Central America Travel














Destinations: Mexico, Central America | CDC Travelers' Health Home About CDC Press Room Funding A-Z Index Centers, Institute & Offices Training & Employment Contact Us CDC en Español Search: Travelers' Health Travelers' Health Home > Destinations > Mexico and Central America Health Information for Travelers to Countries in Mexico and Central America On This Page Vaccines for Your Protection Diseases Found in Mexico and Central America Other Health Risks What You Need To Bring With You Staying Healthy During Your Trip After You Return Home For More Information Travel Notices in Effect Update: Dengue and Travelers (Updated November 3, 2005) U.S. Department of State See all Traveler's Health travel notices Vaccines for Your Protection: Mexico and Central America Routine Vaccinations Check with your healthcare provider: you and your family may need routine as well as recommended vaccinations. Before travel, be sure you and your children are up to date on all routine immunizations according to schedules approved by the Advisory Committee on Immunization Practice (ACIP). See the schedule for adults and the schedule for infants and children . Some schedules can be accelerated for travel. 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. Recommended Vaccinations and Preventive Medications The following vaccines may be recommended for your travel to Mexico and Central America. Discuss your travel plans and personal health with a health-care provider to determine which vaccines you will need. 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. Hepatitis B , especially if you might be exposed to blood or body fluids (for example, health-care workers), have sexual contact with the local population, or be exposed through medical treatment. Hepatitis B vaccine is now recommended for all infants and for children ages 11–12 years who did not receive the series as infants. Malaria: if you are traveling to a malaria-risk area in this region, see your health care provider for a prescription antimalarial drug. For details concerning risk and preventive medications, see Malaria Information for Travelers to Central America and Mexico . Rabies , if 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 Yellow fever , for travelers to endemic areas in Panama As needed, booster doses for tetanus-diphtheria and measles . Required Vaccinations None. Diseases found in Mexico and Central America (risk can vary by country and region within a country; quality of in-country surveillance also varies) Malaria An Anopheles freeborni mosquito takes a blood meal. Malaria is always a serious disease and may be a deadly illness. Humans get malaria from the bite of a mosquito infected with the parasite. Prevent this serious disease by seeing your health care provider for a prescription antimalarial drug and by protecting yourself against mosquito bites ( see below ). Your risk of malaria may be high in these countries, including some cities. Travelers to malaria-risk areas, including infants, children, and former residents of Mexico and Central America, should take an antimalarial drug. Chloroquine is the recommended drug for Mexico, Belize, Guatemala, El Salvador, Nicaragua, Honduras, Costa Rica, and the Bocas Del Toro Province of Panama. Travelers to Darién Province and San Blas Province in Panama (including the San Blas Islands) should take one of the following antimalarial drugs: (listed alphabetically): atovaquone/proguanil, doxycycline, mefloquine, or primaquine (in special circumstances). For additional information on malaria risk and prevention, see Malaria Information for Travelers to Central America and Mexico . Yellow Fever Yellow fever is present only in Panama in this region. A certificate of yellow fever vaccination may be required for entry into certain countries in the region if you have visited Panama, Trinidad & Tobago, or an endemic area in South America or sub-Saharan Africa. For detailed information, see Comprehensive Yellow Fever Vaccination Requirements . Also, find the nearest authorized U.S. yellow fever vaccine center . Food and Waterborne Diseases 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. Additional information: see the Safe Food and Water page for a list of links. Other Disease Risks Dengue , filariasis , leishmaniasis , onchocerciasis , and American trypanosomiasis (Chagas disease) are diseases carried by insects that also occur in this region. Myiasis (botfly) is endemic in Central America. Protecting yourself against insect bites ( see below ) will help to prevent these diseases. Other Health Risks 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. What You Need To Bring With You 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 . Staying Healthy During Your Trip Travelers should take the following precautions 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: Wear long-sleeved shirts, long pants, and hats when outdoors. Wear long-sleeved shirts, long pants, and hats. 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 . 