Nicaragua
Reasonable dental care can be found in the larger towns and cities
Some international medication is available from the larger pharmacies and hospitals in the larger towns and cities.
Screening is inconsistent in Nicaragua, therefore blood supplies should be considered as unsafe
Medical care is limited, particularly outside Managua. Basic medical services are available in Managua.
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 which 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.
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
Dengue hemorrhagic fever - occurs
Encephalitis (Venezuelan equine) - occurs
Leishmaniasis - occurs
Malaria - common
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 shigella dysenteria type I infections have been caused by drug-resistant enterobacteria.
Brucellosis - occurs
Cholera - occurs
Helminthic (parasitic worm) infections - common
Hepatitis - occurs
Leptospirosis - occurs
Other hazards:
Diseases such as measles and diphtheria are commonly reported.
Influenza risk extends throughout the year.
Rabies - prevalent (usually dogs and bats)
Yellow fever: A yellow fever vaccination is required from travelers over 1 year of age coming from infected areas.
