Traveler Health   

Whether you are traveling throughout Montana or abroad, understand the risks associated with your travel destination. For more information about traveler’s health, please refer to the CDC Yellow Book.

Montana Traveler Resources

Cold Disorders:

  • Hypothermia:
    • This is a Medical Emergency caused by prolonged exposure to very cold temperatures
    • Symptoms: shivering, exhaustion, slurred speech, bright red cold skin (in babies), memory loss, and confusion
    • While you wait for medical help, do what you can to warm the person up
  • Frostbite:
    • Injury caused by freezing
    • Symptoms: numbness, skin that feels unusually firm or waxy, a white or grayish-yellow skin area
    • Redness or pain in any skin area usually the beginning signs of frostbite – Get out of the cold or protect exposed skin
  • Prevention: 
    • Dress in warm, winter-appropriate clothing, wearing many layers if necessary
    • Avoid spending time outside when the temperature is well below freezing
    • Lookout for any red and painful skin (may be beginnings of frostbite).

Learn more information about Cold Disorders.

Heat Disorders:

  • Dehydration:
    • Symptoms: extreme thirst, dark-colored and less frequent urination, fatigue, and dizziness.
    • Drink lots of water and eat foods high in water (ex. Fruits and vegetables) to prevent dehydration
  • Sunburn:
    • Symptoms: red, painful, blistering or peeling of the skin, caused by too much unprotected exposure to the sun
    • Wear and reapply sunscreen every hour before spending time in the sun
    • If a sunburn develops, drink lots of fluids, treat with after-sun lotion/aloe vera, and avoid sun exposure until burn heals
  • Heat rashes:
    • Symptoms: a ‘prickly’ red rash that generally disappears a person returns to a cool environment
  • Heat cramps:
    • Symptoms: cramping that usually happens in the muscles used while working hard in the heat
    • Usually alleviated by rest, drinking water, and replenishing salt lost through sweat by drinking or eating something with salt
  • Heat exhaustion:
    • Symptoms: headache, nausea, dizziness, weakness, and thirst after time spent in high heat
  • Heatstroke
    • This is a Medical Emergency
    • Signs: confusion, headache, irritability, and emotional instability
    • Symptoms: a body temperature of over 104 F
  • Prevention:
    • Wear sunscreen
    • Stay cool indoors
    • Go to a public air-conditioned building (ex. Shopping mall)
    • Use your stove and oven less
    • Take a cool shower or bath
    • Put a cold, wet washcloth, or towel on the back of your neck
    • Avoid hot and heavy meals
    • Stick to shaded areas
    • Drink plenty of fluids
    • Replace your salt and minerals (ex. Drink a sports drink)

Learn more information about Heat Disorders.

Tick-borne Diseases:

  • In the United States, some of the most common tickborne diseases are:
  • Prevention:
    • Use insect repellents containing DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone. Treat clothing and gear, such as boots, pants, socks, and tents with products containing 0.5% permethrin.
    • Treat dogs and cats for ticks as recommended by a Veterinarian.
    • Check for ticks daily, especially under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and on the hairline and scalp.
    • Shower soon after being outdoors.
    • Learn more about landscaping techniques that can help reduce blacklegged tick populations in the yard.

Learn more at CDC’s Tickborne Diseases of the United States webpage and DPHHS’ Tickborne Illnesses 

Water-borne Diseases:

In Montana, as well as other states across the US, there are many potential sources of exposure to untreated water. This includes drinking unfiltered water from rivers and streams; a common occurrence among those who like to hike, backpack, camp, and swim.

Learn more information at DPHHS’ Recreational Water Illness and Injury webpage.

International Travel

Requirements by Country:

 

Canada Travel Requirements:

 

Cruise Ship Guidance:

  • Check if you are up to date with your COVID-19 vaccines before cruise ship travel.
  • If you have a medical condition or are taking medication that weakens your immune system, you might NOT be fully protected even if you are up to date with your COVID-19 vaccines. Talk to your healthcare provider about your risk before travel. Even after vaccination, you may need to continue taking precautions.
  • The virus that causes COVID-19 spreads easily between people in close quarters on board ships. If the virus is spreading on board a cruise ship, passengers and crew are at risk for infection.
  • Check directly with your cruise line about their testing or vaccination protocols before travel.
  • If your cruise line does not have a testing requirement, get tested for current infection with a COVID-19 viral test as close to time of cruise departure as possible (no more than 3 days before you travel).
  • Get tested again with a COVID-19 viral test 3-5 days after your cruise.
  • Cruise Ship Travel Guidance 

 

Testing Requirement before Air Travel to U.S. 

