The
natural, inalienable rights and legal rights of the citizenry to
be accurately informed must not, by corruption, be perverted,
lest that citizenry, acting on such perversion in their daily
judgments, certainly suffer to their physical and spiritual
detriment.™
Wherever your travels take you this spring break, stay healthy and safe with these tips from CDC Travelers' Health.
Before Your International Adventure: Find out what health advice,vaccines,
and medicines are needed at yourdestination,and
plan a visit with your doctor at least before you leave.Pack
smartand prepare a travel health kit.Consider
additional insurancethat covers medical care and emergency evacuation.
During Your Break:
Choose safe transportation. Always wear a seat belt, and ride only in marked taxis or ride-sharing
vehicles. Be alert when crossing the street, especially in countries where people drive on the left.
Be careful when indulging in the local cuisine. In developing countries, eat only food that has
been fully cooked and served hot. Don’t eat fresh vegetables or fruits unless you can peel them yourself.
Drink only bottled, sealed beverages, and avoid ice. Remember, the alcohol content of beer, wine, and mixed
drinks aren't high enough to kill the viruses and bacteria that can cause diarrhea.
Wear sunscreenwith SPF 15 or higher when outdoors. Apply sunscreen first, then insect
repellent.
Prevent bug bites. Use insect repellent to protect against diseases spread by mosquitoes, such as
Zika and dengue. Also, takemedicationto
protect against malaria.
Feeling Ill after Your Trip?Call
your doctorand tell them where you’ve recently traveled, including where you went and
what you did on your trip. If you need help finding a travel medicine specialist,find
a clinic here.
Change in Treatment:Starting April 1, 2019, clinicians treating
patients with severe malaria should call CDC to obtain IV artesunate, available through an expanded access
investigational new drug protocol.
There are approximately 300 cases of severe malaria in the United States each year, most acquired from travel
to countries with malaria. Severe malaria is treated with intravenous (IV) antimalarial medications. Beginning
April 1, 2019, the only US Food and Drug Administration (FDA)-approved IV antimalarial in the United States
(quinidine) will no longer be available. When IV quinidine is no longer available, CDC will
make another IV treatment (artesunate) available for severe malaria. IV artesunate is neither FDA-approved nor
commercially available for hospitals to purchase and keep in stock (additional
information).
How to Counsel Your Patient:Prevention is critical. Patients traveling todestinationswhere
there is risk for malaria should use specific malaria prevention interventions. Often this includesavoiding
mosquito bitesthrough insect repellents or insecticide treated bed nets and specificmedicines
to prevent malaria(chemoprophylaxis).
Zika Travel Update
Change in Travel Guidance:CDC has updated itsZika
travel guidancefor pregnant women and couples who may want to become pregnant.
Many areas of the world continue to have Zika transmission, and some areas have outbreaks of Zika. Other areas
have confirmed Zika in the past, and we may not know if they have current cases.
CDC collaborated with the World Health Organization and the European Centre for Disease Prevention and Control
to review current scientific data available on Zika virus transmission and disease for every country of the
world. This review showed that the spread of Zika is no longer at the same high levels seen during the main
outbreak period in the Americas during 2015 to 2017. As a result, CDC updated its Zika travel guidance.
How to Counsel Your Patient:For countries with current or past transmission but
no current outbreak (purple countries on the map), CDC no longer recommends that pregnant women avoid travel.Instead,
discuss travel plans with your pregnant patients. Talk with them about the risks and consequences of possible
Zika infection and their willingness to accept that risk if they choose to travel.CDC’s
recommendation that pregnant women not travel to areas where a Zika outbreak is occurring has not changed.
Weight Loss Surgery Infections in Mexico
CDC continues to investigate an ongoing outbreak of multidrug-resistantPseudomonas
aeruginosainfections in patients who had surgery at Grand View Hospital in Tijuana, Mexico, on or
after August 1, 2018, including some who had surgery in 2019. To date, CDC has identified 18 patients who
developed infections. ACDC
Level 2 Travel Alertadvising against surgery at Grand View Hospital remains in effect.
Mexican health officials identified poor infection control practices at Grand View Hospital, including failure
to follow recommended practices for assuring the quality of sterilization of medical devices and instruments.
These actions might put patients at risk for bacterial infections, such asPseudomonas
aeruginosa, and for infection with bloodborne viruses such as hepatitis B, hepatitis C, and HIV.
