All children should be up-to-date on routine childhood immunizations, as recommended by the American Academy of Pediatrics, prior to international travel. For adults, the following should be considered prior to departure:

Measles-mumps-rubella vaccine: two doses are recommended (if not previously given) for all travelers born after 1956, unless blood tests show immunity. Many adults born after 1956 and before 1970 received only one vaccination against measles, mumps, and rubella as children and should be given a second dose before travel. MMR vaccine should not be given to pregnant or severely immunocompromised individuals.

Tetanus-diphtheria vaccine is recommended for all travelers who have not received a tetanus-diphtheria immunization within the last 10 years.

Influenza vaccine is recommended for all travelers during flu season, which runs from May through October. Influenza vaccine may cause soreness at the injection site, low-grade fevers, malaise, and muscle aches. Severe reactions are rare. Influenza vaccine should not be given to pregnant women during the first trimester or those allergic to eggs.

An outbreak of murine typhus was reported from the Waikato region of North Island in October 2006. See ProMED-mail (October 5, 2006) for details. Murine typhus is caused by an organism called Rickettsia typhi. The infection is carried by rats, which are asymptomatic, and transmitted by rat fleas. Travelers who visit rat-infested buildings may be at risk, especially in coastal areas. Symptoms include fever, headache, muscle aches, vomiting, and rash. Most cases are mild and respond well to a short course of doxycycline, which is the drug of choice.

For an overview, go to Emerging Infectious Diseases in an Island Ecosystem: The New Zealand Perspective by Crump et al. in Emerging Infectious Diseases.

Leptospirosis is frequently reported in farmers and meat workers. The animal reservoir includes cattle, pigs, dogs, sheep, possums, and rats.

Legionnaires' disease is reported from South Island. Some cases have been caused by inhalation of dust from contaminated potting mix and compost bags. See ProMED-mail (Oct. 27, 2005) for further information.

HIV (human immunodeficiency virus) infection is reported, but travelers are not at risk unless they have unprotected sexual contacts or receive injections or blood transfusions.

For further information on health issues in New Zealand, go to the World Health Organization - Western Pacific Region.

Bring adequate supplies of all medications in their original containers, clearly labeled. Carry a signed, dated letter from the primary physician describing all medical conditions and listing all medications, including generic names. If carrying syringes or needles, be sure to carry a physician's letter documenting their medical necessity.Pack all medications in hand luggage. Carry a duplicate supply in the checked luggage. If you wear glasses or contacts, bring an extra pair. If you have significant allergies or chronic medical problems, wear a medical alert bracelet.

Make sure your health insurance covers you for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation, should be seriously considered. If illness occurs while abroad, medical expenses including evacuation may run to tens of thousands of dollars. For a list of travel insurance and air ambulance companies, go to Medical Information for Americans Traveling Abroad on the U.S. State Department website. Bring your insurance card, claim forms, and any other relevant insurance documents. Before departure, determine whether your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures. The Medicare and Medicaid programs do not pay for medical services outside the United States.

Pack a personal medical kit, customized for your trip (see description). Take appropriate measures to prevent motion sickness and jet lag, discussed elsewhere. On long flights, be sure to walk around the cabin, contract your leg muscles periodically, and drink plenty of fluids to prevent blood clots in the legs. For those at high risk for blood clots, consider wearing compression stockings.

Avoid contact with stray dogs and other animals. If an animal bites or scratches you, clean the wound with large amounts of soap and water and contact local health authorities immediately. Wear sun block regularly when needed. Use condoms for all sexual encounters. Ride only in motor vehicles with seat belts. Do not ride on motorcycles.

For an ambulance in New Zealand, call 111.

High quality medical care is widely available, but there are waiting lists for certain types of treatment.

Before you leave, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency medical care if needed.

All children should be up-to-date on routine childhood immunizations, as recommended by the American Academy of Pediatrics. Children who are 12 months or older should receive a total of 2 doses of MMR (measles-mumps-rubella) vaccine, separated by at least 28 days, before international travel. Children between the ages of 6 and 11 months should be given a single dose of measles vaccine. MMR vaccine may be given if measles vaccine is not available, though immunization against mumps and rubella is not necessary before age one unless visiting a country where an outbreak is in progress. Children less than one year of age may also need to receive other immunizations ahead of schedule (see the accelerated immunization schedule).

Be sure to pack a medical kit when traveling with children. In addition to the items listed for adults, bring along plenty of disposable diapers, cream for diaper rash, and appropriate antibiotics for common childhood infections, such as middle ear infections.

Helpful maps are available in the University of Texas Perry-Castaneda Map Collection and the United Nations map library. If you have the name of the town or city you'll be visiting and need to know which state or province it's in, you might find your answer in the Getty Thesaurus of Geographic Names.

Americans living or traveling in New Zealand are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website, https://travelregistration.state.gov, and to obtain updated information on travel and security within New Zealand.Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Consulate General in Auckland is located on the third floor of the Citibank Centre, 23 Customs Street East, between Commerce and Queen Streets. The telephone number is (64)(9) 303-2724. The fax number is (64-9) 366-0870. See also the Consulate General home page via the Internet at http://www.usembassy.org.nz.

The U.S. Embassy is located at 29 Fitzherbert Terrace, Thorndon, Wellington; the telephone number is (64)(4) 462-6000. The fax number is (64)(4) 471-2380.

For after-hours emergencies anywhere in New Zealand, a duty officer can be contacted by telephone. Persons seeking after-hours assistance may call (64)(4) 462-6000; after listening to a brief recording, the caller may leave a message on the voice mail system, describing the nature of the emergency and giving a point of contact. The phone system will automatically call the duty officer in Wellington or in Auckland, who will listen to the message and take the appropriate action.

For information on safety and security, go to the U.S. Department of State, United Kingdom Foreign and Commonwealth Office, Foreign Affairs Canada, and the Australian Department of Foreign Affairs and Trade.