Puerto Rico poses no major health problem for most travelers. If you have a chronic condition, however, you should check with your doctor before visiting the islands. For conditions such as epilepsy, diabetes, or heart problems, wear a MedicAlert Identification Tag (tel. 800/825-3785; 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.
Finding a good doctor in Puerto Rico is easy, and most speak English.
If you worry about getting sick away from home, consider purchasing medical travel insurance and carry your ID card in your purse or wallet. In most cases, your existing health plan will provide the coverage you need.
Pack prescription medications in your carry-on luggage, and carry prescription medications in their original containers. Also bring along copies of your prescriptions, in case you lose your medication or run out. Carry the generic name of prescription medicines, in case a local pharmacist is unfamiliar with the brand name.
And don't forget sunglasses and an extra pair of contact lenses or prescription glasses.
Contact the International Association for Medical Assistance to Travelers (IAMAT; tel. 716/754-4883 or, in Canada, 416/652-0137; www.iamat.org) for tips on travel and health concerns in the countries you're visiting, and for lists of local, English-speaking doctors. The United States Centers for Disease Control and Prevention (tel. 800/311-3435; www.cdc.gov) provides up-to-date information on health hazards by region or country and offers tips on food safety. The website www.tripprep.com, sponsored by a consortium of travel medicine practitioners, may also offer helpful advice on traveling abroad. You can find listings of reliable clinics overseas at the International Society of Travel Medicine (www.istm.org).
It's best to stick to bottled mineral water here. Although tap water is said to be safe to drink, many visitors experience diarrhea, even if they follow the usual precautions. The illness usually passes quickly without medication, if you eat simply prepared food and drink only mineral water until you recover. If symptoms persist, consult a doctor.
The sun can be brutal, especially if you haven't been exposed to it in some time. Experts advise that you limit your time on the beach the first day. If you do overexpose yourself, stay out of the sun until you recover. If your exposure is followed by fever or chills, a headache, or a feeling of nausea or dizziness, see a doctor.
Sandflies (or "no-see-ums") can still be a problem in Puerto Rico but are not the menace they are in other Caribbean destinations. They appear mainly in the early evening, and even if you can't see these tiny bugs, you sure can "feel-um."
Your favorite insect repellent will protect you from them, should they become a problem.
Although mosquitoes are a nuisance, they do not carry malaria in Puerto Rico. However, after a long absence, the dreaded dengue fever has returned to Puerto Rico. The disease is transmitted by the Aede mosquito, and its symptoms include fever, headaches, pain in the muscles and joints, skin blisters, and hemorrhaging. It usually is gone after a week but the strongest cases are fatal.
Hookworm and other intestinal parasites are relatively common in the Caribbean, though you are less likely to be affected in Puerto Rico than on other islands. Hookworm can be contracted by just walking barefoot on an infected beach. Schistosomiasis (also called bilharzia), caused by a parasitic fluke, can be contracted by submerging your feet in rivers and lakes infested with a certain species of snail.
Like major urban areas along the East Coast, Puerto Rico has been hard hit by AIDS and other sexually transmitted diseases. Exercise at least the same caution in choosing your sexual partners and practicing safe sex as you would at home.
Most health insurance policies cover you if you get sick away from home, but they are not likely to provide for medical evacuation in case of life-threatening injury or illness. It's a good idea to buy a travel insurance policy that provides for emergency medical evacuation. If you have to buy a one-way same-day ticket home and forfeit your nonrefundable round-trip ticket, you might be out big bucks. And the cost of a flying ambulance could wipe out your life's savings.
Check with your insurer, particularly if you're insured by an HMO, about the extent of its coverage while you're overseas. With the exception of certain HMOs and Medicare/Medicaid, your medical insurance should cover medical treatment -- even hospital care -- overseas. However, most out-of-country hospitals make you pay your bills upfront, and they send you a refund after you've returned home and filed the necessary paperwork.
If you require additional insurance, try one of the following companies:
- MEDEX International (tel. 888/MEDEX-00 [633-3900] or 410/453-6300; fax 410/453-6301; www.medexassist.com)
- Travel Assistance International (tel. 800/821-2828; www.travelassistance.com); for general information on services, call the company's Worldwide Assistance Services, Inc. at tel. 800/777-8710.
- The Divers Alert Network (DAN; tel. 800/446-2671 or 919/684-2948; www.diversalertnetwork.org)
Crime & Safety
The U.S. Department of State issues no special travel advisories for the Commonwealth of Puerto Rico, the way it might for, say, the more troubled island of Jamaica. However, there are crime problems in Puerto Rico, but they rarely surface along San Juan's Condado and Isla Verde beaches and Old San Juan. Still caution should be exercised at night, since muggings do happen, and isolated areas should be avoided.
Burglary, including vandalizing of automobiles, is another problem, so don't leave valuables in cars, even when the doors are locked.
Take precautions about leaving valuables on the beach, and exercise extreme care if you're searching for a remote beach where there's no one in sight. The only person lurking nearby might be someone not interested in surf and sand but a robber waiting to make off with your possessions.
Avoid wandering around the darkened and relatively deserted alleys and small streets of San Juan's Old City at night, especially those off the oceanside Norzagaray Boulevard, which is relatively deserted at night.
If you are traveling out on the island, plan to do your driving during the daylight hours, both for road-safety and crime-precaution reasons. A wrong turn at midnight could lead to a whole lot of trouble of all stripes.
So in short, crime exists here as it does everywhere. Use common sense and take precautions. Theft and occasional muggings do occur on the Condado and Isla Verde beaches at night, so you might want to confine your moonlit beach nights to the fenced-in and guarded areas around some of the major hotels. The countryside of Puerto Rico is safer than San Juan, but caution is always in order. Avoid narrow country roads and isolated beaches at night and exercise caution on them during the day.