Most visitors to Nicaragua travel without incident. However, it is a developing nation with poor infrastructure and a tropical climate, and so there are certain things you should be aware of to avoid an unnecessary visit to the doctor.
Stomach problems and diarrhea are the result of bacteria, viruses and parasites which may be present in contaminated food and water. Many other illnesses affecting travelers, such as infected bug bites, rashes and heat exhaustion, are the result of Nicaragua's tropical climate.
Other more serious diseases are carried by infected mosquitoes; bring clothes that provide protection against bites and repellent.
Particular attention should be paid to the Zika virus which poses serious risks for pregnant women. Travelers who are pregnant should seek medical advice before making plans.
Medical attention in Nicaragua is cheap; however, apart from in the best clinics in the capital, it is probably not up to the standards you are used to at home.
In rural areas and small towns, English-speaking doctors are hard to find. Local clinics are fine for dealing with minor illnesses, cuts and sprains, but for anything more serious you should make your way to Managua, where there are several competent private hospitals. If you develop a life-threatening medical problem, your may want to be evacuated to a country with more advanced medical facilities.
Dengue fever is a mosquito-born viral infection transmitted by Aedes mosquitoes. It's most commonly transmitted during the day and usually close to human habitations, often indoors.
Malaria Transmitted by mosquitoes, although those that carry the disease prefer to bite in the evening. It's more common in rural areas.
Leptospirosis A rare but serious bacterial infection transmitted through water contaminated with animal urine.
Zika virus Another infection transmitted by Aedes mosquitoes. It is of particular concern to pregnant women as it's believed to affect the development of the fetus.
The Zika virus is a mosquito born disease that is spreading rapidly through tropical and sub-tropical areas of Latin America. The illness usually causes only mild symptoms including fever, rash, joint pain and red eyes and most cases doesn't require hospitalization; some patients may not even realize they are infected.
However, the Zika poses a serious threat to pregnant women as it is suspected of traveling through the placenta and causing birth defects including microcephaly. Pregnant women should consider postponing travel to areas affected by Zika until the virus has been controlled and more is known about the effects on fetal development.
The Zika virus has also been linked to Guillain-Barré syndrome, a rare condition affecting the nervous system, although research is continuing into the connection.
As Zika is primarily spread by mosquitoes, it is essential that travelers to areas all over Nicaragua take precautions to avoid bites.
The virus is mainly spread by the Aedes mosquito, which is most active during the day, although can also bite at night. It’s often found indoors or close to buildings.
The virus can also be spread sexually so it's important to use condoms while traveling and for three weeks upon returning from a Zika-infected area to avoid affecting partners.
The Nicaraguan government has launched an extensive and aggressive approach to combat the virus which includes large-scale fumigation efforts in major urban areas. If you develop Zika symptoms you are required by local regulations to immediately report to the health authorities.
For the latest details on the virus and the risks in the region consult the Center for Disease Control's dedicated web page (www.cdc.gov/zika).
To avoid mosquito bites:
Tap water is potable in cities and larger towns but should be avoided in rural areas and throughout the Región Autónoma Atlántico Sur (South Atlantic Autonomous Region; RAAS) and Región Autónoma Atlántico Norte (North Atlantic Autonomous Region; RAAN). In cheaper restaurants, ice and juices are usually made with untreated water.
Travelers should consider packing the following items:
There are no obligatory vaccinations for Nicaragua, with the exception of Yellow Fever for travelers arriving from affected areas. However, you may consider getting typhoid and hepatitis shots before you set out. Some travelers also choose to take anti-malaria medications.
Most health care is cheap in Nicaragua and short-term health insurance is not widely available. Ensure that your travel insurance covers medical bills, hospitalization and evacuation.
For long-term visitors, the Hospital Metropolitano (www.metropolitano.com) in Managua offers a variety of monthly packages that include emergency coverage and discounts on appointments with specialists.