license or permit to travel with certain medications.

Being Prepared for a Pandemic

Review the  U.S. Centers for Disease Control and Prevention website for information about pandemics. In a pandemic, virus control measures could affect your travel:

• Travel restrictions may prevent U.S. citizens from traveling internationally.
• Foreign governments may close borders suddenly or with little advance warning.
• Commercial air, land, and sea carriers could suspend some or all transportation services.
• Some countries may quarantine people who appear sick or test positive with the virus.

These developments could delay your travel or your return to the United States.

Other Health Considerations Abroad

• Review the CDC’s Traveler Advice.
• Review Traveling With Disabilities .
• Review Considerations for Older Travelers .

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Raj Palraj, M.B.B.S., M.D.

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9 common questions about vaccines and travel

• Immunizations

Travel does more than just transport you to a different place. It can broaden your perspective, increase your happiness, give you a chance to try new things, boost your creativity and help you recharge. Even planning a trip can be an exciting task. The anticipation of mapping an itinerary and scheduling your must-see attractions can bring a lot of joy and happiness.

One of the most important tasks before taking a trip is to make an appointment with a travel medicine specialist. These health care professionals help keep travelers safe and happy before and after their journeys.

Here are answers to common questions about travel medicine:

1. who should make an appointment with a travel medicine specialist.

Anyone planning a trip overseas can benefit from seeing a travel medicine specialist. However, a travel clinic appointment is critical if you are traveling to underdeveloped or developing countries where there's a higher risk of contracting severe communicable illnesses while abroad. It is also important for patients with certain medical conditions that make their immune systems weaker and more vulnerable to infectious diseases.

2. What vaccinations do I need to travel overseas?

All travelers should be vaccinated against the flu and current with COVID-19 vaccines and boosters.

In addition, it's important to complete the adult vaccination schedule that includes vaccinations for:

• Chickenpox (varicella)
• Diphtheria, tetanus and pertussis (DTP)
• Pneumococcal
• Measles, mumps and rubella (MMR)

Additional vaccines may be recommended depending on your travel itinerary. For example, hepatitis A vaccination is recommended if you are traveling to Southeast Asia. During your appointment, we can discuss which vaccines are appropriate for your itinerary.

3. Are there travel destinations that have different vaccination recommendations?

Yes. Infectious diseases thrive in different climates. If you travel to a new climate, you may be exposed to diseases to which you don't have any immunity.

Some infections are more prevalent in tropical settings compared to temperate climates. For example, typhoid and hepatitis A are more common in Southeast Asia because these communicable diseases can be spread through contaminated water. Some areas of Africa and South America have a higher prevalence of yellow fever and malaria, which are mosquito-borne infections.

The Centers for Disease Control and Prevention (CDC) has good information online for travelers for each travel destination.

Recommended vaccines may include:

• Hepatitis A
• Hepatitis B
• Japanese encephalitis
• Yellow fever

4. Can my primary care provider give me travel vaccinations?

It depends on your travel destinations and vaccine recommendations. I recommend starting the conversation with your primary care provider and reviewing the CDC recommendations .

If you have a complex itinerary with multiple countries or are traveling to Southeast Asia or Africa, it's better to make an appointment at the travel clinic. I also would recommend patients with organ transplants and immunocompromising conditions seek travel medicine consultation to reduce the risk of illness during travel. During that appointment, we will review your itinerary, provide necessary vaccinations and discuss ways to prevent mosquito-borne or tick-borne diseases.

5. How long before my trip should I go to the travel clinic?

Plan to have an appointment at least four weeks before you travel. Some vaccines require several weeks for immunity to develop, while others require more than one dose of vaccine for full protection.

If your trip is to an underdeveloped or developing country, you may need to schedule an appointment up to two months in advance to receive a complete set of immunizations. This gives your body time to produce the protective antibodies, so you are well protected when you land at your destination.

6. Can I only go to the travel clinic before I travel?

No. The Travel and Tropical Medicine Clinic is available before or after travel. The team can provide consultative services and treatment if you get sick after you return home.

7. I'm going to an all-inclusive resort. Will I have a lower risk of getting sick?

Maybe, but no traveler should take safety for granted. Even in an all-inclusive resort, knowing how food is prepared or the water supply quality is not possible. Mosquitos and other insects could still be a concern. It's important to take all necessary precautions and follow vaccination recommendations when you travel, regardless of your accommodations.

8. How do I lower my risk of malaria when traveling?

Malaria is a disease caused by a parasite. It's spread to humans through the bites of infected mosquitoes. Prophylactic malaria medications are available and are started before the travel, continued during the stay and for a certain duration after returning home. A travel medicine specialist can review the risks and benefits of all prevention and treatment options.

9. How do I stay healthy while traveling?

Nothing can ruin a trip like illness. Make sure all your vaccinations and boosters are up to date, and get any new vaccinations recommended for your destinations.

