Prevention is the key to remaining healthy while traveling abroad. Travelers who receive the recommended vaccinations for the destination and follow common-sense precautions usually come away with nothing more serious than a little diarrhea.
From a health point of view, the Caribbean is generally safe as long as you’re reasonably careful about what you eat and drink. The most common travel-related diseases, such as dysentery and hepatitis, are acquired by consumption of contaminated food and water. Mosquito-borne illnesses aren’t a significant concern on most of the islands, except during outbreaks of dengue fever.
Health standards in major resort islands, such as Barbados, Bermuda and the Cayman Islands, are high, and access to health care is good.
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Before You Go
Many of Haiti’s challenges are health related, due in part to the introduction of cholera by UN peacekeepers and the country's poor infrastructure. Malaria is also seasonally present. A higher level of health vigilance is required in Haiti than in the rest of the Caribbean. Always check reliable travel-health resources before travel to Haiti.
If your health insurance does not cover you for medical expenses while abroad, consider supplemental insurance; travel agents and the internet are good places to start looking. Find out in advance if your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures.
Note that Cuba requires proof of medical insurance to enter the country. On remote islands, such as the Grenadines, you will require transport to more developed areas for any significant problem, so be sure your insurance covers medical transport and evacuation.
At the time of writing there were no recommended vaccinations for the Caribbean, but check with your physician before travelling. If you are traveling away from major resort areas or going to places such as Haiti, however, it is vital that you consult a travel medical clinic at least three weeks before departure to check whether vaccinations are needed.
Bring medications in their original containers and clearly labeled. A signed, dated letter from your physician describing all medical conditions and medications, including generic names, is also a good idea. If carrying syringes or needles, be sure to have a physician’s letter documenting their medical necessity.
Recommended items for a personal medical kit:
- acetaminophen/paracetamol (eg Tylenol) or aspirin
- antibacterial hand sanitizer (eg Purell)
- antibacterial ointment (eg Bactroban) for cuts and abrasions
- antihistamines (for hay fever and allergic reactions)
- anti-inflammatory drugs (eg ibuprofen/Advil)
- DEET-containing insect repellent
- steroid cream or cortisone (for allergic rashes)
It’s always a good idea to consult your government’s travel-health website before departure, if one is available:
In the Caribbean Islands
Availability & Cost of Health Care
Acceptable health care is available in most major cities throughout the Caribbean, but may be hard to locate in rural areas. To find a good local doctor, your best bet is to ask the management of the hotel where you are staying or contact your local embassy.
Many doctors and hospitals expect payment in cash, regardless of whether you have travel-health insurance. If you develop a life-threatening medical problem, you’ll probably want to be evacuated to a country with state-of-the-art medical care. Since this may cost tens of thousands of dollars, be sure you have insurance to cover this before you depart.
Many pharmacies are well supplied, but important medications may not be consistently available. Be sure to bring along adequate supplies of all your prescription drugs.
You are unlikely to come down with an infectious disease in the Caribbean, especially if you are just visiting resorts and the most developed islands. Cruisers will find themselves sprayed with antibacterial hand sanitizer at every turn as the cruise lines seek to prevent mass viral outbreaks.
Dengue fever is a viral infection common throughout the Caribbean. Dengue is transmitted by Aedes mosquitoes, which bite mostly during the daytime and are usually found close to human habitations, often indoors. They breed primarily in artificial water containers, such as jars, barrels, cans, cisterns, metal drums, plastic containers and discarded tires. As a result, dengue is especially common in densely populated, urban environments.
Dengue usually causes flu-like symptoms, including fever, muscle aches, joint pains, headaches, nausea and vomiting, often followed by a rash. The body aches may be quite uncomfortable, but most cases resolve uneventfully in a few days. Severe cases usually occur in children aged under 15 who are experiencing their second dengue infection.
If you suspect you have dengue fever, seek out medical advice. There is no vaccine. The cornerstone of prevention is protection against insect bites.
Hepatitis A is the second-most-common travel-related infection (after traveler’s diarrhea). The illness occurs throughout the world, but the incidence is higher in developing nations. It occurs throughout the Caribbean, particularly in the northern islands.
