CDC Yellow Book: Health Information for International Travel
Edition: 2026
“Top takeaway: Healthcare professionals should promote awareness of travel-related injury risks to international travelers.
Carbon monoxide (CO) inhalation, poisoning, and death can occur during fires but also can result from exposure to improperly vented heating devices (see Air Quality and Ionizing Radiation During Travel chapter; and Poisonings, Envenomations, and Toxic Exposures During Travel chapter). Travelers might want to bring a personal CO detector that can sound an alert in the presence of this lethal gas. Engine exhaust is a dangerous, unanticipated source of CO poisoning; remind travelers to avoid diving and swimming off the back of boats where exhaust fumes typically discharge.”
“Assigning liability…can be far murkier when travelers rent from a third-party host. The big question: What duty – if any – does Airbnb owe its customers to keep them safe?”
“As for where to place the device, (NFPA) offers this guidance: ‘Carbon monoxide is the same composition as air, so placement varies by manufacturer, but does not need to be installed like a smoke alarm. You can place it on a dresser in your sleeping room to provide protection. If you use a plug-in alarm, it would be best to plug it into an outlet that is as close to where you’re sleeping as possible.’”
“Policies differ across hotel chains, but home vacation rental companies Airbnb and VRBO allow guests to search for properties with a carbon monoxide alarm when booking, and both strongly encourage hosts to install the devices.
But this online information isn’t always accurate, said Kris Hauschildt, founder of the Jenkins Foundation, a nonprofit dedicated to preventing carbon monoxide poisoning.
Hauschildt, who started the foundation after her parents died from hotel carbon monoxide poisoning in 2013, said she recently booked an Airbnb that advertised a carbon monoxide alarm, only to arrive and find there wasn’t one.
‘This is the fourth rental I’ve stayed in where this has happened,’ Hauschildt told Health. ‘Hosts have all been responsive to immediately address the issue, but it obviously highlights that safety continues to be in the hands of the consumer.’”
LAKE LURE, N.C. (WLOS) — A group of friends and family had gathered at Lake Lure for what was supposed to be a fun summer getaway to celebrate three birthdays, including Emilie Holochak’s.
But, Holochak said their retreat quickly turned into a life-or-death situation in the middle of the night when they uncovered carbon monoxide in their rental home. Holochak said she and her family met up with their friends Friday morning before it all unfolded.
“This was a group of my friends that are from Raleigh, we all met at Lake Lure… We met on Friday morning, just having a good time, rented a boat, we had golf carts, the whole thing, it was wonderful, cooked, had a great time,” she explained.
The enjoyment of fun quickly took a sour turn.
“It was Saturday at about 2 a.m.,” she said. “Everybody is sleeping and as I mentioned, everybody had sound machines in these bedrooms to drown out noise and help kids sleep – two children in each bedroom and adults. My husband and I and daughter were sleeping in a loft. The door was open, so when the carbon monoxide detector went off at around 2:30 in the morning, we immediately heard it.”
She said she went to check it out and unplugged it and plugged it back in, and it kept going off.
“I woke up a friend, and we decided [to] call 911. They got us connected with the fire department, they sent the fire department and they got there in about 20 minutes,” she said.
After clearing the area, the Lake Lure Fire Department was able to find where the source was coming from.
The dangerous fumes were pouring from the garage, just one room away from where a two-year-old boy was sleeping.
“What we didn’t know is that there’s a huge closet in that room, where one of the two-year-olds was sleeping and we weren’t able to test the levels in that room. We cleared out very quickly but the fireman found the source in the garage. We have four golf carts plugged in. It was the charging station being plugged in; it was emitting all of this carbon monoxide,” she said.
Lake Lure’s Assistant Fire Chief Chris Melton says that situations like this should never be taken lightly, as carbon monoxide is a colorless, odorless gas and it can be fatal without warning.
“When we get a phone call like that, we take it very seriously because of how dangerous carbon monoxide is,” he said.
“Cathy Foley, the mother of Hudson Foley, recently announced the official launch of the Pack Safe Appeal: Hudson’s campaign for Carbon Monoxide Travel Safety, marking the one-year anniversary of the death of her son Hudson from carbon monoxide poisoning while he was travelling in Ecuador.”