CDC recommends that clinicians evaluating patients who had invasive procedures in Tijuana, Mexico,
send any carbapenem-resistant organisms for carbapenemase testing and report these infections to their state
or local health department. Carbapenemase testing is available free of charge through theAntibiotic
Resistance Laboratory Network.Clinicians should discuss bloodborne pathogen testing with all
patients who had invasive procedures at Grand View Hospital on or after August 1, 2018. Visit CDC’soutbreak
websitefor additional information.
Free CE: Drug-ResistantSalmonellaTyphi in Travelers
Join CDC’s COCA call on the recentMMWR:The
Emergence of Extensively Drug-Resistant Salmonella enterica serotype Typhi in Travelers.
Authors include our own Dr. Kristina Angelo, travel medicine specialist, & Dr. Allison Taylor Walker, senior
epidemiologist.
Tuesday, March 19th, 2-3 pm EST. FREE continuing education credit will be offered.
WASHINGTON – As March signals the beginning of and Spring Break vacations to warmer destinations like the Bahamas (Nassau
and Freeport), Aruba, and Bermuda, CBP Preclearance locations in these countries encourages travelers to ‘Know Before You
Go. U...
Enjoy your travels this spring break by practicing healthy contact
lens wear and care habits. Educate yourself and others on how toprotect
your eyesand don’t let an eye infection get in the way of your next vacation.
You can avoid an eye infection and have a safe getaway by following
these important tips:
Wash your hands with soap and water before
touching your contact lenses.
Always take out your contact lenses before
taking a nap or going to sleep overnight, unless your eye care provider says otherwise.
Bring enough contact lens supplies and a pair
of glasses with you in case you need them.
Avoid swimming or showering while wearing
contact lenses
Clean and store your contact lenses by
dumping old solution and using new solution every time.
Note: When signing export certificates for
countries, if there are questions regarding the avian
influenza statement on the certificate please call FSIS at
(202) 720-0082 or (855) 444-9904 for clarification. FSIS
continues to strongly encourage exporters to work closely with
importers to ensure the existence of a valid import permit for
product in the country of destination.
If a country is not listed, it should be assumed that nothing
is known about that country's import requirements, and FSIS
will issue the FSIS Form 9060-5, Meat and Poultry Export
Certificate of Wholesomeness, without any additional
information provided in the "Remarks" section. For a country
that is not listed, exporters are advised to work closely with
the importer for information regarding eligibility of the
product, certification requirements, and the existence of a
valid import permit for the product.
Siluriformes (catfish) Export Eligibility* Siluriformes (catfish) derived fresh, frozen, and
processed products are eligible for export by following the
same policy for exporting meat and poultry products when a
country or FSIS amenable product is not listed in the export
library. After performing re-inspection of the product, FSIS
inspection program personnel will issue the FSIS Form 9060-5S,
Siluriformes Fish and Fish Products Export Certificate of
Wholesomeness, to the exporter without any additional
information provided in the “Remarks” section. Visit the
specific country’s export library page to obtain the most
up-to-date information regarding the individual country
requirements for exporting Siluriformes products.
Index of Export Requirements for Meat & Poultry Products
On January 10, 2018, the
Department of State launched
improvements to how we share
information with U.S. travelers.
These improvements will provide U.S.
citizens with clear, timely, and
reliable safety and security
information worldwide. Under the new
system, every country will have a
Travel Advisory, providing levels of
advice ranging from 1 to 4:
Level 1 - Exercise
Normal Precautions: This
is the lowest advisory level for
safety and security risk. There
is some risk in any
international travel. Conditions
in other countries may differ
from those in the United States
and may change at any time.
Level 2 - Exercise
Increased Caution: Be
aware of heightened risks to
safety and security. The
Department of State provides
additional advice for travelers
in these areas in the Travel
Advisory. Conditions in any
country may change at any time.
Level 3 -
Reconsider Travel: Avoid
travel due to serious risks to
safety and security. The
Department of State provides
additional advice for travelers
in these areas in the Travel
Advisory. Conditions in any
country may change at any time.
Level 4 - Do Not
Travel: This is the
highest advisory level due to
greater likelihood of
life-threatening risks. During
an emergency, the U.S.
government may have very limited
ability to provide assistance.
The Department of State advises
that U.S. citizens not travel to
the country or leave as soon as
it is safe to do so. The
Department of State provides
additional advice for travelers
in these areas in the Travel
Advisory. Conditions in any
country may change at any time.
