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Due to the lapse in government funding, only web sites supporting excepted functions will be updated unless otherwise funded. As a result, the information on this website may not be up to date, the transactions submitted via the website may not be processed, and the agency may not be able to respond to inquiries until appropriations are enacted. Updates regarding government operating status and resumption of normal operations can be found at http://www.usa.gov.

Health Information for Travelers to India

Clinician View

Switch to Traveler View

(/travel/destinations/traveler/pregnant/india)

Vaccines and Medicines

Prepare travelers to India with recommendations for vaccines and medications.

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Recommendations Routine vaccines Hepatitis A Recommended for all travelers Recommended for most

Transmission varied Immunization schedules

Guidance
(http://www.cdc.gov/vaccines/schedules/hcp/index.html)

(/travel/yellowbook/2012/chapter- travelers, including those with 3-infectious-diseases-related-to"standard" itineraries and travel/hepatitis-a) accommodations

Fecal-oral route Hepatitis A (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3(contaminated infectious-diseases-related-to-travel/hepatitis-a.htm) (Yellow Book) food and water) Dosing info (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3infectious-diseases-related-to-travel/hepatitis-a.htm#1933) Person-toperson contact

Hepatitis B

(/travel/yellowbook/2012/chapter- recommended for those who 3-infectious-diseases-related-tomight be exposed to blood or travel/hepatitis-b) other body fluids, have sexual

Consider for most travelers;

Contact with Hepatitis B (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3blood and other infectious-diseases-related-to-travel/hepatitis-b.htm) (Yellow Book) body fluids: Dosing info (Twinrix) (/travel/yellowbook/2012/chapter-3-infectiousUnprotected diseases-related-to-travel/hepatitis-a#1935) contact with the local sex population, or be exposed Injection through medical treatment (e.g., drug use for an accident). Contaminated transfusions Exposure to human blood Contaminated tattoo and piercing equipment

Japanese Encephalitis

(/travel/yellowbook/2012/chapter- groups: mosquitoes 3-infectious-diseases-related-to(primarily Long-term travelers (i.e. trips Culex) travel/japanese-encephalitis)

Recommended for the following

Bite of infected

Japanese encephalitis (/travel/yellowbook/2012/chapter-3-infectiousdiseases-related-to-travel/japanese-encephalitis.htm) (Yellow Book) Japanese Encephalitis Vaccine for US Children
(http://www.cdc.gov/japaneseencephalitis/vaccine/vaccineChildren.html)

lasting a month or more) to endemic areas during Japanese encephalitis virus transmission season. Consider for the following groups: Short-term (<1 month) travelers to endemic areas during Japanese encephalitis virus transmission season if

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their itinerary or activities will increase their risk (e.g. spending substantial time outdoors in rural or agricultural areas; staying in accommodations without air conditioning, screens, or bed nets.) Travelers to an area with an ongoing outbreak of Japanese encephalitis. Travelers to endemic areas who are uncertain of specific activities or duration of travel. Malaria
(/travel/yellowbook/2012/chapter- travelers to malaria risk areas mosquito 3-infectious-diseases-related-to(/travel/yellowbook/2014/chapter- (female travel/malaria) 3-infectious-diseases-related-toAnopheles) travel/travel-vaccines-and-malariainformation-bycountry/india.htm#seldyfm533)

Antimalarials recommended for

Bite of infected

Malaria (/travel/yellowbook/2014/chapter-3-infectious-diseasesrelated-to-travel/malaria) (Yellow Book) Considerations when choosing a drug for malaria prophylaxis
(/travel/yellowbook/2014/chapter-3-infectious-diseases-related-totravel/malaria#3938) (Yellow Boook)

Rabies

(/travel/yellowbook/2012/chapter- groups: 3-infectious-diseases-related-toTravelers involved in outdoor travel/rabies)