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. If you are visiting friends and relatives in your home country, see additional special information about malaria prevention in Recent Immigrants to the U.S. from Malarious Countries Returning 'Home' to Visit Friends and Relatives on the CDC Malaria site. 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. After You Return Home 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. For More Information For more information about these and other diseases, please check the Diseases page and CDC Health Topics A-Z Diseases carried by insects Dengue : http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=dengue.htm : http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=lyme.htm Malaria information for Travelers to Mexico and Central America : http://www.cdc.gov/travel/regionalmalaria/camerica.htm Malaria Frequently asked questions : http://www.cdc.gov/malaria/faq.htm Malaria Prescription Drugs : http://www.cdc.gov/travel/malariadrugs.htm : http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=yellowfever.htm Diseases carried in food or water : http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=cholera.htm Escherichia coli diarrhea : http://www.cdc.gov/ncidod/dbmd/diseaseinfo/escherichiacoli_g.htm Hepatitis A : http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=hav.htm : http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=schisto.htm Typhoid fever : http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=typhoid.htm Diseases from person-to-person contact Hepatitis B : http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=hbv.htm HIV/AIDS prevention : http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=hivaids.htm HIV-infected travelers (in The Immunocompromised Traveler) : http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=special&obj=hivtrav.htm&cssNav=browseoyb 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. Date: November 3, 2005 Content Source: National Center for Infectious Diseases, Division of Global Migration and Quarantine Destinations Vaccinations Diseases Yellow Book Safe Food and Water Illness and Injury Abroad Traveling with Children Cruise Ship and Air Travel Special Needs Travel Traveling with Pets Travel Medicine Clinics Yellow Fever Vaccination Clinics References and Resources Travelers' Health Automated Information Line PHONE: 877-FYI-TRIP toll free (Information about ordering the Yellow Book and International Certificates of Vaccination and recorded messages on travel-related health topics) VIA EMAIL: Contact Us Form Home | Policies and Regulations | Disclaimer | e-Government | FOIA | Contact Us Department of Health and Human Services Centers for Disease Control and Prevention,1600 Clifton Rd, Atlanta, GA 30333, U.S.A Tel: (404) 639-3311 / Public Inquiries: (404) 639-3534 / (800) 311-3435



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Thriving on Complexity Ours is a complex business, and we thrive on that challenge. It is also a dynamic one, with growth driven by an acquisition strategy and a commitment to the professional development of our local teams. We are a grass roots company that is international in every sense of the word. The combination of local knowledge and specialist expertise provides important benefits to clients and intermediaries. In Asia Pacific, it's the QBE difference! QBE Insurance - QBE Asia Pacific - Specialist Risks Unit QBE Insurance - QBE Asia Pacific - Marine Risks Network QBE Insurance - QBE Asia Pacific - Hong Kong QBE Insurance - QBE Asia Pacific - Indonesia QBE Insurance - QBE Asia Pacific - Macau QBE Insurance - QBE Asia Pacific - Mainland China QBE Insurance - QBE Asia Pacific - Malaysia QBE Insurance - QBE Asia Pacific - Philippines QBE Insurance - QBE Asia Pacific - Singapore QBE Insurance - QBE Asia Pacific - Thailand QBE Insurance - QBE Asia Pacific - Vietnam QBE Insurance - QBE Asia Pacific - Fiji QBE Insurance - QBE Asia Pacific - French Polynesia QBE Insurance - QBE Asia Pacific - Japan QBE Insurance - QBE Asia Pacific - Micronesia QBE Insurance - QBE Asia Pacific - New Caledonia QBE Insurance - QBE Asia Pacific - New Zealand QBE Insurance - QBE Asia Pacific - Papua New Guinea QBE Insurance - QBE Asia Pacific - Solomon Islands QBE Insurance - QBE Asia Pacific - Vanuatu QBE Insurance - the Americas QBE Insurance Group Limited, is an insurance and reinsurance company publicly traded on the Australian Stock Exchange. Its history dates back over 116 years when the Company was founded in Australia. Since then the Company has grown to have operations in 47 countries with over $2 billion dollars of capital writing in excess of $3 billion dollars in premium. QBE the Americas operations commenced in 1986 when the QBE Insurance Group established a presence in the U.S. QBE the Americas now conducts business through its five companies, QBE Reinsurance Corporation, QBE Insurance Corporation, QBE Aseguradora de Riesgos del Trabajo S.A.,Argentina, QBE Del Istmo, Panama and QBE Brasil Seguros S.A. Lloyd's The Lloyd's division