Version May 2024
| Geography |
| Countries visited or passed through; urban or rural |
| Dates of travel and duration of stay in each place |
| Means of transportation |
| Accommodations (eg, hotel, dormitory, local household, tent) |
| Activities and exposures during travel |
| Sex or other intimate contact (eg, type, number of partners, barrier protection) |
| Animals, including birds (eg, shared living quarters or physical proximity, seeing rodents, bites, licks) or animal products (eg, hunting, skinning, other) |
| Arthropod (eg, seeing or receiving bites from mosquitoes, flies, ticks, fleas, other) |
| Needle and blood exposure (eg, shared needles, injections, acupuncture, tattoos, ear or other body piercing, dental work, transfusions, surgery) |
| Food and beverages (eg, raw or undercooked flesh, unpasteurized milk, tap or surface water, local delicacies) |
| Soil and water contact (eg, recreational, such as hiking, boating, swimming, hunting, spelunking or professional activities, such as archeological digs) |
| Host factors |
| Age and sex |
| Medical problems and past surgery (eg, splenectomy, gastrectomy, HIV infection) |
| Past infections and vaccines |
| Medications, including immunosuppressive and immunomodulating agents, over the counter drugs, antipyretics |
| Past medical history, including immunosuppression |
| Preparation for travel (eg, vaccines, chemoprophylaxis) |
| Pregnancy |
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