Recommended for the following

and other activities that might bring them into direct contact with dogs, bats, and other mammals (such as campers, hikers, bikers, adventure travelers, and cavers). Those with occupational risks (such as veterinarians, wildlife professionals, researchers). Long-term travelers and expatriates. Children, because they are considered at higher risk; consider lower threshold for vaccination. Recommended for most travelers, especially those who are staying with friends or relatives; visiting smaller cities, villages, or rural areas where exposure might occur through food or water; or prone to "adventurous eating"

Mammal bites Rabies (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3(including dogs, infectious-diseases-related-to-travel/rabies.htm) (Yellow Book) bats, other carnivores)

Typhoid
(/travel/yellowbook/2012/chapter3-infectious-diseases-related-totravel/typhoid-and-paratyphoidfever)

Fecal-oral route Typhoid (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3(contaminated infectious-diseases-related-to-travel/typhoid-and-paratyphoid-fever.htm) food and water) (Yellow Book) Dosing info (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3infectious-diseases-related-to-travel/typhoid-and-paratyphoidfever.htm#1947) (Yellow Book)

Yellow Fever

(/travel/yellowbook/2012/chapter- months old) arriving by air or 3-infectious-diseases-related-tosea without a certificate is travel/yellow-fever) detained in isolation for up to 6

Any traveler (except infants <9

Bite of infected mosquitoes

Yellow Fever (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter3-infectious-diseases-related-to-travel/yellow-fever.htm) (Yellow Book)

days if that person

1) arrives within 6 days of departure from an area with risk of YFV transmission, 2) has been in such an area in transit (except those passengers and members of flight crews who, while in transit through an airport in an area with risk of YFV transmission, remained in the airport during their entire stay and the health officer agrees to such an exemption), 3) arrives on a ship that started from or touched at any port in an area with risk of YFV transmission up to 30 days before its arrival in India, unless such a ship has been disinsected in accordance with the procedure recommended by WHO, or 4) arrives on an aircraft that has been in an area with risk of YFV transmission and has not been disinsected in accordance with
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the Indian Aircraft Public Health Rules, 1954, or as recommended by WHO. The following are regarded as countries and areas with risk of YFV transmission: Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Cte dIvoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, The Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, Sudan, Togo, and Uganda. Americas: Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Peru, Suriname, Trinidad and Tobago, and Venezuela. Note: When a case of yellow fever is reported from any country, that country is regarded by the government of India as a country with risk of yellow fever transmission and is added to the above list.

Non-Vaccine-Preventable Diseases

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The following diseases are possible risks your patients may face when traveling in India. This list is based on our best available surveillance data and risk assessment information at the time of posting. It is not a complete list of diseases that may be present in a destination. Risks may vary within different areas of a destination.

Guidance

Patient Eduction

Notes

Vectorborne
Chikungunya
(/travel/yellowbook/2012/chapter-3-infectiousdiseases-related-to-travel/chikungunya.htm) (CDC

Chikungunya

Yellow Book) Chikungunya Fever Map

(/travel/diseases/chikungunya- day and night, both indoors and outdoors, and often fever) live around buildings (/travel/page/avoid-bug-bites)

Chikungunya

Mosquitoes carrying chikungunya bite during the

Avoid Bug Bites

(http://www.cdc.gov/chikungunya/) (http://www.cdc.gov/chikungunya/map/index.html)

Dengue

Dengue (/travel/yellowbook/2012/chapter-3infectious-diseases-related-to-travel/dengue-feverand-dengue-hemorrhagic-fever.htm) (CDC Yellow Book) Dengue (http://www.cdc.gov/Dengue/) Western Hemisphere Map

(/travel/diseases/dengue-fever) other vectorborne diseases (/travel/page/avoid-bug-bites)

Dengue

More risk in urban and residential areas than for

Avoid Bug Bites

Leading cause of febrile illness among travelers returning from the Caribbean, South America, and South and Southeast Asia

(/travel/yellowbook/2012/chapter-3-infectiousdiseases-related-to-travel/dengue-fever-and-denguehemorrhagic-fever.htm#2332) (/travel/yellowbook/2012/chapter-3-infectiousdiseases-related-to-travel/dengue-fever-and-denguehemorrhagic-fever.htm#2333) (http://www.healthmap.org/dengue/index.php) (http://www.cdc.gov/Other/disclaimer.html)

