Travel Health Warning
Travel Warning – Swine Influenza and Severe Cases of Respiratory Illness in Mexico - Prevent Nonessential Travel to Mexico
As of April 27, 2009, the Government of Mexico has announced 18 laboratory confirmed human cases of swine influenza A/H1N1 infection. Evaluation is continuing to clarify the spread and severity of the illness in Mexico.
Suspect clinical cases have been stated in 19 of the country’s 32 states. The World Health Organization (WHO), the Global Alert and Response Network (GOARN), and the CDC have sent experts to Mexico to work with health authorities.
CDC has confirmed that seven of 14 respiratory specimens sent to CDC by the Mexican National Influenza Center are positive for swine flu virus and are similar to the swine flu viruses lately identified in the U.S..
On April 25, the WHO Director-General declared this event a Public Health Emergency of International Concern below the rules of the International Health Regulations.
CDC and state public and animal health authorities are currently investigating 20 cases of swine flu in humans in California, Texas, Kansas, Ohio, and New York City. Some of the USA cases have been linked to travel to Mexico.
Currently, only two of the 20 cases in the United States have been hospitalized and all have recovered, but deaths are announced to have occurred in Mexico. CDC is concerned that continued travel by United States travelers to Mexico presents a serious risk for further outbreaks of swine flu in the United States.
CDC Recommendations
Presently, CDC recommends that USA travelers avoid all nonessential travel to Mexico. Changes to this recommendation will be posted at http – //wwwn.cdc.gov/travel/.
Please check this site frequently for updates.
When you have to travel to an area that has announced cases of swine flu –
Stay Informed
o Check updates from the –
o Centers for Disease Control and Prevention,
o Secretaria de Salud,
o World Health Organization
o Monitor announcements from Mexico’s Ministry of Health and local government including information about affected areas, as not all areas are equally affected.
o Follow local public health guidelines, including any movement restrictions and prevention recommendations.
o Be aware that Mexico is checking all exiting airline passengers for signs of swine flu. Exit screening may cause significant delays at airports.
Prepare for your trip before you leave
Antiviral Medications – Travelers from the United States going to Mexico who are at high risk of severe disease from influenza are advised to take antiviral medications for prevention of swine influenza during travel.
The recommended antiviral drugs for swine influenza are oseltamivir (brand name Tamiflu ) and zanamivir (brand name Relenza ). Both are prescription drugs that fight against swine flu by keeping flu viruses from reproducing in the body.
These drugs can prevent infection when taken as a preventative. Speak to your physician about correct indications for using influenza antiviral medications. Always seek medical care when you are severely ill.
Antiviral chemoprophylaxis, or taking medicine to prevent flu viruses from reproducing in the body, (pre-exposure or post-exposure) is recommended for the following individuals -
o Household close contacts who are at high risk for complications of influenza (for example, persons with certain chronic health conditions and the elderly) of a confirmed or suspected case.
o School-aged children who are at high risk for complications of influenza (for example, persons with certain chronic health conditions) who had close contact (face-to-face) with a confirmed or suspected case.
o Travelers to Mexico who are at high risk for complications of influenza (for example, persons with certain chronic health conditions and the elderly).
o Border workers (Mexico) who are at high risk for complications of influenza (for example, persons with certain chronic medical conditions and the elderly).
o Health care workers or public health workers who’d unprotected close contact with an ill confirmed case of swine influenza A (H1N1) virus infection during the ill person’s infectious period.
Antiviral chemoprophylaxis could be considered for the following –
o Any healthcare worker who’s at high risk for complications of influenza (for example, persons with certain chronic medical conditions and the elderly) who’s working in an area with confirmed swine influenza A (H1N1) cases, and who’s caring for patients with any acute febrile respiratory disease.
o Persons who aren’t at high risk but who are travelers to Mexico or first responders or border workers who are working in areas with confirmed cases of swine influenza A (H1N1) virus infection.
Further information about CDC’s recommendations for antiviral use during the swine flu outbreak may be found at the following websites –
o Healthcare specialists
o http – //www.cdc.gov/swineflu/recommendations.htm
o General public
o http – //www.cdc.gov/swineflu/antiviral_swine.htm
For all travelers, CDC recommends the following steps to help you stay healthy –
o Make sure you’re up-to-date with all your routine vaccinations, including a seasonal influenza vaccine. The seasonal vaccine is not expected to offer protection against swine influenza viruses, but it can protect against seasonal influenza viruses which could still be circulating in Mexico and the Southern Hemisphere.
o Pack a travel health kit that contains basic first aid and medical supplies. See Pack Smart in Your Survival Guide to Safe and Healthful Travel for a list of what to include in your travel health kit.
o Identify the health-care resources in the area(s) you’ll be visiting.
o Check if your medical insurance plan will cover you abroad. Consider buying additional insurance that covers medical evacuation in case you become sick. For more information, see Medical Information for American Citizens Traveling Abroad from the USA Department of State.
o Do not forget that USA embassies, consulates and military facilities don’t have the legal authority, capability, and resources to evacuate or to give medications, vaccines or medical care to private USA citizens overseas.