Food and water safety is important while traveling. Only eat well-cooked food. Avoid eating from roadside stands and uncooked foods, like salad and raw vegetables. Drink bottled beverages only, including bottled water. This is especially important if you travel in resource-limited regions, such as Southeast Asia or Africa.

Hand hygiene is important at home and overseas. Wash your hands often using soap and hot water. Avoid crowded places, follow respiratory etiquette and consider optional masking. Mosquitos and bugs can transmit parasites and diseases, like yellow fever and malaria. Use mosquito repellents. Mosquito nets may be appropriate in some parts of the world, as well.

As you make travel plans, schedule an appointment with a travel medicine specialist to get the vaccinations and information you need to be healthy and safe on your journey.

Raj Palraj, M.D. , is a physician in Infectious Diseases and Travel and Tropical Medicine in La Crosse , Wisconsin.

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Vaccines for Travelers

Vaccines protect travelers from serious diseases. Depending on where you travel, you may come into contact with diseases that are rare in the United States, like yellow fever. Some vaccines may also be required for you to travel to certain places.

Getting vaccinated will help keep you safe and healthy while you’re traveling. It will also help make sure that you don’t bring any serious diseases home to your family, friends, and community.

On this page, you'll find answers to common questions about vaccines for travelers.

Which vaccines do I need before traveling?

The vaccines you need to get before traveling will depend on few things, including:

• Where you plan to travel . Some countries require proof of vaccination for certain diseases, like yellow fever or polio. And traveling in developing countries and rural areas may bring you into contact with more diseases, which means you might need more vaccines before you visit.
• Your health . If you’re pregnant or have an ongoing illness or weakened immune system, you may need additional vaccines.
• The vaccinations you’ve already had . It’s important to be up to date on your routine vaccinations. While diseases like measles are rare in the United States, they are more common in other countries. Learn more about routine vaccines for specific age groups .

How far in advance should I get vaccinated before traveling?

It’s important to get vaccinated at least 4 to 6 weeks before you travel. This will give the vaccines time to start working, so you’re protected while you’re traveling. It will also usually make sure there’s enough time for you to get vaccines that require more than 1 dose.

Where can I go to get travel vaccines?

Start by finding a:

• Travel clinic
• Health department
• Yellow fever vaccination clinic

Learn more about where you can get vaccines .

What resources can I use to prepare for my trip?

Here are some resources that may come in handy as you’re planning your trip:

• Visit CDC’s travel website to find out which vaccines you may need based on where you plan to travel, what you’ll be doing, and any health conditions you have.
• Download CDC's TravWell app to get recommended vaccines, a checklist to help prepare for travel, and a personalized packing list. You can also use it to store travel documents and keep a record of your medicines and vaccinations.
• Read the current travel notices to learn about any new disease outbreaks in or vaccine recommendations for the areas where you plan to travel.
• Visit the State Department’s website to learn about vaccinations, insurance, and medical emergencies while traveling.

Traveling with a child? Make sure they get the measles vaccine.

Measles is still common in some countries. Getting your child vaccinated will protect them from getting measles — and from bringing it back to the United States where it can spread to others. Learn more about the measles vaccine.

Find out which vaccines you need

CDC’s Adult Vaccine Quiz helps you create a list of vaccines you may need based on your age, health conditions, and more.

Take the quiz now !

Get Immunized

Getting immunized is easy. Vaccines and preventive antibodies are available at the doctor’s office or pharmacies — and are usually covered by insurance.

Find out how to get protected .

CDC Health Information for International Travel: Yellow Book

As unprecedented numbers of travelers cross international borders each day, the need for up-to-date, actionable information about the health challenges posed by this mass movement has never been greater. For both international travelers and the health professionals who care for them, CDC Health Information for International Travel (more commonly known as the Yellow Book ) is the definitive guide to staying healthy and safe anywhere in the world. The Yellow Book is produced biennially with input from hundreds of travel medicine experts and is published through a unique collaboration between CDC, the CDC Foundation and Oxford University Press. 

The 2018 edition codifies the U.S. government’s most current health guidelines and information for international travelers, including pretravel vaccine recommendations, destination-specific advice, and easy-to-reference maps , tables and charts . The book also offers updated guidance for specific types of travel and travelers, including:

• Precautions for pregnant travelers, immunocompromised travelers and travelers with disabilities
• Special considerations for newly arrived adoptees , immigrants and refugees
• Practical tips for last-minute or resource-limited travelers
• Advice for air crews , humanitarian workers , missionaries and others who provide care and support overseas

The 2018 Yellow Book includes important travel medicine updates:

• The latest information about emerging infectious disease threats such as Zika , Ebola  and MERS
• New cholera vaccine recommendations
• Updated guidance on the use of antibiotics in the treatment of travelers' diarrhea
• Special considerations for unique types of travel, such as wilderness expeditions , work-related travel  and study abroad
• Destination-specific recommendations for popular itineraries, including new sections for travelers to Cuba and Burma

Written by a team of CDC experts on the forefront of travel medicine, the Yellow Book provides a user-friendly, vital resource for those in the business of keeping travelers healthy abroad. Order the 2018 edition online .