Eastern Hemisphere Map

DengueMap

(interactive map)

Airborne & Droplet

H5N1 Avian Influenza Highly Pathogenic Avian Influenza A (H5N1) in People (http://www.cdc.gov/flu/avianflu/h5n1people.htm) (/travel/diseases/avian-birdflu)

Avian Flu

Endemic among poultry in India

Influenza (/travel/yellowbook/2012/chapter-3infectious-diseases-related-to-travel/influenzaseasonal-zoonotic-and-pandemic.htm) (CDC Yellow Book) Tuberculosis (TB) Tuberculosis wwwnc.cdc.gov/travel/destinations/clinician/pregnant/india Tuberculosis Risk generally low for most tourist travelers

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Health Information for Travelers to India - Clinician view | Travelers' Health | CDC Tuberculosis Risk generally low for most tourist travelers (/travel/yellowbook/2012/chapter-3-infectious(/travel/diseases/tuberculosis) High burden of MDR TB in India diseases-related-to-travel/tuberculosis.htm) (CDC Those anticipating possible prolonged exposure Yellow Book) to TB environments (such as working in hospitals, Tuberculosis (http://www.cdc.gov/tb/) prisons, or homeless shelters) or those who stay for years in an endemic country should have a 2-step Map (/travel/yellowbook/2012/chapter-3tuberculin skin test (TST) or a single interferon- infectious-diseases-related-torelease assay (IGRA) before leaving the US. If travel/tuberculosis.htm#2805) predeparture test is negative, a single TST or IGRA Multidrug resistant (MDR) TB (map should be repeated 810 weeks upon return.

Tuberculosis

(/travel/yellowbook/2012/chapter-3-infectiousdiseases-related-to-travel/tuberculosis.htm#2806) )

Patient Counseling
Counsel your patients on actions they can take on their trip to stay healthy and safe.

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Safe Food and Water

Counsel travelers to be diligent about food and water precautions: Avoid cooked food served at room temperature. Avoid raw food, including raw vegetables unless they can be washed thoroughly. Drink only beverages from sealed bottles or cans. Water is safe if it has been boiled or chemically treated. Avoid ice unless made from bottled/disinfected water. Consider prescribing an antibiotic for self-treatment of travelers diarrhea, factoring in resistance issues at the destination.

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Additional Resources Food & Water Precautions (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/food-and-water-precautions.htm) (YB) Water Disinfection for Travelers (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/water-disinfection-for-travelers.htm) (YB) Food Poisoning from Marine Toxins (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/food-poisoning-from-marinetoxins.htm) (YB) Travelers Diarrhea (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/travelers-diarrhea.htm) (YB) Persistent Travelers Diarrhea (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-5-post-travel-evaluation/persistent-travelers-diarrhea.htm) (YB)

Information for travelers who are pregnant

Foodborne and waterborne illness (toxoplasmosis, listeriosis, hepatitis E) may have serious sequelae in pregnant women, so urge adherence with food and water precautions. T reating T rav elers Diarrhea Compounds containing bismuth subsalicylate (including Pepto-Bismol and Kaopectate) are contraindicated in pregnant women. Oral rehydration is the mainstay of therapy. Loperamide should be used only when necessary. Antibiotic treatment of travelers diarrhea during pregnancy can be complicated. Azithromycin or an oral third-generation cephalosporin may be the best options, if an antibiotic is needed. Additional Resources Pregnant Travelers (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-8-advising-travelers-with-specific-needs/pregnant-travelers.htm) (YB)
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Insect Avoidance
Counsel travelers to be diligent in insect precautions:

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Cover exposed skin. Use an appropriate insect repellent. (see below) Use permethrin-treated (http://npic.orst.edu/pest/mosquito/ptc.html) (http://www.cdc.gov/Other/disclaimer.html) clothing and gear (such as boots, pants, socks, and tents). Travelers can buy pre-treated clothing and gear or treat them at home. Treated clothing remains protective after multiple washings. Permethrin should NOT be used directly on skin. Stay and sleep under in air-conditioned or screened rooms. Use a bed net if sleeping area is exposed to the outdoors. More I nformation on I nsect Repellents DEET (concentration of 20% or more) is the only insect repellent shown to be effective against ticks. However, several EPA-registered active ingredients provide reasonably long-lasting protection against mosquitoes: DEET (chemical name: N,N-diethyl-m-toluamide or N,N-diethyl-3-methyl-benzamide): Concentrations above 50% show no additional protective benefit. Picaridin (KBR 3023 [Bayrepel] and icaridin outside the United States; chemical name: 2-(2-hydroxyethyl)-1-piperidinecarboxylic acid 1methylpropyl ester): Must be reapplied more often than DEET. Oil of lemon eucalyptus (OLE) or PMD (chemical name: para-menthane-3,8-diol), the synthesized version of OLE. Pure oil of lemon eucalyptus (essential oil) is not the same product; it has not undergone similar testing for safety and efficacy, is not registered with EPA as an insect repellent, and is not covered by this recommendation. IR3535 (chemical name: 3-[N-butyl-N-acetyl]-aminopropionic acid, ethyl ester). Products with <10% active ingredient may offer only limited protection (12 hours). Encourage patients to use repellents and reapply only as instructed. If sunscreen is also needed, they should apply sunscreen first and repellent second. Encourage them to follow package directions for using repellent on children (http://www.fda.gov/Drugs/EmergencyPreparedness/ucm085277.htm)
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(http://www.cdc.gov/Other/disclaimer.html) and avoid applying to their hands, eyes, and mouth.

For more detailed information, visit the Yellow Book: Protection against Mosquitoes, Ticks, & Other Insects & Arthropods Additional Resources

(/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/protection-against-mosquitoes-ticks-and-other-insects-and-arthropods.htm)

Using Insect Repellents Safely (EPA) (http://epa.gov/pesticides/insect/safe.htm) (http://www.cdc.gov/Other/disclaimer.html) Insect Repellent Use and Safety (CDC) (http://www.cdc.gov/ncidod/dvbid/westnile/qa/insect_repellent.htm) National Pesticide Information Center (http://npic.orst.edu/index.html) (http://www.cdc.gov/Other/disclaimer.html) In addition to malaria, dengue (http://travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/dengue-fever-and-dengue-hemorrhagic-fever.htm) (http://www.cdc.gov/Other/disclaimer.html) , filariasis (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/filariasislymphatic.htm) , Japanese encephalitis (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/japanese-encephalitis.htm) , and leishmaniasis (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/leishmaniasis-cutaneous.htm) can be contracted by insect bites while in India. Advise travelers to follow the insect avoidance measures described above to prevent these illnesses.

Information for travelers who are pregnant

EPA does not recommend any additional precautions for using registered repellents on pregnant or lactating women. Counsel pregnant travelers to observe routine precautions while using insect repellents.
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Outdoor Safety

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Advise travelers to exercise caution during outdoor activities. Important tips include dressing appropriately for the climate (such as loose, lightweight clothing in hot climates and warm layers in cold climates), staying hydrated, avoiding overexposure to the sun, and practicing safe swimming habits. To avoid infection while swimming, travelers should not swallow water when swimming and avoid contact with water that may be contaminated from poor sanitation. Encourage travelers to learn basic first aid and CPR before travel, especially if they will be traveling to remote areas where medical assistance may not be accessible. Help them assemble a travel health kit (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/travel-healthkits.htm) . Additional Resources: Sunburn (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/sunburn.htm) Problems with Heat & Cold (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/problems-with-heat-and-cold.htm) Schistosomiasis and leptospirosis are endemic in India. Travelers should avoid swimming in fresh, unchlorinated water, such as lakes, ponds, or rivers. Additional Resources Map 3-14. Geographic distribution of schistosomiasis (/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/schistosomiasis.htm#2696) Schistosomiasis (/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/schistosomiasis.htm) Leptospirosis (/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/leptospirosis.htm)
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Animal Avoidance
Counsel travelers to be cautious around all animals.