“Airbnb operates in countries and states with a wide variety of carbon monoxide regulations, which presents a tough compliance challenge for the company. The company says it has advocated for carbon monoxide detector regulation in numerous countries, but family members of people who have died in Airbnbs say the wide variability in local and international regulation is more reason for the company to set its own standard on carbon monoxide detectors.
“It’s really hard to mandate things in 220 countries and regions and cities all over the world,” Chesky said. “And then if you mandate something, you have to have a mechanism to verify that it happens.”
Members of the Grace Fellowship Church in Fort Thomas are mourning the loss of a mother following a youth group retreat this weekend.
Kentucky State Police say two women from the church were on the retreat with a youth group at The Bluegrass Palace in Langley, Kentucky, when they were found unresponsive.
Kara Hanks, a mother and one of the leaders of the youth group, was dead by the time she arrived at the hospital, according to Floyd County Coroner Greg Nelson.
Troopers said the women were taken to the hospital for suspected carbon monoxide poisoning. Nelson said he couldn’t confirm a cause of death until after the toxicology report and an autopsy were finished.
A Laguna Beach, California, couple filed a lawsuit against Sun Valley Co. last month, alleging that four members of their family suffered carbon-monoxide poisoning while on resort property in December 2022.
George Sumner and Lauren Sumner are asking for compensation of more than $10,000 for alleged negligence and “significant bodily injuries,” according to their initial complaint, filed in 5th District Court by Boise-based attorney David Comstock.
According to the lawsuit, the couple booked a guest cottage near the Sun Valley Pavilion for themselves, their two minor children and George Sumner’s parents for Dec. 21-27, 2022. The two-story house at 152 Baldy View Loop was built in 1950 and is heated by a basement gas furnace, Comstock wrote. The type of heating system was allegedly not specified in the vacation listing, he said.
Blood tests administered to three members of the Sumner family in the St. Luke’s Wood River emergency room on Dec. 23, 2022, allegedly showed that Lauren, George’s mother, Melinda, and Melinda’s husband, Steven, had carboxyhemoglobin levels between 13-16%, the lawsuit states.
Levels above 2% for nonsmokers and 9% for smokers indicate carbon-monoxide poisoning, according to the Centers for Disease Control and Prevention (CDC). People with underlying heart conditions may die at an exposure level above 10%, and levels over 50% are lethal, according to the CDC.
The Sumners’ complaint stated that, upon arriving at the cottage on Dec. 21, 2022, the family realized that the heat had not been turned on and ate dinner at the adjacent Sun Valley Lodge while waiting for the home to warm up. The children slept in twin beds on the second floor while adults slept on the first floor that night, Comstock stated.
However, on the morning of Dec. 22, 2022, both children allegedly woke up feeling “unwell” and suffered vomiting, “stomach aches, headaches, and nausea” over the next few hours, the complaint stated. Lauren Sumner and George Sumner’s mother, Melinda Grubbs-Sanders, also allegedly awoke with headaches that morning, Comstock stated.
Lauren and Melinda stayed behind in the cottage to rest and supervise the children that morning, according to the lawsuit. Lauren allegedly called St. Luke’s for health advice on Dec. 22 and was advised to “try over-the-counter supplemental oxygen and electrolyte tablets,” Comstock wrote. These measures allegedly improved the older child’s health, but the younger child “was still nauseous and vomiting into the evening” as temperatures outside dropped to around zero degrees, Comstock stated.
When the Sumner family awoke the next morning, Dec. 23, “many of their symptoms had grown worse,” the lawsuit stated. Melinda Grubbs-Sanders allegedly “awoke with the same headache and almost lost her balance in the shower after experiencing severe lightheadedness,” and Steven Grubbs-Sanders “also awoke feeling lightheaded and struggling to catch his breath,” according to the complaint.
Because the younger child was still vomiting and she still had a headache, Lauren stayed behind in the cottage on Dec. 23 while her husband and their older child left to go skiing, the lawsuit stated. While showering on Dec. 23, Lauren allegedly “got so lightheaded she almost fainted” and lay on the shower floor and bathroom floor because she could not walk, Comstock stated.
