Public Health Guidance for Potential COVID-19 Exposure Associated with International or Domestic Travel

Public Health Guidance for Potential COVID-19 Exposure Associated with International or Domestic Travel
Updated Oct. 19, 2020

CDC has separate guidance for exposures in healthcare settings and U.S. communities, and for critical infrastructure workers.

Summary of changes

On October 19, 2020

  1. Added information about transport of individuals with confirmed or probable COVID-19 or known exposure to someone with COVID-19.

On August 6, 2020

  1. Harmonized post-travel guidance for international and domestic travelers.

On August 3, 2020

  1. Added section for Individuals with Confirmed or Probable COVID-19 or Known Exposure to Someone with COVID-19.
  2. Added Traveler Contact Information section.

Background

The COVID-19 pandemic has spread in all regions internationally as well as throughout the United States. Individuals who travel internationally, or domestically outside of their communities, may be at risk for exposure to SARS-CoV-2, the virus that causes COVID-19, before, during, or after travel, and could spread the virus to others at their travel destination or upon returning to their home community.

As part of a broader strategy aimed to limit continued new introduction of COVID-19 into U.S. communities, all travelers should remain vigilant for signs and symptoms suggestive of COVID-19 and take routinely recommended precautions to limit community spread after traveling from one location to another. Travelers with greater potential risk of exposure because of the circumstances of their travel (e.g., travel from or to an area that is experiencing a high level of spread based on country, state, or county data) or activities during travel (e.g., attendance at a large social gathering or mass gathering) are recommended to take additional precautions during the 14 days after travel (see table below).

Audience and Purpose

This page provides U.S. public health officials with an overview of CDC’s recommendations for domestic and international travelers with potential COVID-19 exposure.

Recommendations

CDC’s post-travel recommendations for all travelers—both international and domestic—are provided in the table below. Individuals should additionally follow guidance of the state and local authorities for jurisdiction-specific instructions.

CDC’s post-travel recommendations for all travelers—both international and domestic—are provided in the table below. Individuals should additionally follow guidance of the state and local authorities for jurisdiction-specific instructions.
Type of Travel Recommended Precautions
Any domestic or international travel Travelers should be vigilant about following recommended precautions to prevent exposure to others.
Situations with potentially higher risk of exposure, such as:

 

Travelers should take the following precautions in addition to the ones listed above.

 

1For the purpose of this guidance, fever is defined as subjective fever (feeling feverish) or a measured temperature of 100.4oF (38oC) or higher. Note that fever may be intermittent or may not be present in some people, such as those who are elderly, immunosuppressed, or who take certain fever-reducing medications (e.g., nonsteroidal anti-inflammatory drugs [NSAIDS]).

2Cruise ships subject to the No Sail Order should follow Interim Guidance During the Period of the No Sail Order for disembarking crew.

3See below for guidance on air crews and here for guidance for other essential workers.

Individuals with Confirmed or Probable COVID-19 or Known Exposure to Someone with COVID-19

Individuals with confirmed or probable COVID-19 should delay travel until they meet criteria for discontinuing isolation. Individuals who have been exposed to a person with confirmed COVID-19 should delay travel until 14 days after their last potential exposure. Health departments may request use of federal public health travel restrictions for individuals with confirmed or probable COVID-19 or with known exposure, if they intend to travel before being cleared to do so by public health authorities, by contacting the CDC quarantine station with jurisdiction for the area where the person is located.

If travel is necessary (e.g., for repatriation or to obtain medical care that is not available locally), transportation should be conducted in a manner that does not expose conveyance operators (e.g., air crews, bus drivers) or other travelers. The mode of transportation should be guided by distance (e.g., ground vs. air transportation) to destination and the clinical condition of the traveler (i.e., whether medical care may be needed en route).

  • Options for travelers with confirmed or probable COVID-19 are private vehicle or approved medical transport (i.e., ground or air medical transport with infection control precautions in place to protect vehicle operators and medical personnel).
  • Options for travelers with known exposure to someone with COVID-19 are private vehicle or private air charter with precautions in place to protect air crews.

Travel should also be coordinated with public health authorities at traveler’s intended destination. For international transport with a destination within the United States, per CDC regulations (42 Code of Federal Regulations, Part 71: Foreign Quarantineexternal icon), the conveyance operator must notify CDC in advance through the CDC quarantine station with jurisdiction for the port of entry or the CDC Emergency Operations Center (770-488-7100 or eocreport@cdc.gov).

Traveler Contact Information

CDC supports domestic COVID-19 control efforts by making contact information for international air passengers available to state and local health departments for the purpose of public health follow-up or contact tracing. At present, collection of traveler contact information is occurring for passengers from countries subject to entry restrictions under Presidential Proclamation.

Follow-up with travelers may include contacting travelers; providing instructions for what travelers should do if they develop illness compatible with COVID-19; and intermittent check-ins during the two weeks after arrival. Mobile applications or automated text messaging may be useful to provide information to travelers or conduct monitoring of travelers. Follow-up with travelers is at the discretion of health departments and may be considered by jurisdictions that are implementing containment measures. Decisions about whether to conduct follow-up and what it would involve could be based on the status of the COVID-19 outbreak in the jurisdiction, status of the COVID-19 outbreak in travelers’ countries or states of origin, the volume of travelers, available resources, competing priorities of public health officials, and other factors, as applicable.

Crews on Passenger or Cargo Flights

CDC and the Federal Aviation Administration have jointly provided Updated Interim Occupational Health and Safety Guidance for Air Carriers and Crews pdf icon[PDF – 7 pages]external icon. This FAA-CDC guidance includes recommendations for aircrews to self-monitor under the supervision of their employer’s occupational health program and to remain in their hotel rooms to the extent possible and practice social distancing while on overnight layovers. As long as crew members re­­­­­main asymptomatic and have no known exposures to a person with COVID-19, they may continue to work on flights into, within, or departing from the United States. Crew members who follow their carrier’s occupational health plan as well as the FAA-CDC guidance are not subject to CDC’s recommendation to stay at home for 14 days after travel from an area with high risk of COVID-19. If they develop fever, cough, shortness of breath, or other symptoms of COVID-19, crew members should self-isolate and be excluded from work on commercial flights until cleared to work by their employer’s occupational health program following CDC’s criteria for Discontinuation of Isolation for Persons with COVID-19 Not in Healthcare Settings.

Crew members who have known exposure to persons with COVID-19 should be excluded from work until 14 days after the last potential exposure. While air travel is a vital economic activity, CDC does not recommend allowing crew members with known exposures to continue to work, even if asymptomatic, because of the inability of crew members to remove themselves from the workplace if they develop symptoms during a flight and the challenges involved in effectively isolating a symptomatic person on board an aircraft.