Health & insurance
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.
Before You Go
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 Vivian Pellas in Managua offers a variety of monthly packages that include emergency coverage and discounts on appointments with specialists.
There are no obligatory vaccinations for Nicaragua, with the exception of Yellow Fever for travelers arriving from affected areas. However, you may consider getting rabies, tetanus, typhoid and hepatitis shots before you set out. If planning on extended travel in the remote northwest corner of the Caribbean coast, it's worth considering taking anti-malaria medications.
Travelers should consider packing the following items:
- antidiarrheal drugs (eg loperamide)
- acetaminophen/paracetamol (Tylenol) or aspirin
- anti-inflammatory drugs (eg ibuprofen)
- antihistamines (for hay fever and allergic reactions)
- antibacterial ointment (eg Bactroban) for cuts and abrasions
- steroid cream or cortisone (for poison ivy and other allergic rashes)
- bandages, gauze, gauze rolls
- adhesive or paper tape
- scissors, safety pins, tweezers
- pocket knife
- DEET-containing insect repellent for the skin
- permethrin-containing insect spray for clothing, tents and bed nets
- oral rehydration salts
- iodine tablets or a Steripen (for water purification)
- syringes and sterile needles
- contraceptive pills
Availability & Cost of Health Care
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. In towns such as León and Granada it's possible to find specialist doctors, and a visit to a specialist costs around US$30 to US$40. For serious medical emergencies you should make your way to Managua, where there are several international-standard private hospitals. If you develop a life-threatening medical problem, your may want to be evacuated to a country with more advanced medical facilities.
Pharmacies in large towns tend to be relatively well-stocked and many medicines that are prescription-only in the States and Europe are available freely over the counter.
- Dengue fever Mosquito-borne 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. Malaria cases in Nicaragua are rare, and tend to be restricted to the remote northeast coast.
- 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-borne disease that is spreading rapidly through tropical and sub-tropical areas of Latin America. In Nicaragua there's a moderate risk of catching it, so mosquito bite prevention is essential. 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:
- Cover up exposed skin and use liberal amounts of insect repellent containing DEET, picaridin or oil of lemon (OLE).
- Treat your clothing and shoes with permethrin solution before arriving in Nicaragua.
- When booking accommodations, choose air-conditioned rooms, which offer some protection from bites. If this is not available, look for a room with good screens on the windows.
- Bring a mosquito net.
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.