Central America
3.3 Central America
(Belize, Costa Rica, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama)
3.3.1 Disease risks
Food and water-borne diseases including amoebic and bacillary dysentry, other diarrhoeal diseases and typhoid fever are common throughout the area. Hepatitis A occurs throughout the area and hepatitis E has been reported in Mexico. Helminth infections are also common. All countries except Panama have reported cholera in recent years.
Malaria present in all countries - see individual entries below
Other arthropod-borne diseases (see Chapter 7):
- Yellow fever - the South American endemic zone extends into Panama
- Cutaneous and mucocutaneous leishmaniasis in all countries
- Visceral leishmaniasis - El Salvador, Guatemala, Honduras, Mexico and Nicaragua
- Onchocerciasis (river blindness) in two small foci in the south of Mexico and four dispersed foci in Guatemala
- American trypanosomiasis (Chagas' disease) in localised foci in rural areas in all countries
- Dengue fever and Venezuelan equine encephalitis may occur in all countries
- Rocky Mountain spotted fever.
Diseases of close association:
- In 1994, an international commission certified the eradication of endemic wild poliovirus from the Americas. Ongoing surveillance in formerly endemic Central and South American countries confirms that poliovirus transmission remains interrupted.
- Tuberculosis endemic.
Sexually transmitted and blood-borne infections:
Hepatitis B of low prevalence in most countries (intermediate prevalence in Guatemala and Honduras); HIV endemic throughout the area.
Other hazards could include:
- Leptospirosis.
- Rabies in animals (usually dogs and bats).
- Snakes and scorpions in some areas.
3.3.2 Recommendations for immunisations and malaria chemoprophylaxis (see later chapters for general health precautions)
| FOR ALL COUNTRIES Check routine immunisations including tetanus. Immunisation against hepatitis A and typhoid generally advised. For longer stays, consider immunisation against diphtheria, hepatitis B and check BCG status; for longer rural travel, out of reach of medical attention, consider immunisation against rabies. |
3.3.3 Country by country variations and malaria chemoprophylaxis:
Belize
Yellow fever vaccination certificate required from travellers coming from infected areas.
Malaria risk (predominantly P.vivax) throughout the year.
Recommended prophylaxis: chloroquine.
Costa Rica
Malaria risk (almost exclusively P.vivax) throughout the year in rural areas below 700m in Alajuela, Guanacaste, Limon and Heredia provinces.
Recommended prophylaxis: for the rural areas above only, chloroquine.
El Salvador
Yellow fever vaccination certificate required from travellers over six months of age coming from infected areas.
Malaria risk (almost exclusively P.vivax) throughout the year in Santa Ana province.
Recommended prophylaxis: for the risk area, chloroquine.
Guatemala
Yellow fever vaccination certificate required from travellers over one year of age coming from countries with infected areas.
Malaria risk (predominantly P.vivax) throughout the year below 1,500m in several Departments.
Recommended prophylaxis: chloroquine.
Honduras
Yellow fever vaccination certificate required from travellers coming from infected areas.
Malaria risk (predominantly P.vivax) throughout the year in most areas.
Recommended prophylaxis: chloroquine.
Mexico
Malaria risk (almost exclusively P.vivax) throughout the year largely in rural areas. There is a significant risk of transmission in the states of: Campeche, Chiapas, Guerrero, Michoacan, Oaxaca, Quintana Roo, Sinaloa and Tabasco and moderate risk in the states of Chichuahua, Durango, Hidalgo, Jalisco, Nayarit, Sonora and Veracruz.
Recommended prophylaxis: for the risk areas, chloroquine; in other areas none but bear in mind the remote possibility of malaria.
Nicaragua
Yellow fever vaccination certificate required from travellers over one year of age coming from infected areas.
Malaria risk (predominantly P.vivax) throughout the year in most areas.
Recommended prophylaxis: chloroquine.
Panama
Yellow fever vaccination certificate recommended for all travellers going to Chepo Darien and San Blas.
Malaria risk (predominantly P.vivax) throughout the year in three provinces: Bocas de Toro in the west, and Darien and San Blas in the east where chloroquine resistant P.falciparum has been reported. The canal area itself is considered malaria free.
Recommended prophylaxis: for above areas, chloroquine west of the canal; chloroquine plus proguanil east of the canal.