Travel Vaccines and Advice for Costa Rica

• Typhoid – Typhoid, caused by Salmonella Typhi, is primarily transmitted through tainted food and water. Protection against this disease involves vaccination combined with good hygiene and careful food consumption.
• Hepatitis A – Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus, typically spreading through contaminated food or water. Symptoms include jaundice, fatigue, and abdominal pain. The hepatitis A vaccine is an effective prevention method, administered in two shots over six months. The vaccine is recommended for travelers to areas with high hepatitis A rates and certain high-risk groups.
• Chikungunya – Chikungunya, carried by Aedes mosquitoes, can be prevented by using mosquito repellents and eliminating standing water. Vaccination is recommended fro those traveling to regions effected by the disease.
• Rabies – Rabies, a lethal viral infection, is primarily transmitted through the saliva of infected animals. Vaccination is paramount for prevention, involving post-exposure prophylaxis (PEP) for potential exposures and pre-exposure prophylaxis (PrEP) for those at heightened risk, such as travelers.
• Hepatitis B – Hepatitis B, a liver infection transmitted through infected fluids, can be prevented through safe practices and the hepatitis B vaccine. The vaccine prompts the immune system to produce antibodies, offering robust and long-lasting protection against the virus.
• Measles, Mumps, Rubella (MMR) – Measles, mumps, and rubella are infectious diseases that can lead to severe health issues. They are transmitted through respiratory droplets and close contact. The MMR vaccine, a safe and effective immunization, is recommended by the CDC as the best way to prevent these diseases.

Malaria is present in the provinces of Alajuela and Limon. Travelers are advised to take antimalarials to protect themselves from infection. Atovaquone, doxycycline, mefloquine and tafenoquine are recommended for travelers to the region. Malaria parasites in Costa Rica are resistant to chloroquine. Speak with your travel health specialist to identify which antimalarial is best for your trip and medical history.

The CDC recommends prescription antimalarial medication for travelers heading to Alajuela and Limón provinces, where malaria transmission is ongoing. The rest of Costa Rica carries little to no malaria risk, so standard bite prevention covers it outside those two provinces.

Malaria isn’t the only bite-borne risk. Aedes mosquitoes that spread other diseases bite during the day, while the Anopheles mosquitoes behind malaria bite from dusk to dawn. Repellent needs to be an all-day habit.

An EPA-registered repellent with DEET, picaridin, or oil of lemon eucalyptus works well against mosquitoes. Permethrin-treated clothing adds another layer, especially for hikers and anyone spending long stretches outdoors. In Alajuela and Limón, sleeping under a permethrin-treated bed net matters if the room isn’t screened or air-conditioned.

Rural and rustic housing adds exposure to other biting insects that are most active at night. Screened or air-conditioned rooms cut that risk substantially. A Passport Health travel specialist can prescribe the right antimalarial medication for a Costa Rica itinerary, recommend repellents and advise on nettings.

Per the CDC, Costa Rica’s biggest water-related risks come from contact with floodwater, mud or contaminated soil after heavy rain. Travelers doing river crossings, jungle hikes, or rural farm stays face the highest exposure.

Avoid wading through floodwater or standing water where possible, and keep any open cuts or wounds covered and dry. Stick to bottled or properly treated water, and skip ice unless it’s made from purified water. A portable water filter or purification tablets are worth packing for stays outside major hotels and resorts.

Standard food safety habits apply everywhere in the country. Travelers’ diarrhea is the most common illness reported by travelers, and it comes from contaminated food or water rather than a single named disease. Cooked and served hot is safest. Raw produce is safer peeled or washed in treated water first.

Street food and fruit stands are everywhere in Costa Rica and can be one of the best parts of the trip. But, they carry more risk than a sit-down restaurant. A Passport Health specialist can go over options for travelers’ diarrhea before departure, useful for anyone heading somewhere remote.

Altitude sickness, marked by symptoms such as headaches and fatigue due to low oxygen levels at high elevations. AMS can be avoided through gradual ascent, hydration, and certain medications like acetazolamide. If AMS strikes, descending promptly to lower altitudes, resting, and seeking medical assistance if symptoms persist are crucial steps for recovery.

• Chagas Disease – Spread when an infected bug’s feces gets rubbed into a bite, a scratch, or the eyes or mouth, usually while someone sleeps. Exposure is concentrated in rural adobe or thatch housing where the bugs hide in wall cracks. A bed net or sealed room cuts the risk substantially.
• Dengue – Spread through the bite of an infected Aedes mosquito, which feeds mostly during the day rather than at dusk or dawn. Costa Rica carries an ongoing dengue risk. Daytime repellent use is the main defense, since bite-prevention timing differs from the mosquitoes that spread malaria.
• Hantavirus – Spread by breathing in dust contaminated with the urine, droppings, or saliva of infected rodents, most often in rural cabins, barns, or storage buildings. Avoiding contact with rodents and the spaces where they nest is the primary way to lower exposure.
• Leishmaniasis – Spread through the bite of an infected sand fly, most active at dawn, dusk, and after dark in forested or rural areas. Costa Rica is on the CDC’s current risk list for leishmaniasis. Sand flies are small enough to pass through standard mosquito netting, so fine-mesh netting or permethrin-treated clothing offers better protection.
• Leptospirosis – Spread through contact with fresh water, mud, or soil contaminated with infected animal urine, most often after flooding or heavy rain. Avoiding floodwater and keeping open cuts covered are the most effective precautions, especially for river crossings and rural farm stays.
• Melioidosis – Spread through contact with contaminated fresh water, mud, or soil, particularly after heavy rain, or by breathing in contaminated dust during severe weather. Costa Rica is on the CDC’s current risk list for melioidosis. Bandaging open wounds and avoiding floodwater or muddy water after storms are the main ways to reduce exposure.
• Tuberculosis (TB) – Spread when someone breathes in bacteria released into the air by a person with active TB who is coughing, speaking or singing nearby. The highest risk is tied to prolonged close contact rather than casual tourism. Extended stays, healthcare work or time in crowded indoor settings raise exposure.
• Zika – Spread through the bite of an infected mosquito, and less commonly through sex or from a pregnant individual to their unborn baby. Pregnant travelers face the highest stakes, since infection during pregnancy can cause serious birth defects, and should talk with a doctor before this trip.