Travelers to the Yucatán need to be careful chiefly about food- and water-borne diseases, though mosquito-borne infections can also be a problem, Zika and dengue being the most high profile. Most of these illnesses are not life threatening, but they can certainly impact on your trip or have other long-term consequences. Besides getting the proper vaccinations, it’s important that you bring a good insect repellent and exercise care in what you eat and drink.
Be sure to keep your water intake up; it can get hot in these parts and it's easy to get dehydrated if you're not careful, whether you're lying on a beach or exploring ruins. Both are thirsty work.
Private hospitals give better care than public ones, but are more expensive.
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Before You Go
Bring medications in their original containers, clearly labeled. A signed, dated letter from your physician describing all medical conditions and medications, including generic names, is a good idea. If carrying syringes or needles, be sure to have a physician’s letter documenting their necessity.
Make sure all routine vaccinations are up to date and check whether all vaccines are suitable for children and pregnant women at www.cdc.gov/travel. Since most vaccines don’t produce immunity until at least two weeks after they’re given, visit a physician four to eight weeks before departure.
Hepatitis A All travelers (not recommended for pregnant women or children under two years); gamma globulin is the alternative.
Hepatitis B Long-term travelers in close contact with local population (requires three doses over a six-month period).
Rabies Recommended only for travelers who may have direct contact with stray dogs and cats, bats and wildlife.
Typhoid Recommended for all unvaccinated people, especially for those staying in small cities, villages and rural areas.
In the Yucatán
- Hepatitis A occurs throughout Central America. It’s a viral infection of the liver usually acquired by ingestion of 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 uneventfully, 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 Mexico.
Dengue Fever & Chikungunya Virus
Dengue fever is a viral infection found throughout Central America. In Mexico, the risk is greatest along the Gulf coast, especially from July to September. Dengue is transmitted by Aedes mosquitoes, which bite preferentially during the day and are usually found close to human habitations, often indoors. They breed primarily in artificial water containers, such as cisterns and discarded tires. As a result, dengue is especially common in urban environments.
- Dengue usually causes flu-like symptoms, including fever, muscle aches, joint pains, headache and nausea, and it's often followed by a rash.
- Expect similar symptoms if infected by the mosquito-transmitted chikungunya virus.
- There is no vaccine and no specific treatment for dengue and chikungunya, except analgesics. Severe cases may require hospitalization.
Zika has had a lot of press and is, unfortunately, present in the Yucatán, though at what density it is still unclear. What's not unclear is how to avoid it: take basic precautions to avoid mosquito bites. Use mosquito nets and repellent, wear insecticide-impregnated clothing, and avoid being outdoors without protection.
In itself, it presents as a relatively mild case of flu-like symptoms and generally goes away on its own. However, Zika has been linked to microcephaly, a birth deformation where the brain does not grow to normal size. Apparently most dangerous in the first trimester, Zika should be treated very seriously by pregnant women, women hoping to become pregnant, and their partners. At this time, research indicates that the virus can be spread by blood or unprotected sex much the same way many other STDs are. Though still not clear, the virus may also be linked to a rare nervous system disorder in men and women, Guillain–Barré syndrome.
Currently, there is no vaccine.
Occurs in Chiapas and in rare cases, Quintana Roo. It’s transmitted by mosquito bites, usually between dusk and dawn. The main symptom is high spiking fevers, which may be accompanied by chills, sweats, headache, body aches, general weakness, vomiting or diarrhea.
- Taking malaria pills is strongly recommended when visiting rural areas. For Mexico, the first-choice malaria pill is chloroquine.
- Protecting yourself against mosquito bites is just as important as taking malaria pills, as no pills are 100% effective. If you develop a fever after returning home, see a physician, as malaria symptoms may not occur for months. It can be diagnosed by a simple blood test.
- To prevent bites, wear long sleeves, long pants, hats and shoes (rather than sandals). In areas with chaquistes (gnatlike sand flies that can leave welts), avoid exposing your flesh at dusk and dawn when they're out in full force.
- Don’t sleep with the window open unless there is a functional screen. Use a good insect repellent that should be applied to exposed skin and clothing, but don't use DEET-containing compounds on children under two years.
- Insect repellents containing certain botanical products, including eucalyptus oil and soybean oil, are effective but last only 1½ to two hours. Where there is a high risk of malaria, use DEET-containing repellents. Products based on citronella are not effective.
- If sleeping outdoors or in accommodations that allow entry of mosquitoes, use a mosquito coil.
Typhoid fever is caused by ingestion of food or water contaminated by Salmonella typhi. Fever occurs in virtually all cases. Other symptoms may include headache, malaise, muscle aches, dizziness, loss of appetite, nausea and abdominal pain. Either diarrhea or constipation may occur.
The drug of choice for typhoid fever is usually a quinolone antibiotic, such as ciprofloxacin (Cipro) or levofloxacin (Levaquin).
Snake & Scorpion Bites
Venomous snakes in the Yucatán generally do not attack without provocation, but may bite humans who accidentally come too close. Coral snakes are somewhat retiring and tend not to bite humans unless considerably provoked.
- In the event of a venomous snake or scorpion bite, place the victim at rest, keep the bitten area immobilized and move them immediately to the nearest medical facility. Avoid using tourniquets, which are no longer recommended.
- To prevent scorpion stings, be sure to inspect and shake out clothing, shoes and sleeping bags before use. If stung, apply ice or cold packs.
Sunburn & Heat Exhaustion
To protect yourself from excessive sun exposure, you should stay out of the midday sun, wear sunglasses and a wide-brimmed hat, and apply sunscreen with SPF 30 or higher, providing both UVA and UVB protection.
- Sunscreen should be applied to all exposed parts of the body approximately 30 minutes before sun exposure and be reapplied after swimming or vigorous activity.
- Do not apply sunscreen or bug repellent prior to swimming in cenotes (limestone sinkholes) – it pollutes the water.
- Drink plenty of fluids and avoid strenuous exercise when the temperature is high. Heat exhaustion is characterized by dizziness, weakness, headache, nausea or profuse sweating.
Tap water is generally not safe to drink.
- Vigorous boiling for several minutes is the most effective means of water purification.
- Another option is to disinfect water with iodine pills. Instructions are usually provided and should be carefully followed.
- Numerous water filters are on the market. Those with smaller pores (reverse osmosis filters) provide the best protection, but they are relatively large and readily plugged by debris. Those with somewhat larger pores (microstrainer filters) are ineffective against viruses, although they do remove other organisms.