During your visit to an area affected by swine flu
Monitor the local situation
o Pay attention to announcements from the local government
o Follow local public health guidelines, including any movement restrictions and avoidance recommendations
Practice healthy habits to help stop the spread of swine flu
o Wash your hands often with soap and water. This removes germs from your skin and helps prevent illnesses from spreading.
o Use waterless alcohol-based hand gels (containing at least 60% alcohol) when soap isn’t available and hands are not visibly dirty.
o Cover your mouth and nose with a tissue when you cough or sneeze and put your used tissue in a wastebasket.
o When you don’t have a tissue, cough or sneeze into your upper sleeve, not your hands.
o Wash your hands after coughing or sneezing, using soap and water or an alcohol-based hand cleaner (with at least 60% alcohol) when soap and water are not available.
o Avoid touching your eyes, nose, or mouth. Germs spread that way.
o Attempt to avoid close contact with sick people . (Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people .)
o It is important to follow the advice of local health and government authorities. You might be asked to restrict your movement and stay in your home to contain the spread of swine flu.
Seek medical care when you feel sick
o If you are ill with fever and other symptoms of swine flu like cough and sore throat, see a physician, especially if you think you might have had contact with somebody with swine flu or severe respiratory illness in the past 7 days before becoming ill.
o If you need to find local medical care, a U.S. consular officer can help you locate medical services and will inform your family or friends in the U.S. of your disease. to contact the U.S. Embassy or consulate in the country where you are visiting, call the Overseas Citizens Services at –
o 1-888-407-4747 if calling from the USA or Canada,
o 00 1 202-501-4444 if calling from overseas, or
o Find your local USA Embassy at Websites of USA Embassies, Consulates, and Diplomatic Missions.
o Do not travel while you are sick, except to get local medical care.
o Try to limit contact with others as much as possible. By limiting your contact with other individuals , you can help prevent the spread of swine flu.
o For more information about what to do when you become sick while you are traveling outside the U.S., visit Your Survival Guide for Safe and Healthy Travel.
After your return from an area that has stated cases of swine flu –
o Closely monitor your health for 7 days.
o If you become ill with fever and other signs of swine flu like cough and sore throat and quite possibly vomiting and diarrhea during this period, call your physician or clinic for an appointment right away. Your physician may test you for influenza and decide whether influenza antiviral treatment is indicated.
o When you make the appointment, tell the doctor the following –
o Your signs,
o Where you traveled, and
o When you have had close contact with a person infected with swine flu.
o Avoid leaving your home while sick except to get local medical care, or as instructed by your doctor. Do not go to work or school while you are ill. When you have to leave your home (for example, to seek medical care) wear a surgical mask to keep from spreading your illness to others.
o Always cover your nose and mouth with a tissue when you cough or sneeze. Throw away used tissues in a trash can.
o Wash your hands with soap and water often and namely after you cough or sneeze. When soap and water aren’t available, use an alcohol-based hand gel containing at least 60% alcohol.
o Prevent close contact with other individuals as much as possible
o Wear a surgical mask if you’re in contact with other people
Status of Entry and Exit Screening in the United States and Mexico
Mexico Exit Screening
Swine influenza screening has been instituted at airports and land borders for travelers departing Mexico, according to Mexican health authorities. Passengers showing symptoms of swine influenza will be asked to submit voluntarily to physical examination and further examination, when needed.
USA
Currently, the USA is not conducting enhanced entry screening of passengers arriving from Mexico, nor is the USA conducting exit screening of passengers departing for Mexico.
The Department of Homeland Security will provide Travel Health Alert Notices to USA travelers going to and coming from Mexico at all airports, seaports, and land border crossings. These notices provide advice to travelers on how to reduce their risk of getting sick, the signs of swine flu, and what to do if the traveler becomes sick.
CDC will provide all ill passengers and their contacts arriving from Mexico with Travel Health Alert Notices. These notices provide advice information regarding seeking health advice from a physician and how to prevent disease in persons who have been exposed but who aren’t ill.
Additional Information
When you’ve specific questions about the swine influenza cases see http – //www.cdc.gov/contact/ or call 1-800-232-4636, which is 1-800-CDC-INFO.
To learn more about travel health, visit www.cdc.gov/travel.
For the swine Influenza situation in Mexico, visit –
o Secretaria de Salud – Secretary of Health, Mexico [Web page in Spanish]
o World Health Organization – Influenza-Like Illness in the United States and Mexico
o Pan American Health Organization
For the swine Influenza situation in the USA, visit –
o For information on antivirals
o http – //www.cdc.gov/swineflu/recommendations.htm (for health care specialists)
o http – //www.cdc.gov/swineflu/antiviral_swine.htm (for the public)
o For information on swine flu in the United States, visit www.cdc.gov/flu/swine
Swine influenza travel health updates will be posted on http – //wwwn.cdc.gov/travel/ as information becomes available.