©David Snyder/CDC Foundation

Emergency Support

In case of emergency abroad, first call the local equivalent of 911 listed in the global 911 directory .

You may also contact International SOS by phone at +1-617-998-0000 or through the Assistance App .

IEMT Portal

Access your International Emergency Management Team (IEMT) portal for information.

Tips for Traveling with Medication

Photo via Tomek Baginski/Unsplash

Many common U.S. medications and supplements are illegal abroad or require government authorization before your arrival.

Drug Facts: Traveling with Medication

Adderall. Benadryl. Birth control. Protein powder. These are just a few of the common U.S. medications and supplements that are illegal in some countries or require government authorization prior to your arrival.

Travelers are often caught off guard by the wide variance of laws regulating the importation of and access to medications across borders, whether mailed or hand carried. Depending on your destination, you could be subject to increased scrutiny from customs officials ( not a big deal, you think ) or confiscation and imprisonment ( that escalated quickly ). In Turkey, Egypt, and Malaysia, for example, a drug offense conviction can result in the death penalty.

Know Before You Go

Be aware of your destination’s banned and restricted medications. The US embassy website of your destination country is a good place to start—a quick query in the search bar should do the trick. You can also check your airline's website to see if things like flying with Adderall, for example, are prohibited.

If any of your medications are on the embassy's or airline's list of banned or restricted substances, you'll need to talk with your health care provider about suitable alternatives. Make sure the alternative medications are legally permitted and readily available in your destination.

Common Restrictions

• Narcotics and psychotropic medications (e.g. Adderall and Ambien)
• Over-the-counter medications and nutritional supplements (e.g. protein powder)
• Hormone medications (e.g. birth control pills, morning after pills, and hormone therapy medication for gender transition)
• Certain ingredients or quantities of ingredients (e.g. pseudoephedrine found in Sudafed, and diphenhydramine HCI found in Benadryl and Tylenol PM)

Ignorance isn’t an Excuse

Take this example of an American Toyota executive arrested in Tokyo after Japanese customs officials found a controlled pain medication in a package she mailed to herself. Japanese authorities can detain suspects without charge for up to 23 days, and the executive spent almost three weeks in jail before being released without charge. At a press conference, Toyota explained that their executive did not intentionally violate local laws; however, ignorance, in this case, had serious repercussions .

Chronic Conditions

For travelers with chronic physical or mental health conditions, anticipate how your new environment can affect your health. For example, if you have asthma and are traveling to areas with high levels of air pollution, you’ll want to discuss mitigation strategies with your health care provider. If you require injections, you’ll need to review airline and country-specific regulations for traveling with needles or syringes. Many airlines, like Emirates, have a list of prohibited goods on their website, as well as guidelines for traveling with a chronic health condition.

Mental Health

Practice self-care; difficulty in adjustment can be mitigated by trying to maintain your daily routine while abroad. If there are aspects of your routine that keep you happy at home—for example, working out—try to find facilities in your destination by which you can continue them.

Preexisting mental health conditions can be intensified by living in a different culture, and local resources may be less than or different from those to which you’re accustomed to at home. Discuss these concerns with your health care provider and know the counseling resources available to you abroad—including International SOS —should you need help.

Sexual and Reproductive Health

Cultural norms and laws that impact individuals’ access to sexual and reproductive health vary by country (and by state in the US). Consider bringing personal care and health-related items that may be unavailable or difficult to obtain in your destination, including menstruation products and contraceptives; as with your prescription and over-the-counter medications, make sure any contraceptives you bring with you are legal in your destination country.

Before You Leave

• Research your destination and transit locations. The International SOS destination guides, available in the Assistance App and member portal , include medical information such as vaccines, documentation, medication, clinics, and hospitals. Log in with your HarvardKey.
• If you're traveling to a region with a high risk of malaria, review the CDC's malaria advice and assess whether you'd like to carry preventative medication with you. Speak to your doctor about obtaining malaria medication, and treat it during travel just like you would any other prescription.
• Obtain necessary permits or government authorization.
• Ask your doctor for a letter on their letterhead explaining your medical treatment and necessity, translated into the host country’s language, if necessary.
• If you have to take your medication at a specific time, talk with your doctor about adjusting your schedule accordingly based on your travel time and time zone changes.
• Pack enough medication to last the length of your trip—plus extra in case of delays, but no more than personal-use quantities.

During Travel

• Keep all medications in your carry-on luggage and in their original, labeled containers; do not combine multiple medications into one container.
• The name on the prescription should match the name on travel documents and identification.
• Be prepared for additional screening.
• Carry a written prescription and a letter from your doctor explaining the medication and medical condition.
• Do not have banned or controlled substances mailed to you.
• In case of an emergency, contact International SOS if you are sick, injured, or need medical advice.

