Mexico
Reasonable quality dental care can be found in the larger towns and cities
Supplies of international medications are generally available
Blood supplies should be considered as unsafe in Mexico
Adequate medical care can be found in all major cities. Health facilities in Mexico City are excellent. Care in more remote areas is limited.
Recent medical and dental exams should ensure that the traveler is in good health. Carry appropriate health and accident insurance documents and copies of any important medical records. Bring an adequate supply of all prescription and other medications as well as any necessary personal hygiene items, including a spare pair of eyeglasses or contact lenses if necessary.
Drink only bottled beverages (including water) or beverages made with boiled water. Do not use ice cubes or eat raw seafood, rare meat or dairy products. Eat well-cooked foods while they are still hot and fruits that can be peeled without contamination. Avoid roadside stands and street vendors.
Swim only in well-maintained, chlorinated pools or ocean water known to be free from pollution. Wear clothing that reduces exposed skin and apply repellents containing DEET to remaining areas. Sleep in well-screened accommodations. Carry anti-diarrheal medication. Reduce problems related to sun exposure by using sunglasses, wide-brimmed hats, sunscreen lotions and lip protection.
AIDS occurs. Blood supply may not be adequately screened and/or single-use, disposable needles and syringes may be unavailable. When possible, travelers should defer medical treatment until reaching a facility where safety can be assured. (The U.S. Embassy reports that blood screening in Mexico City is yielding a level of confidence in the blood supply there similar to that in most U.S. cities. Officials have expressed concern, however, that Mexico gets about one-third of its blood supply from 25,000 "professional" donors who sell their blood to hospitals and families in need. Past testing for AIDS antibodies indicated that 10% of these donors had been exposed to the AIDS virus.)
CDC has issued an Advisory Memorandum that discourages travelers from consuming any "untreated ground water which has not been tested sufficiently to guarantee its safety. Travelers are advised that, while they may know of persons who have consumed such water with no ill effects, the fact that the water is not tested or treated places the user at risk of a variety of potential hazards, including cholera. Travelers who insist upon drinking water from Mexican springs are advised that boiling the water should make it safe from biological hazards, although not from chemical hazards. Persons who become ill after drinking the water should seek medical attention." Furthermore, CDC advises that "water and perishable foods, including shellfish and other seafood, should not be brought into the U.S. by returning travelers."
Air pollution is severe in Mexico City and persons with cardiopulmonary disease will find their condition aggravated. The severe pollution problem is further aggravated by periodic thermal inversions from December to February. (The health services of the Ministries of Foreign Affairs of Britain, Canada, Australia and Germany have all gone on record recommending against bringing children under the age of 12 to live in Mexico City. This recommendation is based on the high level of pollution in general and especially atmospheric pollution. The U.S. Embassy in Mexico has not officially cautioned against children living in Mexico City.)
The combination of aridness related to the altitude and the long dry season and severe air pollution cause irritation of the mucous membranes of the respiratory tract. Upper respiratory problems such as rhinitis, sinusitis and bronchitis are leading causes of medical attention.
Altitude of Mexico City may cause lightheadedness, insomnia, slight headache or shortness of breath. Travelers are advised to avoid overeating, alcoholic beverages or undue exertion until such symptoms have disappeared.
Rodents pose a significant health hazard, especially in market areas in Mexico City.
High concentrations of natural arsenic have been reported to be contaminating the water in southwestern Coahuila and eastern Durango states, an area known as the Comarca Lagunera (the Lagoon Region) due to the once-abundant lakes in the area. As the water supply has been depleted, the natural arsenic has become more concentrated in the remaining water. The effects of the arsenic have been most noted in persons having long-term exposure to the water.
Cholera: Although limited in effectiveness, vaccination may be appropriate for persons living and/or working in less than sanitary conditions for more than 3 months where medical facilities are unavailable. Vaccination may also be appropriate for travelers with impaired gastric defenses who are planning an extended visit or being exposed to unsanitary conditions. Vaccination is not advised for pregnant women, infants younger than 6 months old, or persons with a history of severe reaction to the vaccine.
Hepatitis A: Consider active immunization with hepatitis A vaccine or passive immunization with immune globulin (IG) for all susceptible travelers. Especially consider choosing active immunization for persons planning to reside for a long period or for persons who take frequent short-term trips to risk areas. The importance of protection against hepatitis A increases as length of stay increases. It is particularly important for persons who will be living in or visiting rural areas, eating or drinking in settings of poor or uncertain sanitation, or who will have close contact with local persons (especially young children) in settings with poor sanitary conditions.
Rabies: Preexposure vaccination should be considered for persons staying longer than 30 days who are expected to be at risk to bites from domestic and/or wild animals (particularly dogs), or for persons engaged in high risk activities such as spelunking or animal handling. Need for vaccination is more important if potential exposure is in rural areas and if adequate postexposure care is not readily available.
Typhoid: Vaccination should be considered for persons staying longer than 3 weeks, adventurous eaters, and those who will venture off the usual tourist routes into small cities, villages and rural areas. Importance of vaccination increases as access to reasonable medical care becomes limited. Contraindications depend on vaccine type.
Note: All routine vaccines (such as DTP or Td, Hib, MMR, polio, varicella, influenza and pneumococcal) should be kept up-to-date as a matter of good health practice unrelated to travel.
Insect-borne illness:
Dengue fever - occurs (activity has increased in the northern border states of Coahuila, Tamaulipas and Nuevo Leon)
Dengue hemorrhagic fever - occurs
Encephalitis (Venezuelan equine) - occurs
Leishmaniasis - occurs
Malaria - occurs
Onchocerciasis (river blindness) - occurs
Trypanosomiasis (Chagas' disease) - occurs
Food-borne and water-borne illness: diseases, including amoebic and bacillary dysenteries and other diarrheal diseases, and the typhoid fevers are very common throughout the area. Many Salmonella typhi infections have been caused by drug-resistant enterobacteria.
Cholera - occurs
Helminthic (parasitic worm) infections - common
Hepatitis - occurs
Other hazards:
High levels of immunization coverage have reduced the incidence of diseases such as measles and diphtheria.
Influenza risk extends from November to April in areas north of the Tropic of Cancer and throughout the year in areas south of that.
Rabies - prevalent (usually dogs and bats)
Yellow fever: A yellow fever vaccination certificate is required from travelers over 6 months of age coming from infected areas. The following countries or areas are regarded as infected:
Africa: Angola, Benin, Cameroon, Gabon, Gambia, Ghana, Guinea, Liberia, Nigeria, Sierra Leone, Sudan, Zaire.
America: Bolivia, Brazil, Colombia, Ecuador, Peru.
