Mosquitoes, too, like Latin America

In February a few years ago, a group of middle-aged novice travelers ventured to Costa Rica to tour Braulio Carrillo National Park, which rises and falls between cool, high mountains and low, torrid jungles, all of it washed by swift, curving rivers and waterfalls.

Unbeknown to them, this lovely, pristine region was a mosquito-infested area fraught with health perils. Eight of the group’s members contracted traveler’s diarrhea, four came down with typhoid fever and two were infected with malaria.

Because tropical environments are havens for the cultivation of exotic diseases, anyone planning to visit Latin America should check into the health hazards at their destinations and take appropriate measures to protect their health before they leave.

Latin America is a vast and varied region, and each country has specific health recommendations for travelers. A growing number of travelers are exploring destinations that are off the beaten track — such as ecoadventures to places like Belize, the Galápagos Islands, Costa Rica, the Amazon and Peru — and the health risks in such locales are greater.

Here is a rundown on some of the health problems you may encounter there and on how you should prepare for them before you depart.

The Caribbean

Traveler’s diarrhea is this region’s number-one traveler’s illness. It can be caused by viruses, bacteria or parasites in contaminated food or water. Infections may cause diarrhea and vomiting, usually due to bacteria and parasites, and fever from typhoid fever.

Traveler’s diarrhea may last three to seven days. Clinicians recommend that travelers take an antidiarrheal kit with them. The best prevention is to make sure that your food and drinking water are safe.

Malaria, transmitted by mosquitoes, is a problem in Haiti and rural areas of the Dominican Republic. Oral antimalarial medication is extremely effective. An additional measure, one that helps prevent any mosquito-borne disease, is the use of insect repellent that contains DEET.

Another mosquito-transmitted disease, yellow fever, can be prevented with a vaccine that is recommended for those traveling to Trinidad and Tobago. Typhoid fever, a common bacterial disease that can be life threatening, is prevalent in developing countries.

Rabies is found in much of the Caribbean, most commonly in caves where bats reside or in rural areas where they come into contact with domestic dogs.

Central America and Mexico

Hepatitis A is a worldwide concern and preventable with a vaccine. It can be transmitted by person-to-person contact or from contaminated water or ice or in shellfish harvested from contaminated water or from fruits, vegetables or other foods contaminated during harvesting or subsequent handling.

South America

Vaccine requirements and recommendations for travel to all of South America are basically the same, but the Centers for Disease Control have an advisory issued for an outbreak of dengue fever in rural areas outside of Rio de Janeiro.

Dengue is a virus transmitted by mosquitoes. Epidemic transmission is usually seasonal, during and shortly after the rainy season. There is no vaccine, but successful measures in preventing mosquito bites, such as using a mosquito-repellent containing DEET, wearing loose-fitting clothes and covering arms, legs are the neck areas, can be employed.

The standard measures for general health protection while traveling through South America include antimalarial medication and vaccines for hepatitis A and B, tetanus/diphtheria, typhoid and yellow fever.

If traveling to Brazil first with onward travel to other South American countries, you are required to get the yellow fever vaccine and certificate. It must be presented to Brazilian officials when applying for a visa. ITN

—Dr. Larry G. Baratta is chief medical officer of Passport Health (, with clinics nationwide. Reach him by e-mail at

Next month in this column: Dr. Alan M. Spira discusses the malaria medication controversy.