Returning to the U.S.

• If you're prescribed medication abroad, review U.S. Customs & Border Patrol's list of restricted and prohibited items to certify that medication obtained abroad may be brought back into the country.
• Declare all medication and associated items at customs.
• Carry medication obtained abroad in its original container.

Stay Up To Date

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• Patient Care & Health Information
• Diseases & Conditions
• Traveler's diarrhea

Traveler's diarrhea may get better without any treatment. But while you're waiting, it's important to try to stay hydrated with safe liquids, such as bottled water or water with electrolytes such as an oral rehydration solution (see below). If you don't seem to be improving quickly, several medicines are available to help relieve symptoms.

Anti-motility agents. These medicines — which include loperamide and drugs containing diphenoxylate — provide prompt but temporary relief by:

• Reducing muscle spasms in your gastrointestinal tract.
• Slowing the transit time through your digestive system.
• Allowing more time for absorption.

Anti-motility medicines aren't recommended for infants or people with a fever or bloody diarrhea. This is because they can delay clearance of the infectious organisms and make the illness worse.

Also, stop using anti-motility agents after 48 hours if you have stomach pain or if your symptoms worsen and your diarrhea continues. In such cases, see a doctor. You may need blood or stool tests and treatment with an antibiotic.

• Bismuth subsalicylate. This nonprescription medicine can decrease the frequency of your stools and shorten the length of your illness. However, it isn't recommended for children, pregnant women or people who are allergic to aspirin.
• Antibiotics. If you have more than four loose stools a day or severe symptoms, including a fever or blood, pus or mucus in your stools, a doctor may prescribe a course of antibiotics.

Before you leave for your trip, talk to your doctor about taking a prescription with you in case you get a serious bout of traveler's diarrhea.

Avoiding dehydration

Dehydration is the most likely complication of traveler's diarrhea, so it's important to try to stay well hydrated.

An oral rehydration salts (ORS) solution is the best way to replace lost fluids. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes. They also contain glucose to enhance absorption in the intestinal tract.

Bottled oral rehydration products are available in drugstores in developed areas, and many pharmacies carry their own brands. You can find packets of powdered oral rehydration salts, labeled World Health Organization (WHO)- ORS , at stores, pharmacies and health agencies in most countries. Reconstitute the powder in bottled or boiled water according to the directions on the package.

If these products are unavailable, you can prepare your own rehydrating solution in an emergency by mixing together:

• 3/4 teaspoon table salt.
• 2 tablespoons sugar.
• 1 quart uncontaminated bottled or boiled water.
• Sugar-free flavor powder, such as Crystal Light (optional).

You or your child can drink the solution in small amounts throughout the day as a supplement to solid foods or formula, as long as dehydration persists. Small amounts reduce the likelihood of vomiting. Breastfed infants also can drink the solution but should continue nursing on demand.

If dehydration symptoms — such as dry mouth, intense thirst, little or no urination, dizziness, or extreme weakness — don't improve, seek medical care right away. Oral rehydration solutions are intended only for urgent short-term use.

Lifestyle and home remedies

If you do get traveler's diarrhea, avoid caffeine, alcohol and dairy products, which may worsen symptoms or increase fluid loss. But keep drinking fluids.

Drink canned fruit juices, weak tea, clear soup, decaffeinated soda or sports drinks to replace lost fluids and minerals. Later, as your diarrhea improves, try a diet of easy-to-eat complex carbohydrates, such as salted crackers, bland cereals, bananas, applesauce, dry toast or bread, rice, potatoes, and plain noodles.

You may return to your normal diet as you feel you can tolerate it. Add dairy products, caffeinated beverages and high-fiber foods cautiously.

Preparing for your appointment

Call a doctor if you have diarrhea that is severe, lasts more than a few days or is bloody. If you are traveling, call an embassy or consulate for help locating a doctor. Other signs that you should seek medical attention include:

• A fever of 102 F (39 C) or higher.
• Ongoing vomiting.
• Signs of severe dehydration, including a dry mouth, muscle cramps, decreased urine output, dizziness or fatigue.

If you have diarrhea and you've just returned home from a trip abroad, share that trip information with your doctor when you call to make an appointment.

Here's some information to help you get ready, and what to expect.

Information to gather in advance

• Pre-appointment instructions. At the time you make your appointment, ask whether there are immediate self-care steps you can take to help recover more quickly.
• Symptom history. Write down any symptoms you've been experiencing and for how long.
• Medical history. Make a list of your key medical information, including other conditions for which you're being treated and any medicines, vitamins or supplements you're currently taking.
• Questions to ask your health care professional. Write down your questions in advance so that you can make the most of your time.

The list below suggests questions to ask about traveler's diarrhea.