 

Vaccine Requirement for Air Travel to U.S.

Cholera:

You can get sick with cholera by drinking water or eating food contaminated with cholera bacteria. Cholera symptoms include diarrhea, nausea, dizziness, and vomiting. People with severe cholera have large amounts of watery diarrhea. Often described as “rice-water stool,” cholera diarrhea can have a pale, milky appearance. Cholera can lead to death if a person becomes dehydrated from loss of fluids and electrolytes.

What can travelers do to prevent cholera?

Travelers can protect themselves against cholera, even travelers going to areas of active cholera transmission, by taking the following steps:

Choose food and drinks carefully

  • Only eat foods that are cooked and served hot
  • Avoid food that has been sitting on a buffet
  • Eat raw fruits and vegetables only if you have washed them in clean water or peeled them
  • Only drink beverages from factory-sealed containers
  • Avoid ice because it may have been made from unclean water
  • Drink pasteurized milk

Wash hands carefully

  • Wash hands often with soap and water for 20 seconds, especially after using the bathroom and before eating
  • If soap and water aren’t available, use an alcohol-based hand sanitizer that contains at least 60% alcohol
  • Keep your hands away from your face and mouth

Learn more information about Cholera. 

Dengue:

Dengue symptoms usually start within a few days of being bitten but can take up to 2 weeks to develop. Symptoms can be mild or severe and can include fever with nausea, vomiting, rash, headache, eye pain, joint and muscle pain. In severe cases, dengue can cause shock, internal bleeding, and even death. Learn more about severe dengue. 

What can travelers do to prevent dengue?

Travelers can protect themselves from dengue by taking the following steps.

  • Wear long-sleeved shirts and long pants
  • Treat clothing and gear with permethrin
  • Keep mosquitoes out of your hotel room or lodging
  • Sleep under a mosquito net 

Learn more about Dengue.

Ebola:

Health Screening at U.S. Airports:

Starting the week of October 10, 2022, CDC and Department of Homeland Security will implement funneling of U.S.-bound air passengers who have been to Uganda in the prior 21 days. These passengers will fly into 5 U.S. airports where they will undergo entry health screenings.

  • Airports include New York (JFK), Chicago (ORD) Newark (EWR), Atlanta (ATL), and Washington D.C. Dulles (IAD)
  • Current risk for importation of Ebola to the U.S. is low at this time.  However, public health entry screening is part of a layered approach that, when used with other public health measures already in place to detect ill arriving travelers, can slow and reduce the spread of disease into the United States.

 

Why is CDC doing entry health screening?

  • Public health entry screening has four main goals:
    • To identify travelers who may be infected or at high risk for infection with Ebola virus disease (EVD)  based on travel history, current health status, or potential high-risk exposures
    • To ensure that these travelers are directed to appropriate care, if needed, which will also help protect the health of all Americans.
    • To provide health messaging to travelers from Uganda about actions to take if they develop symptoms after travel
    • To confirm availability of contact information for all travelers from Uganda for public health follow up.

 

Who will be following up with the air passengers?

  • State and local health departments will follow-up with air travelers from Uganda, conducting health assessments, providing additional information, and doing check ins with the travelers (as determined by the health department).  CDC will update its guidance on risk assessment and management of persons with potential Ebola virus exposure to support state and local health departments.  

 

How will travelers be monitored for symptoms after arrival?

  • Following public health entry screening by CDC at the arrival airport, additional risk assessments and monitoring will be coordinated by the health departments of jurisdiction. CDC will share travelers’ contact information with the health departments of jurisdiction, and the health departments will establish contact with travelers, confirm risk level, and provide guidance for how travelers should report status to state and local health authorities.

 

Measles:

Measles is a disease caused by a highly contagious virus. People with measles spread the virus through the air when they cough, sneeze, or breathe.  

Symptoms of measles may include rash, high fever, cough, runny nose, and red, watery eyes. Some people who become sick with measles also get a serious lung infection, such as pneumonia.

What can travelers do to prevent measles?

Getting vaccinated is the best way to protect against measles.

Learn more information about Measles.

