In 1996 a man from Tennessee came back from a trip to South America and died of yellow fever. Although he was advised to receive the yellow fever vaccine, he chose not to get it. The decision cost him his life.

Because unusual infectious diseases, such as typhoid, yellow fever or cholera rarely or never occur in the United States, we don't often think about them. However, in some parts of the world, these diseases are common and often fatal.

When traveling, protect yourself and your family by considering the following four-step plan:

Step 1: Consult resources on disease risks and vaccines available for international travel

Resources available include travel clinics, doctors, travel agencies, airlines, cruise lines, missionary organizations, and academic institutions. The following is a list of organizations that provide up-to-date information on disease risks (and the necessity of vaccines) based on where you are traveling:

• The Centers for Disease Control and Prevention (CDC) maintains a website that contains a wealth of information on the diseases that are likely to be encountered on your trip and the best ways to prevent or avoid them. 
• A directory of travel clinics in the United States is provided on the websites of two professional organizations: the International Society of Travel Medicine and the American Society of Tropical Medicine and Hygiene.
• Information about the prevalence of various diseases throughout the world is provided by the World Health Organization (WHO).

Step 2: Prepare for the possibility of vaccines at least eight weeks before leaving

In most developed countries such as Japan, Canada, Australia, New Zealand and Western Europe, the risk of various infectious diseases is the same as that in the United States. However, various vaccines, as well as preventive measures against diseases such as malaria, must be considered when traveling to developing countries or regions, such as Africa, South America, Asia, the Mediterranean Basin, Mexico, the Caribbean, Central America or Oceania.

Prepare for the health risks that you may encounter on your trip at least eight weeks before you leave. Some vaccines require more than one dose to be effective, and all vaccines require several weeks before they are fully effective.

Step 3: Know the five vaccines recommended before traveling to developing countries

Five vaccines are often recommended for travel to developing countries: hepatitis A, cholera, typhoid, yellow fever and Japanese encephalitis. For more information on specific vaccines, see the website section, "Vaccine and Diseases."

The five vaccines can be divided into two groups.

• The first group consists of hepatitis A virus, cholera and typhoid. All these infections are transmitted by contaminated food or contaminated water. Two of these diseases, cholera and typhoid, can be avoided by staying in standard tourist accommodations and drinking only bottled or boiled water and avoiding uncooked meat, unpeeled fruits, shellfish, beverages with ice, salads and food from street vendors. However, hepatitis A virus is so prevalent, and so easily transmitted, that even standard tourist accommodations and careful avoidance of various foods and beverages may not protect against infection. The hepatitis A vaccine is recommended for all children in the U.S. beginning at 1 year of age. If your child did not receive this vaccine yet, be sure they get at least one dose prior to traveling. This vaccine is also recommended for adults who wish to avoid hepatitis A infection.
• The second group consists of yellow fever and Japanese encephalitis virus. Both diseases are transmitted by the bite of a mosquito. The yellow fever vaccine has a very low rate of side effects and is required or recommended for entry into several countries. Japanese Encephalitis can typically be avoided by not engaging in high-risk activities. Newer Japanese Encephalitis virus vaccines have a much lower rate of side effects than previous versions. Recommendations for use depend on an individual’s age and travel plans.

Step 4: Consider other vaccines

You should also consider the meningococcal vaccine and, depending on where and when you are traveling, the rabies vaccine.

All routinely recommended vaccines including DTaP or Tdap, measles, mumps and rubella (MMR), varicella (chickenpox), Haemophilus influenzae type b (Hib), polio, hepatitis B, hepatitis A, rotavirus, influenza, COVID-19 and pneumococcus should be up to date. Preferably at least two doses of vaccines that require more than one dose should be given prior to travel.

Download our Q&A, "Infectious Diseases and Travel," for more information.

Other considerations for travel

Travel notices

Checking travel notices is one way to stay safe and healthy during your trip. Travel notices inform travelers and healthcare professionals about local health issues related to specific destinations. These issues could arise from disease outbreaks (Ebola), special events (the Olympics), natural disasters (earthquakes) or other conditions that may affect travelers’ health, well-being and safety. Be sure to check the CDC’s travel health notices webpage before leaving for any international trip. Travel notices are categorized in three levels:

• Level 1: Watch — This is a reminder for the traveler to practice usual precautions for the specific destination, such as being up to date on all recommended vaccines, as well as any travel vaccines outlined for your specific destination; and practicing good travel health behaviors, like eating food that is cooked and served hot, drinking sealed, bottled water and beverages and choosing safe modes of transportation. Level 1 notices have limited impact on the traveler as risk caused by the specified event or outbreak is only slightly elevated.
• Level 2: Alert — Enhanced precautions are recommended under this notice as a result of an increased risk either in defined settings or for those with specific risk factors. Enhanced precautions might include actions like receiving a travel vaccine that isn’t normally recommended for that destination, avoiding the most congested or populated areas of your destination, or adhering to strict hygiene practices.
• Level 3: Warning — A Level 3 notice means a high risk exists for travelers who may either become ill or experience conditions not suitable for supporting travelers. In these scenarios, travelers are typically recommended to avoid all non-essential travel to this destination.

Prescription medicines

If you take prescription medicines on a regular basis, it’s important to make sure you have an adequate supply for the duration of your trip. These medications should be packed in carry-on luggage to prevent them from being lost. Travelers who have severe allergies are also recommended to pack their epinephrine auto-injector in case of emergency. If any of the medications are injectable or considered to be controlled substances, travelers should consider having their doctor write a letter identifying their need to use these medicines.

Other ways to stay healthy

We all know it’s important to pack the right clothes for your travel destination, both according to the weather and any special activities you might be doing while there, such as hiking or swimming. But travelers should also pack a travel health kit that includes basic first-aid supplies, insect repellant and sunscreen. It is also a good idea to carry your health insurance card as well as the names and phone numbers for your family members’ healthcare providers.