• What's causing my symptoms?
• Are there any other possible causes for my symptoms?
• What kinds of tests do I need?
• What treatment approach do you recommend?
• Are there any possible side effects from the medicines I'll be taking?
• Will my diarrhea or its treatment affect the other health conditions I have? How can I best manage these conditions together?
• What is the safest way for me to rehydrate?
• Do I need to follow any dietary restrictions and for how long?
• How soon after I begin treatment will I start to feel better?
• How long do you expect a full recovery to take?
• Am I contagious? How can I reduce my risk of passing my illness to others?
• What can I do to reduce my risk of this condition in the future?

In addition to the questions that you've prepared, don't hesitate to ask questions as they occur to you during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to talk about in-depth. Your doctor may ask:

• What are your symptoms?
• When did you first begin experiencing symptoms?
• Have you traveled recently?
• Where did you travel?
• Have you taken any antibiotics recently?
• Have your symptoms been getting better or worse?
• Have you noticed any blood in your stools?
• Have you experienced symptoms of dehydration, such as muscle cramps or fatigue?
• What treatments have you tried so far, if any?
• Have you been able to keep down any food or liquid?
• Are you pregnant?
• Are you being treated for any other medical conditions?
• Feldman M, et al., eds. Infectious enteritis and proctocolitis. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed May 25, 2021.
• LaRocque R, et al. Travelers' diarrhea: Microbiology, epidemiology, and prevention. https://www.uptodate.com/contents/search. Accessed May 26, 2021.
• Ferri FF. Traveler diarrhea. In: Ferri's Clinical Advisor 2023. Elsevier; 2023. https://www.clinicalkey.com. Accessed April 28, 2023.
• Diarrhea. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea. Accessed April 27, 2023.
• Travelers' diarrhea. Centers for Disease Control and Prevention. https://wwwnc.cdc.gov/travel/yellowbook/2020/preparing-international-travelers/travelers-diarrhea. Accessed April 28, 2023.
• LaRocque R, et al. Travelers' diarrhea: Clinical manifestations, diagnosis, and treatment. https://www.uptodate.com/contents/search. Accessed May 26, 2021.
• Khanna S (expert opinion). Mayo Clinic. May 29, 2021.

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Can I Travel Abroad with HIV?

With proper treatment, people with HIV can lead healthy and active lives, including traveling for business and pleasure. However, traveling to other countries, particularly developing countries, may require some advance preparation and special precautions.

Before You Travel

Covid-19 information.

CDC recommends making sure you are up to date with COVID-19 vaccines, including boosters, and consider getting tested before travel. Follow all requirements and recommendations at each location during travel. If you are traveling internationally, check the COVID-19 Travel Health Notice for your destination and visit CDC’s International Travel webpage for requirements and recommendations.

Before you travel, see your health care provider or travel health specialist to discuss the medical risks you might face and what you should do to prepare for safe and healthy travel. Ideally, this conversation should take place at least 4-6 weeks before your scheduled departure.

Talk to your provider about the places you plan to visit . They may:

• Recommend certain travel vaccines . Most travel vaccines are made from killed bacteria or viruses and can be given safely to people with HIV and others with weakened immune systems. However, they may be less effective than in people with strong immune systems and may not provide full protection. Your doctor may recommend blood tests to confirm that a vaccine was effective or recommend additional precautions to keep you safe. Some vaccines are made from live viruses and many people with weakened immune systems should not take them. However, depending on the circumstances, the benefits of protection may outweigh the risks. Talk to your health care provider about what is recommended for you.
• Recommend you pack a supply of medicine like antibiotics to treat travelers’ diarrhea , which can affect people with weakened immune systems.
• Provide you with the name(s) of health care providers or clinics that treat people with HIV infection in the region you plan to visit.
• Advise you on how to minimize the risk of malaria and other insect-borne diseases such as dengue and yellow fever , depending on your destination. People who have weakened immune systems can get seriously ill from malaria, so it’s important to closely follow your doctor’s instructions for taking the preventative medicine, which may include taking it for several weeks before and after the trip. You should also take steps to avoid bug bites : wear insect repellent, wear long pants and sleeves, and sleep under a net if your rooms are exposed to the outdoors.

Also, educate yourself about your insurance policies:

• Review your medical insurance to see what coverage it provides when you are away from home . You may purchase supplemental traveler’s insurance to cover the cost of emergency medical evacuation by air and the cost of in-country care if these costs are not covered by your regular insurance. View the U.S. State Department’s information on insurance for overseas travel .
• Take proof of insurance , such as a photocopy or scan your policy and send the image to an e-mail address you can access both in the United States and abroad. Leave a copy at home and tell your friends or family where it is located.