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Travelers should avoid touching, petting, handling, or feeding animals, including pets. Arthropods such as spiders and scorpions can pose a stinging risk, and travelers should exercise care in environments where these creatures are likely to be present. Stress the urgency of treating suspected and probable rabies infection by: Washing the wound immediately with soap and clean water. Seeking medical attention as soon as possible. Travelers at risk for rabies should consider medical evacuation insurance, since postexposure prophylaxis may not be available at the destination. Additional Resources Animal-Associated Hazards (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/animal-associated-hazards.htm) (YB) Rabies (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/rabies.htm) (YB) Criteria for Preexposure Immunization for Rabies (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/rabies.htm) (YB) Protection against Mosquitoes, Ticks, & Other Insects & Arthropods (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travelconsultation/protection-against-mosquitoes-ticks-and-other-insects-and-arthropods.htm) (YB)

Information for travelers who are pregnant

If needed, preexposure and postexposure prophylaxis for rabies are not altered by pregnancy.
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Hygiene
People who are ill should not travel. Urge travelers to practice hand hygiene and sneeze into a tissue or their sleeve.

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Body Fluids
Counsel travelers on the risks of diseases associated with the exchange of saliva, blood, vomit, semen, urine, and feces. Travelers should:

Use a latex condom correctly every time they engage in sex (vaginal, anal, and oral-genital). Not inject drugs. Limit alcohol consumption. Not have tattoos, piercings, or other procedures that use needles (acupuncture) unless the needles are packaged new or sterilized. Ensure that medical and dental equipment is sterile or disinfected if seeking care. Additional Resources: HIV & AIDS (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/hiv-and-aids.htm) (YB) Hepatitis B (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/hepatitis-b.htm) (YB) Hepatitis C (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/hepatitis-c.htm) (YB) Medical Tourism (http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/medical-tourism.htm) (YB)
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Medical Care Abroad

Travelers should plan for how to obtain health care during their trip, should the need arise.

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Discuss supplemental travel health insurance and medical evacuation insurance, and consider helping the traveler obtain an extra month of prescriptions for any needed medications. Travelers may think they can find cheaper antimalarial drugs at their destination. To ensure medication quality, urge them to have their prescriptions filled in the United States.

Information for travelers who are pregnant

Counsel pregnant travelers on the following: Determine beforehand whether blood is routinely screened for HIV and hepatitis B and C at their destination (http://www.who.int/bloodsafety/global_database/en/) (http://www.cdc.gov/Other/disclaimer.html) . Pregnant travelers should consider the safety of blood transfusions, if needed, when making plans for international travel. The pregnant traveler should also be advised to know her blood type. Research the prevalence of tuberculosis (TB) at the patients destination, along with her planned itinerary. If exposure to TB will be a risk, she should receive skin testing before and after travel.
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Safe Transportation
Motor vehicle crashes are the #1 killer of healthy US citizens in foreign countries.

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Most recommendations for safe transportation are basic and could be considered common sense. However, travelers often do not think about the importance of being aware and careful when walking, riding, driving, or flying. In many places cars, buses, large trucks, rickshaws, bikes, pedestrians, and even animals share the same lanes of traffic, increasing the risk for crashes. Counsel travelers to think about transportation options before they arrive, especially if they will be driving in India. Medical Ev acuation I nsurance If your patient is seriously injured, emergency care may not be available or may not meet US standards. Trauma care centers are uncommon outside urban areas. Encourage patients to purchase medical evacuation insurance (http://travel.state.gov/travel/cis_pa_tw/cis/cis_1470.html) (http://www.cdc.gov/Other/disclaimer.html) . Some basic reminders to review with your patients: Choose safe vehicles and avoid motorbikes when possible. Wear a seatbelt or a helmet at all times. Do not drive after drinking alcohol or ride with someone who has been drinking. Avoid driving at night; street lighting in certain parts of India may be poor. If they will be driving, remind them to get any driving permits and insurance they may need. It is recommended to get an International Driving Permit (IDP). Avoid using local, unscheduled aircraft, and fly on larger planes (more than 30 seats) when possible. Helpful Resources Road Safety Overseas (http://travel.state.gov/travel/tips/safety/safety_1179.html) (http://www.cdc.gov/Other/disclaimer.html) (Information from the US Department of State): Includes tips on driving in other countries, International Driving Permits, Auto Insurance, and other resources. The Association for International Road Travel (http://www.asirt.org) (http://www.cdc.gov/Other/disclaimer.html) has country-specific Road Travel Reports (http://www.asirt.org/KnowBeforeYouGo/CountryRoadTravelReports/tabid/171/Default.aspx) (http://www.cdc.gov/Other/disclaimer.html) available for most countries for a minimal fee. Encourage your patients to look up the information provided by the US Department of State for the Traffic Safety and Road Conditions for India (http://travel.state.gov/travel/cis_pa_tw/cis/cis_1139.html#traffic_safety) (http://www.cdc.gov/Other/disclaimer.html) . Remind your patients that traffic flows on the left side of the road in India. Encourage them to pay close attention to the flow of traffic, especially when crossing the street.

