For general information about health issues in Central America, log on to the Centers for Disease Control and Prevention's website at www.cdc.gov/travel. In addition to the recommendations below, the CDC advises visitors to Central America to protect themselves against hepatitis A and B. Consult your doctor for more information about these vaccinations.
Before You Go -- It can be hard to find a doctor you can trust when you're in an unfamiliar place. Try to take proper precautions the week before you depart to avoid falling ill while you're away from home. Amid the last-minute frenzy that often precedes a vacation, make an extra effort to eat and sleep well.
Pack prescription medications in their original labeled containers in your carry-on luggage. Also, bring along copies of your prescriptions in case you lose your pills or run out. Carry written prescriptions in generic form, in case a local pharmacist is unfamiliar with the brand name. If you wear contact lenses, pack an extra pair or your glasses.
If you worry about getting sick away from home, you may want to consider medical travel insurance.
If you suffer from a chronic illness, consult your doctor before your departure. For conditions such as epilepsy, diabetes, or heart problems, wear a MedicAlert identification tag (tel. 888/633-4298; www.medicalert.org), which will immediately alert doctors to your condition and give them access to your records through MedicAlert's 24-hour hot line.
Contact the International Association for Medical Assistance to Travelers (IAMAT; tel. 716/754-4883, or 416/652-0137 in Canada; www.iamat.org) for tips on travel and health concerns in the countries you're visiting, and lists of local, English-speaking doctors.
General Availability of Healthcare -- Not surprisingly, most of the region's best hospitals and healthcare centers are in the big cities, but service varies widely. If you do get sick, it's best to contact your home country's consulate or embassy. They all have health departments with staff who can recommend the best English-speaking doctors and hospitals in the area.
Common Diseases & Ailments
Dietary Distress -- It's unfortunate, but many travelers to Central America do suffer from some sort of food or waterborne illness. Most of this is just due to tender northern stomachs coming into contact with slightly more aggressive Latin American intestinal flora. Symptoms vary widely -- from minor cases of diarrhea to debilitating flulike illnesses. To minimize your chances of getting sick, be sure to always drink bottled or boiled water and avoid ice. In high altitudes, you will need to boil water for several minutes longer before it is safe to drink. If you don't have access to bottled water, you can treat it with iodine or chlorine, with iodine being more effective. You can buy water purification tablets at pharmacies and sporting-goods stores. You should also be careful to avoid raw food, especially meats, fruits, and vegetables. If you peel the fruit yourself, you should be fine.
If you do suffer from diarrhea, it's important to keep yourself hydrated. Many pharmacies sell Pedialyte, which is a mild rehydrating solution. Drinking fruit juices or soft drinks (preferably without caffeine) and eating salted crackers are also good remedies. In extreme cases of diarrhea or intestinal discomfort, it's worth taking a stool sample to a lab for analysis. The results will usually pinpoint the amoebic or parasitic culprit, which can then be readily treated with available over-the-counter medicines.
Typhoid Fever is a food- or waterborne illness that occurs throughout Central America (it's caused by salmonella). Long-term travelers should seriously consider taking a typhoid fever vaccine before setting off, as the malaria-like symptoms are very unpleasant.
Hepatitis A is another viral infection acquired through water and food (it can also be picked up off infected people), this time attacking the liver. Usually the symptoms of fever, jaundice, and nausea will pass but it can in some cases cause liver damage. There is an effective vaccine that you can take before the trip.
Tropical Illnesses -- Yellow fever is no longer a problem in Central America. However, if you are traveling from South America or Africa you will require a vaccination certificate to enter Nicaragua, El Salvador, Honduras, Guatemala, and Belize.
Malaria does exist in Central America, especially in rural areas. To protect yourself, wear mosquito repellent with DEET, wear long-sleeved shirts and trousers, and use mosquito nets. You can also take antimalaria drugs before you go; consult your doctor about the pros and cons of such medications. Be sure to ask whether a recommended drug will cause you to be hypersensitive to the sun; it would be a shame to come down here for the beaches and then have to hide under an umbrella the whole time. Because malaria-carrying mosquitoes usually come out at night, you should do as much as possible to avoid being bitten after dark. Also be aware that symptoms such as high fever, chills, and body aches can appear months after your vacation.