Stay Up to Date on Your Sexual Health Care

Whether you are traveling or staying close to home for events, CDC recommends the following:

• Visit your health care provider or find a health clinic to stay up to date with your sexual health care. Discuss the types of sex you have so that your provider can offer testing and prevention services, including vaccines , that are right for you.
• Know your HIV status. If you don’t know your HIV status, get tested near where you live, work, or play, including options for ordering free self-testing kits Exit Disclaimer . No matter your results, there are steps you can take to stay healthy. If you don’t have HIV, you have options to prevent HIV, including finding a PrEP provider to see if PrEP is right for you. If you test positive, you can find a care provider and live well with HIV. HIV treatment will keep you healthy and prevent you from transmitting HIV to your sex partners.
• If you are sexually active, get tested for other sexually transmitted infections (STIs), like gonorrhea and syphilis. This is one of the most important things you can do to protect your health. You can also find STI testing sites near you and learn more about how to prevent STIs .
• Get tested for viral hepatitis and consider vaccinations for hepatitis A and B. Learn about hepatitis testing, prevention, and treatment.
• Learn more about mpox and be sure to get your two-dose mpox vaccine. Mpox cases in the United States are becoming increasingly rare, but unvaccinated and under-vaccinated people who could benefit from vaccine may still be at risk. The best protection against mpox occurs 2 weeks after the second shot , so plan ahead and use other strategies to prevent mpox.
• Be knowledgeable of other infections like shigella and meningococcal disease , and how to prevent them.

When You Travel Abroad

Food and water in developing countries may contain germs that could make you sick.

• eat raw fruit or vegetables that you do not peel yourself;
• eat raw or undercooked seafood or meat;
• eat unpasteurized dairy products;
• eat anything from a street vendor;
• drink tap water (in developing countries some hotels may purify their own water, but it is safer to avoid it), drinks made with tap water, or ice made from tap water.

Do eat and drink:

• hot coffee or tea;
• bottled water and drinks (make sure the seals are original and have not been tampered with);
• water that you bring to a rolling boil for one full minute then cool in a covered and clean vessel;
• fruits that you peel;
• wine, beer and other alcoholic beverages are also safe.
• Tuberculosis is very common worldwide and can be severe in people with HIV. Avoid hospitals and clinics where coughing TB patients are treated. See your doctor upon your return to discuss whether you should be tested for TB.
• Animal wastes , such as fecal droppings in soil or on sidewalks, can pose hazards to individuals with weakened immune systems. Physical barriers, such as shoes, can protect you from direct contact. Likewise, towels can protect you from direct contact when lying on a beach or in parks. If you are in physical contact with animals, wash your hands thoroughly afterwards with soap and water.
• Take all your medications on schedule, as usual.
• Stick to your special diet , if you are on one.
• Take the same precautions that you take at home to prevent transmitting HIV to others.

Are There Restrictions on Traveling Abroad?

Some countries restrict visitors with HIV from entering their borders or staying for long periods of time. Others permit discrimination on the basis of sexual orientation or gender identification. According to the State Department , more than 70 countries consider consensual same-sex relations a crime, sometimes carrying severe punishment. Before you travel internationally, be aware of the laws, policies, and practices in the country or countries you plan to visit. This information is usually available from the consular offices of each country or in the State Department’s country information summaries , along with information about entry and exit requirements.

Traveling to the U.S. from Other Countries

As of January 2010, travelers with HIV or AIDS are allowed entrance into the U.S.

What Travelers’ Health Resources Are Available?

CDC's Yellow Book , a guide to health information for international travelers is an excellent resource for anyone traveling overseas. The section on Immunocompromised Travelers has extensive information for people with HIV.

CDC’s Travelers’ Health website contains find information on:

• travelers’ health for people with weakened immune systems
• travel health notices for destinations
• recommended vaccinations and precautions for destinations

Additionally, the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV contain information about immunization against malaria and other infections that may be useful.

Related HIV.gov Blogs

• People with HIV
• CDC – Get Healthy and Ready for Summer 2023
• U.S. State Dept. – Traveler’s Checklist
• U.S. State Dept. – Your Health Abroad
• U.S. State Dept. – Traveling with Disabilities and Medical Considerations

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Chikungunya in Maldives

• There is an outbreak of chikungunya in Malé and Hulhumalé regions of Maldives (see map).
• Mosquitoes spread the virus that causes chikungunya.
• You can protect yourself by preventing mosquito bites , which includes using insect repellent; wearing long-sleeved shirts and pants; and staying in places with air conditioning or that use window and door screens.
• Vaccination for chikungunya is recommended for people aged ≥ 18 years who are traveling to a destination with a current chikungunya outbreak.
• If you are pregnant, reconsider travel to Maldives, particularly if you are close to delivering your baby. Mothers infected around the time of delivery can pass the virus to their baby before or during delivery. Newborns infected in this way or by a mosquito bite are at risk for severe illness, including poor long-term outcomes.
• You should seek medical care if you develop fever, joint pain, headache, muscle pain, joint swelling, or rash , during or after travel.