Information for travelers who are pregnant

If your pregnant patient has any placental abnormalities or risks for premature labor, you should recommend that she avoid any air travel.
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Review the following general transportation tips with your pregnant patient for her safety and comfort. She should fasten seatbelts at the pelvic area, not across the lower abdomen. Lap and shoulder restraints are best. If she is in a crash, even a minor one, recommend that she consult a physician to determine that the fetus has not been injured. Recommend that she check with her airline about their policies and any paperwork they require for traveling while pregnant. Recommend she walk every half hour during a smooth flight and flex and extend ankles frequently to prevent swelling. Encourage her to drink plenty of fluids during flights.
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Personal Security
Travelers should be reminded on how to protect their personal safety during travel, regardless of their destination.

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The US Department of State has an extensive website (http://travel.state.gov/travel/tips/tips_1232.html#safe_trip) (http://www.cdc.gov/Other/disclaimer.html) with safety information for international travelers, travel alerts and warnings, and country-specific information. Travelers should be directed to the Department of State resources for information and tips on safe travel. Stay abreast of current events, particularly those that could pose a safety or health problem for travelers. You can also receive updates on new travel alerts and warnings from the US Department of State by subscribing to their RSS feeds (http://travel.state.gov/news/news_3162.html) (http://www.cdc.gov/Other/disclaimer.html) .
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Healthy Travel Packing List

Remind your patients to pack health and safety items.

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Medicines and Medical Supplies

Prescription medicines you take for existing conditions Medicines you take regularly and copies of your prescriptions Medical supplies you use for existing conditions Examples: Eyeglasses and contacts with copies of your prescription for glasses/contacts. Consider packing spare glasses and contacts in case yours are damaged. Needles or syringes, such as for diabetes. (Requires a letter from your doctor on letterhead stationery.) Insulin supplies Inhalers Epinephrine auto-injectors (EpiPens) Medical alert bracelet Special prescriptions for the trip Ask your doctor about taking special medicines or supplies: Antibiotic for travelers' diarrhea (/travel/page/travelers-diarrhea) Commercial suture/syringe kit to be used by local health care provider (requires letter from your doctor on letterhead stationery) Medicine to prevent altitude sickness Medicines to prevent malaria, if appropriate Over-the-counter medicines Examples: Antacid Diarrhea medicine (http://wwwnc.cdc.gov/travel/page/travelers-diarrhea) (for example, loperamide [Imodium] or bismuth subsalicylate [PeptoBismol]) Antihistamine Motion sickness medicine Cough drops Cough suppressant/expectorant Decongestant Medicine for pain and fever (such as acetaminophen, aspirin, or ibuprofen) Mild laxative Mild sedative or other sleep aid Saline nose spray