Melioidosis: 

While melioidosis infections have taken place all over the world, Southeast Asia and northern Australia are the areas in which it is primarily found. In the United States, the bacteria that causes melioidosis has been identified in Mississippi, Puerto Rico and the U.S. Virgin Islands.

Transmission: The bacteria are found in soil and water, widely distributed in tropical and subtropical countries. Transmission can occur through subcutaneous inoculation, ingestion, or inhalation; person-to-person transmission is extremely rare but may occur through contact with the blood or body fluids of an infected person.

Prevention: In areas where the disease is widespread, there are things that certain groups of people can do to help minimize the risk of exposure:

  • Persons with open skin wounds and those with diabetes or chronic renal disease are at increased risk for melioidosis and should avoid contact with soil and standing water.
  • Those who perform agricultural work should wear boots, which can prevent infection through the feet and lower legs.
  • Health care workers can use standard precautions when treating patients with melioidosis to help prevent infection.

For more information refer to CDC Yellow Book

Mpox:

An outbreak is occurring around the world in areas where mpox is not usually found. Previously, mpox was found mainly in Central and West Africa, often in forested areas. People infected with mpox develop a rash that can look like pimples or blisters and the rash may be painful or itchy.

What can travelers do to prevent Mpox?

Travelers can protect themselves against infection by taking the following steps.

  • Avoid close, skin-to-skin contact with people who have a rash that looks like mpox.
    • Do not touch the rash or scabs of a person with mpox.
    • Do not kiss, hug, cuddle or have sex with someone with mpox.
  • Avoid contact with objects and materials that a person with mpox has used.
    • Do not share eating utensils or cups with a person with mpox.
    • Do not handle or touch the bedding, towels, or clothing of a person with mpox.
  • Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.

Learn more information about Mpox. 

Polio:

Polio is a life-threatening disease caused by a virus that affects the nervous system and is usually spread from one person to another when stool (poop) or, less commonly, droplets from a sneeze or cough of an infected person gets into the mouth of another person. For example, you can get polio if you:

  • Eat raw or undercooked food or drink water or other drinks that are contaminated with the stool of an infected person.
  • Put a contaminated object such as a toy in your mouth.
  • Touch a contaminated object and put your fingers in your mouth.
  • Have close contact with a person sick with polio, for example when caring for them.

What can travelers do to prevent polio?

  • Wash your hands often

Learn more information about Polio. 

Yellow Fever:

Most people infected with yellow fever virus do not get sick or have only mild symptoms. People who do get sick will start having symptoms (e.g., fever, chills, headache, backache, and muscle aches) 3–6 days after they are infected. 

What can travelers do to protect themselves?

Get the yellow fever vaccine and take steps to prevent mosquito bites.

Learn more information about Yellow Fever.

Zika Resources 

Common mosquito-borne diseases associated with travel outside Montana:

For more information about traveler's health, please refer to the  CDC Yellow Book.

 

Traveling to another country to get medical care can be risky. Learn about the risks and how to minimize them.

Risks:

Infectious Disease. All medical procedures have some risk of complications, those associated with procedure done in other countries include wound infections, bloodstream infections, donor-derived infections, and diseases such as hepatitis B, hepatitis C, HIV.

Antibiotic resistance. Antibiotic resistance is definitely a concern and a global problem; however, you are more likely to get an antibiotic-resistant infection in some countries. Highly drug-resistant bacteria have caused infectious disease outbreaks among medical tourists.

Quality of Care. Some countries’ requirements for maintaining licensure, credentialing, and accreditation may also be less than what would be required in the United States. In some countries, counterfeit medicines and lower quality medical devices may be used.

Communication challenges. Communicating with staff at the destination and healthcare facility may be challenging. Receiving care at a facility where you do not speak the language fluently could lead to misunderstandings about your care.

Air Travel. Flying after surgery can increase the risk for blood clots, including deep vein thrombosis. If you get chest or abdominal surgery do not travel by air for at least 10 days to avoid risks associated with changes in atmospheric pressure. People who get cosmetic procedures of the face, eyelids, or nose, or who have had laser treatments should wait 7–10 days before flying.

Continuity of Care. You may need to get health care in the United States if you have complications after returning.

Learn how to minimize your medical tourism risk by visiting Medical Tourism: Travel to Another Country for Medical Care | Travelers' Health | CDC.