Dengue fever, transmitted by an aggressive daytime mosquito, is a risk in tropical environments and densely populated urban areas. As with malaria, the best prevention is to avoid mosquito bites; there is no vaccine available. Dengue is also known as "bone-break fever" because it is usually accompanied by severe body aches. The first infection with dengue fever will make you very sick but should cause no serious damage. However, a second infection with a different strain of the dengue virus can lead to internal hemorrhaging and could be life threatening. If you are unfortunate enough to get it, take some paracetamol and lots of fluids.
Bees, Bugs & Bites -- Snakes, scorpions, and spiders rarely bite without provocation. Keep your eyes open and never walk barefoot. If you're in the jungle or rainforest, be sure to shake your clothes and check your shoes before putting them on. Africanized bees (the notorious "killer bees" of fact and fable) are common in this region, but there is no real danger of being attacked unless you do something silly like stick your hand into a hive. Other than mosquitoes, the most prevalent and annoying biting insect you are likely to encounter, especially along the coast, is sand flies. These tiny biting bugs leave a raised and itchy welt, but otherwise are of no significant danger. They tend to be most active around sunrise and sunset, or on overcast days. Your best protection is to wear light long-sleeved shirts and long pants.
The chances of contracting rabies while traveling in Central America are unlikely but not completely impossible. Most infected animals live in rural areas. If you are bitten by an infected dog or bat, wash the wound and get yourself to a hospital as quickly as possible. There is a prevacation vaccine that requires three injections but you should only get it if you are planning a high-risk activity such as cave exploring. Treatment is effective but must be given promptly.
Riptides -- Many of the Pacific coast beaches have riptides: strong currents that can drag swimmers out to sea. A riptide occurs when water that has been dumped on the shore by strong waves forms a channel back out to open water. These channels have strong currents. If you get caught in a riptide, you can't escape the current by swimming toward shore; it's like trying to swim upstream in a river. To break free of the current, swim parallel to shore and use the energy of the waves to help you get back to the beach. Note: Lifeguards are a rarity in the region.
Central America's reputation for gang violence and drug running are not entirely unwarranted. However, such a well-publicized (and sensationalized) crime image will contrast strongly with your experience of the region's friendly, peace-loving people. Travelers rarely experience anything more untoward than being pickpocketed or distracted in some way and relieved of a backpack (and even this is rare). Gun crime is usually confined to the shantytowns and poor barrios and rarely effects tourists. In my experience, the more budget-oriented you are, the more vulnerable you are -- a public chicken bus is not as safe as a private shuttle.
Before you depart, check for travel advisories from the U.S. State Department (www.travel.state.gov), the Canadian Department of Foreign Affairs (www.voyage.gc.ca), the U.K. Foreign & Commonwealth Office (www.fco.gov.uk/travel), and the Australian Department of Foreign Affairs (www.dfat.gov.au/consular/advice).
Once you're in the region, keep some common-sense safety advice in mind: Stay alert and be aware of your surroundings; don't walk down dark, deserted streets; and always keep an eye on your personal belongings. Keep your passport and credit cards on your person (but not stuffed in your back pocket). Theft at airports and bus stations is not unheard of, so be sure to put a lock on your luggage. Rental cars generally stick out, and are easily spotted by thieves.
Public intercity buses are also frequent targets of stealthy thieves. Never check your bags into the hold of a bus if you can avoid it. If this can't be avoided, when the bus makes a stop, keep your eye on what leaves the hold. If you put your bags in an overhead rack, be sure you can see the bags at all times.
Note: This information was accurate when it was published, but can change without notice. Please be sure to confirm all rates and details directly with the companies in question before planning your trip.