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

Public Health Guidance for Potential COVID-19 Exposure Associated with International Travel or Domestic Travel
Updated Aug. 3, 2020

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

Summary of changes

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.

On May 1, 2020

  1. Revised air crews section to align with updated joint Federal Aviation Administration-CDC guidance

On March 30, 2020

  1. Separated guidance for international or cruise travel-associated exposures and U.S. community-related exposures.

Background

The COVID-19 pandemic has spread in all regions internationally as well as in the United States. As part of a strategy aimed to limit continued introduction  of COVID-19  into U.S. communities, the U.S. government has recommended that travelers stay home voluntarily for 14 days after traveling to the United States from other countries with widespread ongoing transmission or on cruise ships or river cruises.

Recommended Public Health Management

CDC’s recommendations for potential international or cruise travel-associated exposures are provided below. Individuals should always follow guidance of the state and local authorities for the area where they are located.

International1 and Cruise Travelers

Exposure

Recommended Precautions

  • Stay home until 14 days after arrival3 and maintain a distance of at least 6 feet (2 meters) from others
  • Self-monitor for symptoms
    • Check temperature twice a day
    • Watch for fever4, cough, shortness of breath, and other symptoms of COVID-19
  • Avoid contact with people at higher risk for severe illness
  • Follow CDC guidance if symptoms develop

1For information about domestic travel see Coronavirus and Travel in the United States.

2As of March 27, 2020, this includes all countries.

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

4For 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 taking certain fever-reducing medications (e.g., nonsteroidal anti-inflammatory drugs [NSAIDS]).

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.

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 of travelers may include contacting travelers; providing instructions for what travelers should do if they develop illness compatible with COVID-19; and intermittent check-in during the two weeks after arrival. Mobile applications or automated text messaging may be useful to provide information to or conduct monitoring of travelers. Follow-up of 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, volume of travelers, available resources, competing priorities of public health officials, or 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[7 pages]external icon. This FAA-CDC guidance includes recommendations for air crews 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 international travel. 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.