Traveler Information

• Travelers’ Health Chikungunya Website
• Health Information for Travelers to Maldives
• CDC Chikungunya Website
• Prevent Mosquito Bites

Clinician Information

• Chikungunya in the CDC Yellow Book (Health Information for International Travel)
• Clinical Signs and Symptoms of Chikungunya Virus Disease  | Chikungunya virus | CDC
• Advisory Committee on Immunization Practices (ACIP) Recommendations for Chikungunya Vaccine

Chikungunya disease is caused by the chikungunya virus and is spread to humans through mosquito bites. Outbreaks have occurred in countries in Africa, Americas, Asia, Europe, the Caribbean, and Indian and Pacific Oceans.

Most people infected with chikungunya virus develop some symptoms. Symptoms of chikungunya usually begin 3–7 days after a bite by an infected mosquito. The most common symptoms are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash. Most people get better within a week; however, some can have severe joint pain for months to years following acute illness.

People at risk for more severe disease include newborns infected around the time of birth, older adults (65 years or older), and people with medical conditions such as high blood pressure, diabetes, or heart disease. Death from chikungunya is rare.

There is no specific treatment for chikungunya; however, the Advisory Committee on Immunization Practices (ACIP) recommends a vaccine for some travelers .

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Travelling with a pet

The United States (US) Centers for Disease Control and Prevention (CDC) announced changes to the import requirements for dogs entering the United States . These changes will come into effect on August 1, 2024 and will impact dogs travelling from Canada to the United States. The CFIA is currently in the process of reviewing these requirements. Further information and guidance will be provided as soon as possible.

New import conditions for personal pet dogs and assistance dogs from countries at high-risk for dog rabies starting September 28, 2023

Personal pet dogs and assistance dogs from countries at high-risk for dog rabies will require an import permit issued by the Canadian Food Inspection Agency before travelling to Canada.

If you're planning on bringing your dog into Canada from September 28, 2023 onwards, prepare in advance and learn more about the import process .

Pets must meet specific requirements when travelling to Canada or another country. It is your responsibility to review all the requirements for your situation.

Some requirements must be completed at specific times and if not completed correctly or on time your pet may not be eligible to travel and be refused entry.

As soon as you know your travel details, contact your local veterinarian to assist with the pet travel process. Requirements could include obtaining a health certificate, updating vaccinations, testing, or administering medications.

Only dogs, cats and ferrets qualify as pets by Canadian Food Inspection Agency (CFIA). Check requirements for other animals if you're travelling with a non-traditional pet.

Travelling to Canada from another country (import requirements)

Requirements for bringing an animal into Canada apply to the following situation:

• animals entering Canada permanently
• animals in transit through Canada on their way to a final destination
• animals entering Canada for a temporary visit
• Canadian animals returning to Canada

Travelling from Canada to another country (export requirements)

The country you're travelling to may have requirements your pet must meet before they can enter the country. Export requirements are determined by each country and can change frequently. Every time you plan to travel with your pet, it is your responsibility to check the requirements and allow enough time to get your pet ready to travel.

• Pets (dogs, cats and ferrets)
• All other animals

Related links

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Treatment and Intervention for Hearing Loss

• No single treatment or intervention for hearing loss is the answer for every child or family.
• Intervention plans will include close monitoring, follow-ups, and any changes needed along the way.
• There are many different options for children with hearing loss and their families.

Treatment and intervention overview

Treatment and intervention options for hearing loss in children include

• Working with a professional (or team) who can help a child and family learn to communicate.
• Getting a hearing device, such as a hearing aid.
• Joining support groups.
• Taking advantage of other resources available to children with a hearing loss and their families.

Early Hearing Detection and Intervention (EHDI) Programs

Every state has an EHDI program. EHDI works to identify infants and children with hearing loss. EHDI also promotes timely follow-up testing and intervention services for any family whose child has a hearing loss.

Important tip‎

Treatment and intervention types, intervention services, early intervention (0-3 years).

Hearing loss can affect a child's ability to develop speech, language, and social skills. The earlier a child who is deaf or hard-of-hearing starts getting services, the more likely the child's communication (speech or sign language) and social skills will reach their full potential.

Early intervention program services help young children with hearing loss learn communication and other important skills. Research shows that early intervention services can greatly improve a child's development.

Babies who are diagnosed with hearing loss should begin to get intervention services as soon as possible, but no later than 6 months of age .

There are many services available through the Individuals with Disabilities Education Improvement Act 2004 (IDEA 2004). Services for children from birth through 36 months of age are called Early Intervention or Part C services. Even if your child has not been diagnosed with a hearing loss, he or she may be eligible for early intervention treatment services. The IDEA 2004 says that children under the age of 3 years (36 months) who are at risk of having developmental delays may be eligible for services. These services are provided through an early intervention system in your state. Through this system, you can ask for an evaluation.

