CDC Commentary: Advice for Patients Traveling During Flu Season

Phyllis E. Kozarsky, MD


December 22, 2009

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Hello, this is Phyllis Kozarsky from the Travelers' Health Branch at CDC. With 2009 H1N1 influenza in the news, your patients may be turning to you for advice on how to avoid getting the flu during travel. There are several recommendations you can provide to help CDC make the case for healthy travel this flu season.

First, vaccines are the most important tool we have for preventing the flu. Encourage your patients to get a seasonal flu vaccine if they haven't already. In addition, patients in high-risk target groups should be encouraged to get the 2009 H1N1 flu vaccine. Priority groups for vaccination include:

  • Pregnant women

  • People who live with or provide care for infants younger than 6 months

  • Healthcare and emergency medical services personnel

  • People 6 months through 24 years of age and,

  • People 25 years through 64 years of age who have certain medical conditions that put them at higher risk for influenza-related complications, such as people with asthma, chronic lung disease, neurologic conditions, weakened immune systems, heart disease, or kidney disorders.

When recommending the 2009 H1N1 vaccine to your patients, be cognizant of the vaccine supply situation in your community. Even though supplies of 2009 H1N1 vaccine are increasing daily, it may be difficult for patients to find the vaccine in your area. Encourage patients who are not in the high-risk target groups to be patient during this beginning phase until more vaccine becomes available. There will be enough vaccine available for anyone who wishes to receive it.

In addition to vaccines, it is important to counsel patients about the possibility of taking antiviral medications with them when they travel. Consider prescribing antivirals if patients are at high risk for flu complications and are traveling to areas where appropriate medical care may not be available. Advise all patients of the signs and symptoms of influenza and remind high-risk patients to contact you, or another health care provider, if clinical signs or symptoms develop. Advise travelers going to or returning from a country with endemic malaria to see a healthcare provider if they experience symptoms of flu. The first symptoms of malaria usually include fever and chills, similar to the symptoms of flu. However, if malaria is left untreated, the disease can quickly become serious and even life threatening.

  • Next, encourage patients to travel only when they feel well. Anyone who has symptoms of flu should delay their travel plans until they have been without fever for at least 24 hours, without the use of fever-reducing medicines.

And, as always, remind patients to follow basic hygiene practices to reduce the chances of spreading or catching the flu:

  • Cover coughs and sneezes with a tissue or sleeve

  • Wash hands often with soap and water. If soap and water are not available, use an alcohol-based hand sanitizer.

  • Avoid touching the eyes, nose, and mouth.

  • Avoid close contact with sick people.

To learn more about advising patients on safe and healthy travel, visit

Thank you.

Phyllis Kozarsky, MD, is an expert travel health consultant for CDC's Travelers Health and Animal Importation team, whose focus is to promote travelers' health and to prevent introduction of diseases related to animal importation to the U.S. She is an editor of CDC's Health Information for the International Traveler, also known as the "Yellow Book."

Dr. Kozarsky began her CDC career in 2001. She is also medical co-director at TravelWell, an Emory Healthcare affiliated program aimed at providing pre-and post-traveler health services to international travelers, and at Grady Memorial Hospital's Immigrant and Refugee clinic. Current research efforts have primarily focused on issues in clinical tropical medicine and travelers' health, including the epidemiology of travel related infections.

She received her bachelor's degree from Hobart and William Smith Colleges in Geneva, New York. She went to Medical College of Pennsylvania in Philadelphia, and received her medical degree from Albert Einstein College of Medicine in New York.

She is the author of many peer-reviewed articles, and is a member many professional organizations, including the International Society of Travel Medicine and the American Society of Tropical Medicine and Hygiene.

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