When George returned with the older child, he allegedly “found Lauren severely disoriented” and, suspecting a gas leak, opened the bedroom windows “to get fresh air into the house,” according to the lawsuit. He allegedly called a front-desk resort employee, who arranged for a maintenance worker to stop by the cottage about two hours later.
The lawsuit states that the maintenance worker arrived with a carbon-monoxide detector. The device allegedly went off as soon as the worker entered the cottage. Another HVAC technician hired by the resort allegedly entered the cottage with a different carbon-monoxide detector, which also began beeping, according to the lawsuit. The latter technician allegedly turned off the furnace, opened up another door and instructed the family to exit “immediately,” the complaint stated.
The technician’s concern allegedly prompted the family to seek treatment in the emergency department at St. Luke’s Wood River Medical Center in Ketchum the night of Dec. 23, 2022. Lauren, the younger child, Melinda, and Steven each required supplemental oxygen at the hospital to remove CO gas from their systems, the complaint stated.
“Blood tests showed that Lauren had an elevated heart rate, and her carboxyhemoglobin level was 15.3 (percent),” Comstock wrote. Melinda’s carboxyhemoglobin level was allegedly 13.1% at the time she was tested, and Steven’s slightly higher, at 13.6%. The child allegedly had “similar or worse carbon monoxide poisoning” than Lauren, the lawsuit said.
The Sumner family also sought hyperbaric oxygen therapy on Dec. 24 and Dec. 26 to treat its alleged carbon-monoxide poisoning, according to the lawsuit. Comstock did not specify where that treatment took place.
The family left Idaho on Dec. 29, but the family members’ symptoms “persisted or worsened” after returning home, Comstock stated. Lauren Sumner allegedly continued to experience “anxiety, chest pains, shortness of breath and brain fog,” while Melinda Grubbs-Sanders continued to experience “shortness of breath, brain fog, and unsteadiness” and the younger child “nausea, headaches, blurred vision” and emotional disturbances, the complaint said.
The four affected family members allegedly sought out “more hyperbaric oxygen treatments, brain scans, echocardiograms, MRIs” and neurological exams after their vacation in Sun Valley. “It is unknown if all the effects of their carbon-monoxide poisoning have been fully discovered or resolved,” Comstock wrote.
The civil lawsuit ultimately alleges negligence, accusing Sun Valley Co. of breaching its duty of maintaining the guest cottage “in a safe condition” and failing to inspect its premises “for conditions or hazards that could pose a threat to guests.” The Sumner family is therefore seeking “economic and noneconomic damages” for “severe emotional distress … accompanied by physical manifestations.”
“Plaintiffs’ injuries have caused and continue to cause great mental and physical distress, suffering, and loss of enjoyment of life,” the lawsuit states. “[Plaintiffs] … will continue to incur medical expenses and other expenses related to their injuries for some time into the future. The exact amount of said expenses is unknown to the plaintiffs at the present time but will be proven with particularity at the time of trial.”
The family has demanded a jury trial with “no less than 12 people.” As of press time, Comstock had not responded to requests for comment and Sun Valley Resort declined to comment
When making vacation plans, most travelers include a safety plan to protect themselves against things like being stranded or getting mugged. Very few consider the possibility of carbon monoxide poisoning in their hotel or Airbnb. There is an easy way to protect you and your loved ones from the hidden danger.
The past 20 years have seen more than 1,000 injuries from carbon monoxide leaks in U.S. hotels, with 32 people, including seven children, dying – that’s according to the non-profit Jenkins Foundation, which tracks carbon monoxide incidents at hotels. While smoke alarms are normally required in every hotel room by law, there is no such law for carbon monoxide detectors, nor are they required by Airbnb, which has seen 10 carbon monoxide deaths in Chile and Mexico in the past five years. What makes the gas so dangerous is that it’s odorless and colorless. The most common causes of carbon monoxide poisoning in hotels are boilers and heaters used to warm swimming pools and water for an entire wing, according to Dr. Lindell Weaver, who specializes in carbon monoxide poisoning. “Carbon monoxide can go through drywall very easily,” Dr. Weaver said. “It can move through crevices and little holes. So, indeed, people often have been poisoned, sometimes quite a distance, remote, from the poisoning or carbon monoxide source.”
