Health, vaccinations and medical care in Costa Rica

Before you go

• No vaccinations are required unless you are arriving from a yellow fever country, in which case the certificate is checked.
• Hepatitis A and typhoid are the standard travel recommendations, plus routine boosters.
• Malaria risk is negligible for ordinary tourist itineraries. Prophylaxis is not normally recommended.
• Rabies exists in bats. Do not handle any wild animal.
• Bring travel insurance that covers medical evacuation, because Corcovado and Tortuguero are a long way from a hospital.

Dengue, which is the real one

• Dengue is present year round and peaks in the rainy season, May to November. Chikungunya and Zika are also present.
• The mosquito that carries it bites in the daytime, which surprises people expecting a dusk problem.
• DEET or picaridin, applied properly and often, is the whole defence. Long sleeves at dawn and dusk help.
• The QDENGA vaccine exists and is worth discussing with a travel clinic, particularly if you have had dengue before.
• A high fever with severe joint pain means a doctor, not paracetamol and a wait. Avoid ibuprofen and aspirin if dengue is suspected.

Healthcare

• Costa Rica's healthcare is the best in Central America and medical tourism is a national industry.
• Go private in an emergency. Hospital CIMA in Escazu, Clinica Biblica and Hospital Metropolitano in San Jose are used to foreign patients and have English-speaking staff.
• The public CCSS system will treat an emergency but the waits are long.
• Pharmacies dispense a lot without a prescription and pharmacists advise well. Farmacia Fischel and Farmacia La Bomba are the big chains.

Everyday

• Tap water is safe in most of the country, including San Jose and the Central Valley. On the Caribbean coast, in Puerto Viejo and in remote areas, drink filtered or bottled.
• The sun is directly overhead. Ten degrees off the equator means burning in 20 minutes, including through cloud.
• Use reef-safe sunscreen where you are snorkelling, which is both good practice and increasingly required.
• Heat and humidity on the coast are serious. Drink far more water than feels necessary.
• Sand flies (purrujas) on the Caribbean beaches are worse than mosquitoes and repellent barely touches them. Cover up at dawn and dusk.