Special Education (3-22 years)

Special education is instruction specifically designed to address the educational and related developmental needs of older children with disabilities, or those who are experiencing developmental delays. Services for these children are provided through the public school system. These services are available through the Individuals with Disabilities Education Improvement Act 2004 (IDEA 2004), Part B.

Assistive Technology

Many people who are deaf or hard-of-hearing have some hearing. The amount of hearing a deaf or hard-of-hearing person has is called "residual hearing." Technology does not "cure" hearing loss but may help a child with hearing loss to make the most of their residual hearing. For those parents who choose to have their child use technology, there are many options, including

• Hearing aids
• Cochlear or brainstem implants
• Bone-anchored hearing aids
• Other assistive devices

Hearing Aids

Hearing aids make sounds louder. They can be worn by people of any age, including infants. Babies with hearing loss may understand sounds better using hearing aids. This may give them the chance to learn speech skills at a young age.

There are many styles of hearing aids. They can help many types of hearing losses. A young child is usually fitted with behind-the-ear style hearing aids because they are better suited to growing ears.

Cochlear and Auditory Brainstem Implants

A cochlear implant may help many children with severe to profound hearing loss—even very young children. It gives that child a way to hear when a hearing aid is not enough. Unlike a hearing aid, cochlear implants do not make sounds louder. A cochlear implant sends sound signals directly to the hearing nerve.

Persons with severe to profound hearing loss due to an absent or very small hearing nerve or severely abnormal inner ear (cochlea), may not benefit from a hearing aid or cochlear implant. Instead an auditory brainstem implant may provide some hearing. An auditory brainstem implant directly stimulates the hearing pathways in the brainstem, bypassing the inner ear and hearing nerve.

Both cochlear and brainstem implants have two main parts. There are the parts that are placed inside the inner ear, the cochlea, or base of the brain, the brainstem during surgery; and the parts outside the ear that send sounds to the parts inside the ear.

Bone-Anchored Hearing Aids

This type of hearing aid can be considered when a child has either a conductive, mixed, or unilateral hearing loss and is specifically suitable for children who cannot otherwise wear ‘in the ear’ or ‘behind the ear’ hearing aids.

Other Assistive Devices

Besides hearing aids, there are other devices that help people with hearing loss. Examples of other assistive devices include

Frequency Modulation (FM) System . An FM system is a device that helps people with hearing loss hear in background noise. FM is the same type of signal used for radios. These systems send sound from a microphone used by someone speaking to a person wearing the receiver. FM is sometimes used with hearing aids. An extra piece is attached to the hearing aid that works with the FM system.

Captioning. Many television programs, videos, and DVDs are captioned. Television sets made after 1993 are made to show the captioning. You don't have to buy anything special. Captions show the conversation spoken in soundtrack of a program on the bottom of the television screen.

Other devices. There are many other devices available for children with hearing loss. Some of these include

• Text messaging
• Telephone amplifiers
• Flashing and vibrating alarms
• Audio loop systems
• Infrared listening devices
• Portable sound amplifiers
• TTY (Text Telephone or teletypewriter)

Medications and Surgery

Medications or surgery may also help make the most of a person’s hearing. This is especially true for a conductive hearing loss, or one that involves a part of the outer or middle ear that is not working in the usual way.

One type of conductive hearing loss can be caused by a chronic ear infection. A chronic ear infection is a build-up of fluid behind the eardrum in the middle ear space. Most ear infections are managed with medication or careful monitoring. Infections that don't go away with medication can be treated with a simple surgery that involves putting a tiny tube into the eardrum to drain the fluid out.

Another type of conductive hearing loss is caused by either the outer and or middle ear not forming correctly while the baby was growing in the mother's womb. Both the outer and middle ear need to work together in order for sound to be sent correctly to the inner ear. If any of these parts did not form correctly, there might be a hearing loss in that ear. This problem may be improved and perhaps even corrected with surgery. An ear, nose, and throat doctor (otolaryngologist) is the health care professional who usually takes care of this problem.

Placing a cochlear implant, auditory brainstem implant, or bone-anchored hearing aid will also require a surgery.

Learning Language

Without extra help, children with hearing loss have problems learning language. These children can then be at risk for other delays. Families who have children with hearing loss often need to change their communication habits or learn special skills (such as sign language) to help their children learn language. These skills can be used together with hearing aids, cochlear or auditory brainstem implants, and other devices that help children hear.

Family Support Services

For many parents, their child's hearing loss is unexpected. Parents sometimes need time and support to adapt to the child's hearing loss.

Parents of children with recently identified hearing loss can seek different kinds of support. Support is anything that helps a family and may include advice, information, having the chance to get to know other parents that have a child with hearing loss, locating a deaf mentor, finding childcare or transportation, giving parents time for personal relaxation or just a supportive listener.

Hearing Loss in Children

Hearing loss can affect a child’s ability to develop communication, language, and social skills. The earlier children with hearing loss start getting services, the more likely they are to reach their full potential.

For Everyone

Health care providers, public health.