Hepatitis A is a viral infection of the liver that is usually acquired by ingesting contaminated water, food or ice, though it may also be acquired by direct contact with infected persons. Symptoms may include fever, malaise, jaundice, nausea, vomiting and abdominal pain. Most cases resolve without complications, though hepatitis A occasionally causes severe liver damage. There is no treatment.
The vaccine for hepatitis A is extremely safe and highly effective. If you get a booster six to 12 months later, it lasts for at least 10 years. You should get it before you go to any developing nation. Because the safety of the hepatitis A vaccine has not been established for pregnant women or children under the age of two, they should instead be given a gamma globulin injection, which temporarily boosts immunity.
HIV/AIDS rates across the Caribbean are estimated at 1%. The highest prevalence is reported in The Bahamas, Haiti, and Trinidad and Tobago. Most cases in the Caribbean are related to heterosexual contact, especially with sex workers. The exception is Puerto Rico, where the most common cause of infection is intravenous drug use. Be sure to use condoms for all sexual encounters. If you think you might visit a piercing or tattoo parlor, or if you have a medical condition that might require an injection, bring along your own sterile needles.
A parasitic infection carried by snails and acquired by exposure of skin to contaminated freshwater, schistosomiasis has been reported in parts of the Dominican Republic, Guadeloupe, Martinique, Puerto Rico, Antigua and Barbuda, Montserrat and St Lucia. To find out whether or not schistosomiasis is present in the areas you’ll be visiting, go to the World Health Organization’s Global Schistosomiasis Atlas (www.who.int/schistosomiasis/epidemiology/global_atlas/en/).
Early symptoms may include fever, loss of appetite, weight loss, abdominal pain, weakness, headaches, joint and muscle pains, diarrhea, nausea and a cough, but most infections are asymptomatic at first.
When traveling in areas where schistosomiasis occurs, you should avoid swimming, wading, bathing or washing in bodies of freshwater, including lakes, ponds, streams and rivers. Toweling yourself dry after exposure to contaminated water may reduce your chance of getting infected, but does not eliminate it. Saltwater and chlorinated pools carry no risk of schistosomiasis.
In places where tap water is safe to drink – much of the Caribbean – your risk of diarrhea is not high. But in places where the tap water is suspect, take the usual precautions: eat fresh fruits or vegetables only if cooked or peeled; be wary of dairy products that might contain unpasteurized milk; and be highly selective when eating food from street vendors.
Zika is present in many parts of the Caribbean. The virus spreads through the bite of an infected Aedes mosquito. Common symptoms include fever, rash, joint pain and conjunctivitis. Most victims experience mild illness with symptoms that last for several days to a week. Since Zika may cause brain damage to a fetus in utero, pregnant women should avoid visiting a Zika hot spot. The virus may also be sexually transmitted by an infected partner. Since there is no vaccine or treatment, the cornerstone of prevention is protection against mosquito bites.
A few things to watch out for:
Mosquito bites Caribbean mosquitoes and other biting/stinging insects come in all shapes and sizes, and are quite common. The biggest concern here, outside the few areas with malaria, is simply discomfort and hassle. Make certain you have a good insect repellent with at least 25% DEET.
Rabies Some islands do have rabies, so do as you would at home and avoid touching or petting strays.
Sea stingers Spiny sea urchins and coelenterates (coral and jellyfish) are a hazard in some areas. If stung by a coelenterate, apply diluted vinegar or baking soda. Remove tentacles carefully, but not with bare hands. If stung by a stinging fish, such as a stingray, immerse the limb in water at about 115°F (45°C).
Sunburn Wear sunscreen with a high SPF as the Caribbean sun is very strong and sunburn is common. Every day we see people who are as pink as lobsters and have their trips ruined because they didn’t apply sunscreen, especially after time in the water.
Tap water is safe to drink on some of the islands, but not on others. Unless you’re certain that the local water is safe, you shouldn’t drink it.
Note: if tap water is safe to drink – as it is on the major destination islands except for Cuba – then avoiding bottled water reduces the significant environmental impact of plastic water containers.