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Important: This document is not a complete medical guide for travelers to this region. Consult with your doctor for specific information related to your needs and your medical history; recommendations may differ for pregnant women, young children, and persons who have chronic medical conditions.

See your doctor at least 4–6 weeks before your trip to allow time for shots to take effect. If it is less than 4 weeks before you leave, you should still see your doctor. It might not be too late to get your shots or medications as well as other information about how to protect yourself from illness and injury while traveling.

• Hepatitis A or immune globulin (IG).
Transmission of hepatitis A virus can occur through direct person-to-person contact; through exposure to contaminated water, ice, or shellfish harvested in contaminated water; or from fruits, vegetables, or other foods that are eaten uncooked and that were contaminated during harvesting or subsequent handling.

• Rabies
I f you might have extensive unprotected outdoor exposure in rural areas, such as might occur during camping, hiking, or bicycling, or engaging in certain occupational activities.

• Typhoid vaccine.
Typhoid fever can be contracted through contaminated drinking water or food, or by eating food or drinking beverages that have been handled by a person who is infected. Large outbreaks are most often related to fecal contamination of water supplies or foods sold by street vendors

Avoid buying food or drink from street vendors, because it is relatively easy for such food to become contaminated.Make sure your food and drinking water are safe. Food and waterborne diseases are the primary cause of illness in travelers. Travelers’ diarrhea can be caused by viruses, bacteria, or parasites, which are found throughout this region and can contaminate food or water. Infections may cause diarrhea and vomiting (E. coli, Salmonella, cholera, and parasites), fever (typhoid fever and toxoplasmosis), or liver damage ( hepatitis). Gnathostomiasis (roundworms) has increased in Mexico, with many cases being reported from the Acapulco area, infection has been reported in travelers. Humans become infected by eating undercooked fish or poultry, or reportedly by drinking contaminated water.

Dengue, filariasis, leishmaniasis, onchocerciasis, and American trypanosomiasis (Chagas disease) are diseases carried by insects that also occur in this region.

Injuries
Motor vehicle crashes are a leading cause of injury among travelers. Protect yourself from motor vehicle injuries: avoid drinking and driving; wear your safety belt and place children in age-appropriate restraints in the back seat; follow the local customs and laws regarding pedestrian safety and vehicle speed; obey the rules of the road; and use helmets on bikes, motorcycles, and motor bikes. Avoid boarding an overloaded bus or mini-bus. Where possible, hire a local driver.

• Long-sleeved shirt, long pants, and a hat to wear whenever possible while outside, to prevent illnesses carried by insects (e.g., malaria, Dengue, filariasis, leishmaniasis, and onchocerciasis).
• Insect repellent containing DEET.
• Bed nets treated with permethrin. For use and purchasing information, see Insecticide Treated Bednets on the CDC malaria site. Overseas, permethrin or another insecticide, deltamethrin, may be purchased to treat bed nets and clothes.
• Flying-insect spray to help clear rooms of mosquitoes. The product should contain a pyrethroid insecticide; these insecticides quickly kill flying insects, including mosquitoes.
• Iodine tablets and portable water filters to purify water if bottled water is not available. See Preventing Cryptosporidiosis: A Guide to Water Filters and Bottled Water for more detailed information.
• Sunblock, sunglasses, and a hat for protection from harmful effects of UV sun rays. See Skin Cancer Questions and Answers for more information.
• Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription(s) or letter from your health-care provider on office stationery explaining that the medication has been prescribed for you.
• Always carry medications in their original containers, in your carry-on luggage.
• Be sure to bring along over-the-counter antidiarrheal medication (e.g., bismuth subsalicylate, loperamide) and an antibiotic prescribed by your doctor to self-treat moderate to severe diarrhea. See suggested over-the-counter medications and first aid items for a travel kit.

Travelers should take the following precautions
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To stay healthy, do.

When using repellent on a child, apply it to your own hands and then rub them on your child. Avoid children's eyes and mouth and use it sparingly around their ears.

• Wash your hands often with soap and water or, if hands are not visibly soiled, use a waterless, alcohol-based hand rub to remove potentially infectious materials from your skin and help prevent disease transmission.
• In developing countries, drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, learn how to make water safer to drink.
• Take your malaria prevention medication before, during, and after travel, as directed. (See your health care provider for a prescription.)
• To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot, even on beaches.
• Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.
• Protect yourself from mosquito insect bites:
o Wear long-sleeved shirts, long pants, and hats when outdoors.
o Wear long-sleeved shirts, long pants, and hats.
o Use insect repellents that contain DEET (N, N-diethylmethyltoluamide). For more information about insect repellents and correct use, see What You Need to Know about Mosquito Repellent on the CDC West Nile Virus site.
o If no screening or air conditioning is available: use a pyrethroid-containing spray in living and sleeping areas during evening and night-time hours; sleep under bed nets, preferably insecticide-treated ones.

Do not

• Do not eat food purchased from street vendors or food that is not well cooked to reduce risk of infection (i.e., hepatitis A and typhoid fever).
• Do not drink beverages with ice.
• Avoid dairy products, unless you know they have been pasteurized.
• Do not swim in fresh water to avoid exposure to certain water-borne diseases such as schistosomiasis. (For more information, please see Swimming and Recreational Water Precautions.)
• Do not handle animals, especially monkeys, dogs, and cats, to avoid bites and serious diseases (including rabies and plague). Consider pre-exposure rabies vaccination if you might have extensive unprotected outdoor exposure in rural areas. For more information, please see Animal-Associated Hazards.
• Do not share needles for tattoos, body piercing or injections to prevent infections such as HIV and hepatitis B.

If you have visited a malaria-risk area, continue taking your antimalarial drug for 4 weeks (chloroquine, doxycycline, or mefloquine) or seven days (atovaquone/proguanil) after leaving the risk area.
Malaria is always a serious disease and may be a deadly illness. If you become ill with a fever or flu-like illness either while traveling in a malaria-risk area or after you return home (for up to 1 year), you should seek immediate medical attention and should tell the physician your travel history.