The most critical health concern in Central America is mosquito-borne illnesses, including malaria, dengue and the Zika virus. All travelers should take precautions to prevent mosquito bites: strong insect repellent with DEET is essential. At the time of writing, pregnant women were advised against traveling to Central America due to the outbreak of the Zika virus.

There are no required vaccinations for Central America, except if you are coming from a yellow-fever-infected country in Africa or South America – then you must have a yellow fever vaccine. Among others recommended are typhoid, rabies and hepatitis A and B. Visit your doctor well ahead of your trip, since most vaccines don’t produce immunity until at least two weeks after they’re given. Ask your doctor for an International Certificate of Vaccination (aka 'the yellow booklet'), which will list all the vaccinations you’ve received. This is mandatory for countries that require proof of yellow-fever vaccination.

Most insurance providers do not cover overseas expenses, so it's strongly recommended to purchase a traveler's insurance policy that includes health coverage.

Checking insurance quotes…

Before You Go

Health Insurance

Find out in advance if your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditure. If the latter, be sure to collect receipts.

If your travel insurance does not cover you for medical expenses abroad, consider buying supplemental insurance. Check lonelyplanet.com/travel-insurance for more information.

Recommended Vaccinations

chicken pox

Recommended for

travelers who’ve never had chicken pox

Dosage

2 doses; 1 month apart

Side effects

fever, mild case of chicken pox

hepatitis A

Recommended for

all travelers

Dosage

1 dose before trip; booster 6-12 months later

Side effects

soreness at injection site, headaches, body aches

hepatitis B

Recommended for

long-term travelers in close contact with the local population

Dosage

3 doses over 6-month period

Side effects

soreness at injection site, low-grade fever

measles

Recommended for

travelers born after 1956 who’ve had only 1 measles vaccination

Dosage

1 dose

Side effects

fever, rash, joint pains, allergic reactions

rabies

Recommended for

travelers who may have contact with animals and may not have access to medical care

Dosage

3 doses over 3- to 4-week period

Side effects

soreness at injection site, headaches, body aches

tetanus-diphtheria

Recommended for

all travelers who haven’t had a booster within 10 years

Dosage

1 dose lasts 10 years

Side effects

soreness at injection site

typhoid fever

Recommended for

all travelers

Dosage

1 dose 2 weeks before travel; booster 2 years later

Side effects

abdominal pain, nausea, rash

yellow fever

Recommended for

required for travelers arriving from a yellow-fever-infected area in Africa or South America

Dosage

1 dose lasts 10 years

Side effects

headaches, body aches; severe reactions are rare

Websites

It’s usually a good idea to consult the health sections of your government’s travel advice website before departure. Other resources:

  • World Health Organization (www.who.int/ith) Publishes a superb book called International Travel and Health, which is revised annually and available on its website at no cost. The website lists updated risks and worldwide vaccination certificate requirements.
  • MD Travel Health (www.mdtravelhealth.com) Provides complete travel health recommendations for every country, updated daily.

In Central America

Availability & Cost Of Healthcare

Good medical care is available in most of the region’s capital cities, but options are limited elsewhere. In general, private hospitals are more reliable than public facilities, which may experience significant shortages of equipment and supplies.

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, take out travel insurance that covers medical expenses before your trip.

US travelers can find a list of recommended doctors abroad and emergency evacuation details on the website of the US State Department (http://travel.state.gov). Click on International Travel, then Before You Go, then Your Health Abroad.

Many pharmacies are well supplied, but important medications may not be consistently available. Be sure to bring along adequate supplies of all prescription drugs.

Mosquito-borne Diseases

All travelers are advised to take precautions against insect-borne diseases, including malaria, chikungunya, dengue and Zika. Many of these illnesses cannot be prevented with vaccines or medication, so the most effective prevention is to avoid bug bites:

  • Use an insect repellent that contains 20% or more DEET.
  • Treat clothing, bedding and camping gear with permethrin, which binds tightly to clothing.
  • Cover exposed skin with long sleeves, pants and hats.
  • Sleep in places with screened windows or use a bed net.

Malaria

Several prescription medications are available for the prevention of malaria. One of these may be recommended, depending where exactly you are traveling in Central America. Consult your doctor well before departure.

Zika

The Zika virus has broken out across the region. At the time of writing, pregnant women were advised against traveling to Central America, as the virus may be linked to microcephaly, a birth defect that affects a baby's brain development.

Zika is primarily transmitted by mosquitoes, but it can also be transmitted by a man to his sex partner or by a woman to her fetus. Be aware that symptoms are usually mild in adults, and many people may not realize that they are infected.

Please refer to the website for the Centers for Disease Control and Prevention (www.cdc.gov) for current information on the virus.

Tap Water

Tap water is not safe to drink in many parts of Central America. Vigorous boiling for one minute is the most effective means of water purification. At altitudes greater than 2000m (6500ft), boil for three minutes.

Another option is to disinfect water with iodine pills. Instructions are usually enclosed and should be carefully followed. Alternatively you can add 2% tincture of iodine to 1L of water (five drops to clear water, 10 drops to cloudy water) and let it stand for 30 minutes. If the water is cold, longer times may be required. The taste of iodinated water may be improved by adding vitamin C (ascorbic acid). Iodinated water should not be consumed for more than a few weeks. Pregnant women, those with a history of thyroid disease and those allergic to iodine should not drink iodinated water.

A number of water filters are on the market. Those with smaller pores (reverse osmosis filters) provide the broadest protection, but they are relatively large and also readily plugged by debris. Those that have somewhat larger pores (microstrainer filters) are ineffective against viruses, although they do remove other organisms. Manufacturers’ instructions must be carefully followed.