Supplies to prevent illness or injury

Hand sanitizer or wipes Alcohol-based hand sanitizer containing at least 60% alcohol or antibacterial hand wipes Insect repellent Select an insect repellent based on CDC recommendations: Avoid Bug Bites (http://wwwnc.cdc.gov/travel/page/avoid-bug-bites) Permethrin Permethrine is insect repellent for clothing. It may be needed if you spend a lot of time outdoors. Clothing can also be treated at home in advance. Bed net For protection against insect bites while sleeping Sunscreen (SPF 15 or greater) with UVA and UVB protection. See Sun Exposure (http://wwwnc.cdc.gov/travel/page/sun-exposure) . Sunglasses and wide brim hat Wear for additional sun protection Safety equipment Examples: child safety seats, bicycle helmets
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Earplugs Water purification tablets See CDC recommendations: Water Disinfection (/travel/page/water-disinfection) . Latex condoms

First-Aid Kit
First aid creams or gels 1% hydrocortisone cream Antifungal and antibacterial ointments or creams Antiseptic wound cleanser Aloe gel for sunburns Insect bite treatment (anti-itch gel or cream) Bandages and blister care Bandages (multiple sizes), gauze, and adhesive tape Moleskin or molefoam for blisters Elastic bandage wrap Elastic/compression bandage wrap for sprains and strains Equipment Disposable gloves Digital thermometer Scissors and safety pins Cotton swabs (Q-Tips) Tweezers Eye drops Oral rehydration salts

Documents
Health insurance documents Health insurance card (your regular plan and/or supplemental travel health insurance plan) and copies of claim forms Proof of yellow fever vaccination If required for your trip, take your completed International Certificate of Vaccination or Prophylaxis card or medical waiver Copies of all prescriptions Make sure prescriptions include generic names. (Bring prescriptions for medicines, eye glasses/contacts, and other medical supplies). Contact card Carry a contact card containing the street addresses, phone numbers, and e-mail addresses of the following: Family member or close contact remaining in the United States Health care provider(s) at home Lodging at your destination Area hospitals or clinics, including emergency services U.S. embassy or consulate in the destination country or countries

Travel Health Notices

There are no notices currently in effect for India.

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Advising Returning Travelers

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Although some illnesses may begin during travel, others may occur weeks, months, or even years after return. A history of travel, particularly within the previous 6 months, should be part of the routine medical history for every ill patient. A newly returned, ill international traveler should be preferentially evaluated by a physician versed in travel-related illness. Here are two professional medical organizations that provide directories of travel clinics throughout the United States: American Society of Tropical Medicine and Hygiene (ASTMH) (http://www.astmh.org/source/ClinicalDirectory/)
(http://www.cdc.gov/Other/disclaimer.html)

International Society of Travel Medicine (ISTM) (http://www.istm.org/WebForms/SearchClinics/Default.aspx?SearchType=Advanced)

(http://www.cdc.gov/Other/disclaimer.html)

Malaria is always a serious disease and may be a deadly illness. Any patient presenting with a fever after traveling in a malaria-risk area during the last year should be evaluated immediately using the appropriate diagnostic tests for malaria (http://www.cdc.gov/malaria/diagnosis_treatment/index.html) . Malaria, especially P. falciparum, requires urgent intervention as clinical deterioration can occur rapidly and unpredictably. For more information on advising patients after international travel, see Yellow Book Chapter 5: Post-Travel Evaluation. (/travel/yellowbook/2012/tableof-contents.htm#26)

Map Disclaimer - The boundaries and names shown and the designations used on maps do not imply the expression of any opinion whatsoever on the part of the Centers for Disease Control and Prevention concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Approximate border lines for which there may not yet be full agreement are generally marked.
Pa g e la st u pda t ed: A u g u st 1 6 , 2 0 1 3 Con t en t sou r ce: Cen t er s for Disea se Con t r ol a n d Pr ev en t ion Na t ion a l Cen t er for Em er g in g a n d Zoon ot ic In fect iou s Disea ses (NCEZID) Div ision of Globa l Mig r a t ion a n d Qu a r a n t in e (DGMQ)

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Centers for Disease Control and Prev ention 1 600 Clifton Rd. Atlanta, GA 30333, USA 800-CDC-INFO (800-232-4636) TTY : (888) 232-6348 - Contact CDCINFO

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