comprises QBE's share of the Lloyd's syndicates managed by Limit. The 2001 results are the first to contain a full year of activity from the acquisition of Limit in August 2000. Gross written premium for the Lloyd's division was $2,182 million, compared with $547 million last year. Net earned premium was up 273% to $1,365 million. Significant progress was made during 2001 towards achieving the objectives set out in last year's annual report. The rationalisation of the structure of the Lloyd's division continued with the merger of syndicates 79 and 2999, the closure of the under-performing syndicate 456 and the disposal of the property and aviation syndicate 318. This resulted in a significant reallocation of QBE's capital towards its best performing Lloyd's syndicates. Our exposure to poor performing US liability business was significantly reduced. QBE is now the sole capital provider to each of Limit's syndicates, other than syndicate 386 where our share has increased to over 40%. For the 2002 underwriting year, QBE provides 78% of Limit's aggregate capacity compared with 72% in 2001. The tragic events of 11 September overshadowed the year and the World Trade Center (WTC) loss had a significant impact on performance. In addition, upgrades were made to prior year outstanding claims provisions, principally to reflect adverse development on US liability business seen across the market. These upgrades have been substantially mitigated by reinsurance protections and provisions established on acquisition to allow for deterioration. Consequently, the result for the year largely reflects the performance of the 2001 underwriting year. The claims ratio was 72.9%, compared with 59.4% for last year. The combined operating ratio was 108.6%, compared with 101.1% last year. Excluding the WTC loss, the combined operating ratio would have been 101.0%. The movement in the commission ratio from 27.3% to 24.6% reflects the change in the mix of business during 2001. The decrease in the expense ratio from 14.4% to 11.1% reflects the synergies and savings delivered by the integration of QBE's former Lloyd's operations with Limit, partly offset by residual post acquisition integration costs during the year. 2001 was a transitional year in the market cycle with the rate increases anticipated at the start of the year not materialising until at least the middle of the year and, in some cases, not until after the impact of 11 September. We are now seeing substantial increases in premium rates across all classes of business underwritten within the Lloyd's division. These rate increases, together with a high level of business retention, new business opportunities and the reallocation of QBE's capital, should ensure profitability for the 2002 underwriting year. Our objectives for 2002 are to: take advantage of the dramatically improved rating environment and return all areas of underwriting to strong profitability; seek further rationalisation of the underwriting and operating structure in order to improve capital efficiency and our expense ratio; acquire further capacity on syndicate 386 as it becomes available; and be actively involved in the reforms proposed for the Lloyd's market. Our business at Lloyd's remains highly dependent upon the quality and commitment of our underwriters and their business franchise. I thank them for their efforts and achievements, which have ensured that QBE's Lloyd's division is now ideally positioned to take advantage of the hard market conditions now prevailing at Lloyd's. Steven Burns, Managing director, Lloyd's division Global Trade Credit "QBE Trade Credit, World-Wide credit solutions in an increasingly volatile business environment" QBE's Trade Credit underwrites $30bn of domestic and export trade credit from units in Australia, New Zealand, Asia and Europe having extensive experience in assessing risks in over 150 markets. We are a Standard and Poors A+ rated company. Supported by a product range of tailored solutions to your credit needs, QBE is uniquely placed to offer our clients the opportunity to conduct business in a secure environment. Established in 1962, we have in the last four decades risen to become the largest Australian Insurer offering both Domestic and Export trade credit insurance and have expanded offshore to service our clients locally around the world. QBE Re QBE Re is a leading global reinsurer providing treaty and facultative reinsurance, direct insurance, and other financial products to its varied clients. QBE Re conducts business through three Divisions: Australia, Europe, and the Americas. As a global reinsurer, QBE Re underwrites traditional and financial products covering all major lines and classes of business. Through its divisional network of companies, QBE Re excels in providing regional expertise and service tailored to local-market needs. For additional solutions from QBE Re, please visit our local teams: QBE Insurance - Australia QBE Insurance - Europe QBE Insurance - the Americas




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