The Travel Advisories for each
country replace previous Travel
Warnings and Travel Alerts. While we
will issue an overall Travel
Advisory level for every country,
levels of advice may vary for
specific locations or areas within a
country. For instance, we may advise
U.S. citizens to “Exercise Increased
Caution” (Level 2) in a country, but
to “Reconsider Travel” (Level 3) to
a particular area within the
country.
Our detailed Travel Advisories
will also will provide clear reasons
for the level assigned, using
established risk indicators, and
offer specific advice to U.S.
citizens who choose to travel there:
C - Crime: Widespread
violent or organized crime is
present in areas of the country.
Local law enforcement may have
limited ability to respond to
serious crimes.
T - Terrorism: Terrorist
attacks have occurred and/or
specific threats against
civilians, groups, or other
targets may exist.
U - Civil Unrest: Political,
economic, religious, and/or
ethnic instability exists and
may cause violence, major
disruptions, and/or safety
risks.
H - Health: Health
risks, including current disease
outbreaks or a crisis that
disrupts a country’s medical
infrastructure, are present. The
issuance of a Centers for
Disease Control Travel Notice
may be a factor.
N - Natural
Disaster: A natural
disaster, or its aftermath,
poses danger.
E - Time-limited
Event: A short-term
event, such as an election,
sporting event, or other
incident that may pose a safety
risk.
O - Other: There
are potential risks not covered
by previous risk indicators.
Read the country’s Travel
Advisory for details.
We will review and update each
Travel Advisory as needed, based on
changes to security and safety
information. Additionally, U.S.
embassies and consulates will now
issue Alerts to replace the current
Emergency Messages and Security
Messages. Alerts will inform U.S.
citizens of specific safety and
security concerns in a country, such
as demonstrations, crime trends, and
weather events.
The Department’s
newly-redesigned hub for traveler
information, travel.state.gov,
will host all Travel Advisories,
recent Alerts issued for each
country, and an interactive map in
mobile-friendly formats. Country
pages on the site will continue to
include all travel information
currently available, including
details about entry/exit
requirements, local laws and
customs, health conditions,
transportation, and other relevant
topics.
To receive security and other
important updates while traveling,
U.S. citizens can enroll their
travel plans in the Smart Traveler
Enrollment Program (step.state.gov),
and follow us on Twitter (@travelgov)
and Facebook (facebook.com/travelgov).
This list
provides notification of updates to the Country Information Sheet, Travel Alerts, and Travel Warnings issued by the
Department of State for Italy, Holy See (Vatican City) and San Marino.
Additional travel information is available at
http://travel.state.gov and http://state.gov.
We encourage you to read the Department of State's current
Country Specific Information for Italy, Holy See (Vatican City) and San Marino:
If you are traveling to Italy, Holy See (Vatican City), and San
Marino, we strongly encourage you to notify the nearest U.S. Embassy or
Consulate by entering your travel plans in STEP. Just go to the STEP home
page
(https://step.state.gov/step/
) and select �Add Trip.� By enrolling a trip, you will have the opportunity to subscribe to the Embassy
or Consulate�s electronic mailing list in order to receive specific notifications about events, security alerts, safety issues or
other information pertinent for travelers to that specific area during
the dates you specify.
SWITZERLAND
This
list provides notification of updates to the Country Information Sheet, Travel Alerts, and Travel Warnings issued by the
Department of State for Switzerland. Additional travel information is
available at http://travel.state.gov and http://state.gov.
We encourage you to read the Department of State's current
Country Specific Information for Switzerland:
If you are traveling to Switzerland, we strongly encourage you
to notify the nearest U.S. Embassy or Consulate by entering your travel
plans in STEP. Just go to the STEP home page (https://step.state.gov/step/
) and select �Add Trip.� By enrolling a trip, you will have the
opportunity to subscribe to the Embassy or Consulate�s electronic mailing list
in order to receive specific notifications about events, security alerts,
safety issues or other information pertinent for travelers to that
specific area during the dates you specify.
SPAIN
This list provides notification of updates to the Country
Information Sheet, Travel Alerts, and Travel Warnings issued by the
Department of State for Spain and Andorra. Additional travel information is
available at http://travel.state.gov and
http://state.gov.
We encourage you to read the Department of State's current
Country Specific Information for Spain and Andorra:
If you are traveling to Spain and Andorra, we strongly encourage
you to notify the nearest U.S. Embassy or Consulate by entering your
travel plans in STEP. Just go to the STEP home page (https://step.state.gov/step/
) and select �Add Trip.� By enrolling a trip, you will have the
opportunity to subscribe to the Embassy or Consulate�s electronic mailing list
in order to receive specific notifications about events, security alerts,
safety issues or other information pertinent for travelers to that
specific area during the dates you specify.