Dr. Weaver encourages travelers to buy a portable carbon monoxide alarm. They cost anywhere from $30 to $100, they’re small, and they don’t take up much room in your luggage. Packing at least one will protect you and your loved ones from the dangers of this deadly gas.
It’s crucial to seek medical treatment as soon as you start feeling sick. If you’re staying at a hotel or resort, there may be a nurse or medical professional on staff who can assess your condition.
“An investigation by NBC News has identified 19 deaths at Airbnb properties involving alleged carbon monoxide poisoning since 2013. All of those deaths happened outside of the U.S. Airbnb says safety is a “top priority” and called the incidents “exceptionally rare.” NBC News’ Hallie Jackson reports.”
“Nineteen of Jade and Cassidee Smith’s family members were exposed to carbon monoxide on Friday night. As a result, seven of them were left unresponsive…”
An important reminder to always pack your own CO alarm when traveling
“The best way to protect yourself from toxic levels of this gas is by having a working carbon monoxide detector that can alert you if you are in danger.”
“Recent traveler deaths from carbon monoxide poisoning in hotels and home rentals serve as reminders why this safety device is a packing list essential. Here’s what you need to know to protect yourself.”
Comparison of four low-level carbon monoxide alarms suitable for home use
or when traveling. Undersea Hyperb Med. 2022 Third Quarter; 49(3):307-313.
Introduction/Background: Interest in carbon monoxide (CO) alarms that are more sensitive than is
required for standard residential CO alarms is growing, as reflected by increased marketing of “low-level” alarms capable of measuring CO levels as low as 10 PPM. At the same time, publicity surrounding
CO poisoning events among travelers in lodging facilities has stimulated interest in travel CO alarms.
We sought to evaluate four low-level alarms that could be used in the home and especially when
traveling.
Materials/Methods: Two each of four brands of low-level alarms (CO Experts, Forensics, Kidde, and
Sensorcon) were acquired by retail purchase and tested. The eight alarms were simultaneously
exposed in an environment with a slowly increasing level of CO from indoor burning of charcoal
briquets. CO levels displayed on the alarms were recorded once per minute. Activation of preset alerts
on the alarms were noted. Finally, alarms were compared for ease of use and features available.
Results: All brands of alarms measured CO similarly over the range from 10-120 PPM. All alarms
performed as claimed by their manufacturers, both regarding range of CO reported and preset alert
activation. Each alerted at CO levels below that required by the Underwriters Laboratories 2034
Standard.
Summary/Conclusions: Since all low-level CO alarms tested measured CO similarly, consumers seeking
a low-level CO alarm for use while traveling should base their decision on features desired and price.
There are definite differences between the alarms tested, in terms of features, expected durability,
ease of operation and price.
“After three Americans died from carbon monoxide poisoning at an Airbnb in 2022, we’re looking at what the host’s responsibilities are when it comes to CO detectors.”
“Initial local reports pointed to the cause being a faulty gas-powered fridge…sources said they were investigating the possibility deadly carbon monoxide gas had been seeping out all night while the couple slept in the main bedroom…”
“Mary Somerville, 39, was found unconscious alongside her husband, Jaime Carsi, 40, in a villa in Majorca on May 6 due to a carbon monoxide leak. The leak is believed to have been caused by a broken fridge in their holiday accommodation.”
“According to Juneau County Sheriff’s Office’s initial statement, deputies went to the cabin, in Armenia Township, around 5 p.m. on Monday, March 27, after getting two calls asking them to check on the individuals there. Upon arrival, they discovered two people, neither of whom appeared to be breathing.”
“Student Tom Hill, 18, collapsed and died 11 days after the holiday home operator was told about a previous tenant becoming unwell…The inquiry heard that a previous guest at the cottage had reported becoming physically unwell during her stay. The carbon monoxide alarm had also sounded.”
