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DENGUE FEVER (BREAKBONE FEVER) Dengue fever is a viral infection found throughout Central America. In Costa Rica outbreaks involving thousands of people occur every year. Dengue is transmitted by aedes mosquitoes, which often bite during the daytime and are usually found close to human habitations, often indoors. They breed primarily in artificial water containers such as jars, barrels, cans, plastic containers and discarded tires. Dengue is especially common in densely populated, urban environments. Dengue usually causes flulike symptoms including fever, muscle aches, joint pains, headaches, nausea and vomiting, often followed by a rash. Most cases resolve uneventfully in a few days. Severe cases usually occur in children under the age of 15 who are experiencing their second dengue infection. There is no treatment for dengue fever except taking analgesics such as acetaminophen/paracetamol (Tylenol) and drinking plenty of fluids. Severe cases may require hospitalization for intravenous fluids and supportive care. There is no vaccine. The key to prevention is taking insect-protection measures. HEPATITIS A Hepatitis A is the second-most-common travel-related infection (after traveler’s diarrhea). It’s a viral infection of the liver that is usually acquired by ingestion of contaminated water, food or ice, though it may also be acquired by direct contact with infected persons. Symptoms may include fever, malaise, jaundice, nausea, vomiting and abdominal pain. Most cases resolve without complications, though hepatitis A occasionally causes severe liver damage. There is no treatment. The vaccine for hepatitis A is extremely safe and highly effective. You should get vaccinated before you go to Costa Rica. Because the safety of hepatitis A vaccine has not been established for pregnant women or children under the age of two, they should instead be given a gammaglobulin injection. LEISHMANIASIS Leishmaniasis occurs in the mountains and jungles of all Central American countries. The infection is transmitted by sand flies, which are about one-third the size of mosquitoes. Most cases occur in newly cleared forest or areas of secondary growth. The highest incidence is in Puerto Viejo de Talamanca. It causes slow-growing ulcers over exposed parts of the body There is no vaccine. RABIES Rabies is a viral infection of the brain and spinal cord that is almost always fatal. The rabies virus is carried in the saliva of infected animals and is typically transmitted through an animal bite, though contamination of any break in the skin with infected saliva may result in rabies. Rabies occurs in all Central American countries. However, in Costa Rica only two cases have been reported over the last 30 years. TYPHOID Typhoid fever is caused by ingestion of food or water contaminated by a species of salmonella known as Salmonella typhi . Fever occurs in virtually all cases. Other symptoms may include headache, malaise, muscle aches, dizziness, loss of appetite, nausea and abdominal pain. A pretrip vaccination for typoid is recommended, but not required. It’s usually given orally, and is also available as an injection. TRAVELER’S DIARRHEA Tap water is safe and of a high quality in Costa Rica, but when you’re far off the beaten path it’s best to avoid tap water unless it has been boiled, filtered or chemically disinfected (iodine tablets). To prevent diarrhea, be wary of dairy products that might contain unpasteurized milk; and be highly selective when eating food from street vendors.
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