UNITED KINGDOM
This list provides notification of updates to the Country
Information Sheet, Travel Alerts, and Travel Warnings issued by the
Department of State for United Kingdom. Additional travel information is
available at http://travel.state.gov and http://state.gov.
We encourage you to read the Department of State's current
Country Specific Information for the United Kingdom:
If you are traveling to the United Kingdon, we strongly
encourage you to notify the nearest U.S. Embassy or Consulate by entering your
travel plans in STEP. Just go to the STEP home page (https://step.state.gov/step/
) and select �Add Trip.� By enrolling a trip, you will have the
opportunity to subscribe to the Embassy or Consulate�s electronic mailing list
in order to receive specific notifications about events, security alerts,
safety issues or other information pertinent for travelers to that
specific area during the dates you specify.
Asia
RUSSIA
This list provides notification of updates to the Country
Information Sheet, Travel Alerts, and Travel Warnings issued by the
Department of State for Russia. Additional travel information is available at http://travel.state.gov and http://state.gov.
We encourage you to read the Department of State's current
Country Specific Information for Russia:
If you are traveling to Russia, we strongly encourage you to
notify the nearest U.S. Embassy or Consulate by entering your travel plans
in STEP. Just go to the STEP home page (https://step.state.gov/step/
) and select �Add Trip.� By enrolling a trip, you will have the opportunity
to subscribe to the Embassy or Consulate�s electronic mailing list
in order to receive specific notifications about events, security alerts,
safety issues or other information pertinent for travelers to that
specific area during the dates you specify.
SOUTH KOREA
This list provides notification of updates to the Country
Information Sheet, Travel Alerts, and Travel Warnings issued by the
Department of State for South Korea. Additional travel information is
available at http://travel.state.gov and
http://state.gov.
We encourage you to read the Department of State's current
Country Specific Information for South Korea:
If you are traveling to South Korea, we strongly encourage you
to notify the nearest U.S. Embassy or Consulate by entering your travel
plans in STEP. Just go to the STEP home page (https://step.state.gov/step/
) and select �Add Trip.� By enrolling a trip, you will have the
opportunity to subscribe to the Embassy or Consulate�s electronic mailing list
in order to receive specific notifications about events, security alerts,
safety issues or other information pertinent for travelers to that
specific area during the dates you specify.
Africa
SAUDI ARABIA
This list provides notification of updates to the Country
Information Sheet,Travel Alerts, and Travel Warnings issued by the
Department of State for Saudi Arabia. Additional travel information is
available at http://travel.state.gov and http://state.gov.
We encourage you to read the Department of State's current
Country Specific Information for Saudi Arabia:
If you are traveling to Saudi Arabia, we strongly encourage you
to notify the nearest U.S. Embassy or Consulate by entering your travel
plans in STEP. Just go to the STEP home page (https://step.state.gov/step/
) and select �Add Trip.� By enrolling a trip, you will have the
opportunity to subscribe to the Embassy or Consulate�s electronic mailing list
in order to receive specific notifications about events, security alerts,
safety issues or other information pertinent for travelers to that
specific area during the dates you specify.
Pacific/Indian Ocean
PHILIPPINES
This list provides notification of updates to the Country InformationSheet,Travel Alerts, and Travel Warnings issued by the Department of Statefor Philippines. Additional travel information is available athttp://travel.state.govand http://state.gov.We encourage you to read the Department of State's current Country SpecificInformation for Philippines:If you are traveling to Philippines, we strongly encourage you to notifythe nearest U.S. Embassy or Consulate by entering your travel plans inSTEP. Just go to the STEP home page (https://step.state.gov/step/ ) andselect �Add Trip.� By enrolling a trip, you will have the opportunity tosubscribe to the Embassy or Consulate�s electronic mailing list in orderto receive specific notifications about events, security alerts, safetyissues or other information pertinent for travelers to that specific areaduring the dates you specify.
_______
VIETNAM
The information provided is from U.S. and
other governmental sources who are solely responsible for the
content provided.
"In a world of lack, Human Utilities
Whole Armour
is the world's
Cornucopia".™
HUMAN UTILITIES WHOLE
ARMOUR ®
"My people are destroyed
for lack of knowledge...." Hosea 4:6-7