“Jessica Taschner was in a coma for a week and her boyfriend died after they were poisoned by carbon monoxide (CO) from a propane-run refrigerator while staying at a cabin… She spent summers there with her family, in the cabin her grandparents had built in the 1950s…”
“You’ve got your suitcase packed with clothes, shoes, and toiletries, and your carry-on has your passport, phone, and laptop. But one thing you are likely missing is a portable carbon monoxide detector. While you may already have one in your home, have you ever thought about bringing a carbon monoxide detector on the road? There have been a number of instances when hotel or vacation-home rental guests have been killed by carbon monoxide poisoning. The gas is odorless and tasteless, which is why it’s crucial to have a detector on hand.”
“Gene Beauchamp, 74, was an Army veteran and served in the Vietnam War…and Phil Mabray, a 61-year-old resident of Biggs in Butte County, were found dead Wednesday at a home on Spinnaker Close in The Sea Ranch…they were discovered by a crew from Gualala-based Gonzalez Tree Service that had been called in to remove a tree that fell onto the home…exact causes of death are being investigated, but the sheriff’s office has pointed to evidence indicating possible carbon monoxide poisoning….a generator was discovered in a hallway of the home, its switch on and its fuel tank empty…about a third of the homes in the community are occupied full time, a third are weekenders and the remainder are vacation and long-term rentals.”
“We put carbon monoxide detectors in our homes to make us aware of any odorless leaks coming from our furnace, stove or generator. However, when staying in hotels, Airbnbs, RVs, tents, campers, etc., there could either be a lack of carbon monoxide detectors in general, or a lack of knowing if they’re working or not.”
Carbon monoxide exposure can be deadly but it’s often the last thing people consider while traveling. Tanya Rivero reports on the symptoms of carbon monoxide poisoning, the lack of regulations in U.S. hotels, and what you can do to protect yourself and your family this holiday season.
“It’s wise to assume that your hotel room does not have a CO detector in place, according to advocates who urge people to pack their own battery-powered or plug-in devices when traveling, noting that regulations vary.”
“Upon investigation it is believed that the couple had been using a small charcoal stove for heat without proper ventilation…There was no carbon monoxide detector inside the cabin at the time.”
“He was not the first guest to fall ill in Room 205. Just when Pawel Markowski thought that nothing could shake him more than nearly losing his life to a carbon monoxide leak at a hotel in Catoosa, Okla., his lawyer sent him the Fire Department’s report.
‘We have previously responded to this exact room number two other times in the last two weeks,’ Denus Benton, Catoosa’s fire chief, wrote….”
“It took only 11 minutes for carbon monoxide to kill.
That’s all the time, authorities believe, that Sarah MacDermid, 31, and her boyfriend Casey Bussiere, 37, had after they were were accidentally – and unknowingly – exposed to carbon monoxide from an inadequately-ventilated propane water heater in a shower building…”
“Two months after the incident, the report from Technical Safety BC’s investigation pointed to an improperly installed propane refrigerator as the main source of the carbon monoxide. It had been installed in 2010 and was not certified for use in Canada, according to the report. The cabin was built in the 1950s and can only be accessed by water or a rough dirt road. It did not have a carbon monoxide detector.”
Keep your family safe by packing a CO alarm when traveling.
VRBO to hosts: “We expect that you install a carbon monoxide and smoke alarm in every hallway near sleeping areas within your vacation rental.” This is openly accessible information on VRBO’s site.
NFPA’s “…updated messaging (includes) directing people to choose hotel/motels that are protected by smoke and CO alarms, as well as sprinklers, and recommends the use of travel CO alarms…”
“When you book your first post-COVID-19 vacation rental, do you know if the hotel you book or home you rent requires CO alarms? The Fire Protection Research Foundation conducted a literature review to summarize existing requirements for installation of CO detection devices and consolidated the available and pertinent non-fire CO incident data.”
“He managed to get me to the kitchen, which was only like 10 feet away from the bed, he put me on a chair and I remember seeing him on the floor … nothing seemed real.”
We’ve added a new page to our website with data, links and resources related to carbon monoxide poisoning in U.S. hotels. It’s the travel season – be aware of CO and pack an alarm when you go.
“Building owners should be especially concerned about brick chimneys…Inspect the chimneys for loose bricks. If the chimney provides ventilation for a fireplace or appliances such as furnaces or water heaters, make sure it still vents…also encourage building owners to ensure they have a working carbon monoxide detector.”
MENU
