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Costa Rica
Risk:
Low-Moderate
Health Overview
Dengue fever is the primary health concern in Costa Rica, with increasing case counts in lowland and coastal areas during the May-November rainy season. The country has the best healthcare system in Central America, with CIMA Hospital in San Jose rivaling many US facilities. Traveler's diarrhea risk is lower than most Latin American destinations but still present. The key differentiator for prepared travelers is having adventure sports coverage — zip-line, white-water, and ATV injuries are the most common tourist medical events.
Key Health Risks
Moderate-High
Dengue Fever
Nationwide risk in lowland areas, and 2026 is an escalating year rather than a quiet one. Weekly case counts tracked below 2025 through the early months, then reversed around epidemiological week 19 in early May and accelerated sharply from June onward; the cumulative total roughly doubled in the seven weeks between weeks 22 and 29. Ministry of Health reporting put the year-to-date total at 3,052 cases by week 31. The geography matters for itinerary planning: the Pacifico Central region has the highest incidence in the country at 206.6 per 100,000, and the canton of Orotina recorded an extraordinary local rate. Peak season runs with the rains, May through November. Aedes aegypti bites during daylight, so DEET and permethrin-treated clothing need to be a daytime routine, not an evening one. Prior infection with one serotype raises the risk of severe dengue on reinfection with another.
Moderate
Traveler's Diarrhea
Lower risk than much of Latin America but still common. Carry azithromycin. Tap water in San Jose is generally safe; use bottled water elsewhere.
Moderate
Adventure Sport Injuries
Zip-line, white-water rafting, ATV, and surfing injuries are the most common tourist medical events. Verify operator safety records. Ensure insurance covers adventure activities.
Health Risk Callout
Rip currents on Pacific coast beaches are the number one cause of tourist deaths in Costa Rica. Many beaches lack lifeguards.
Other Health Risks
Venomous snakes (fer-de-lance in jungle areas), rip currents (Pacific beaches — leading cause of tourist drowning), sun exposure at tropical latitude, Chagas disease (rare). Hantavirus — worth addressing directly because it circulated widely in travel media during 2026: Costa Rica's Ministry of Health issued a statement on 13 May 2026 saying no human hantavirus cases have ever been documented in the country, and that it was responding to repeated public enquiries prompted by outbreaks reported elsewhere. A hantavirus lineage associated with a local mouse species has been identified in Costa Rican wildlife research but has not been linked to human disease. Rodent-avoidance precautions in rustic or poorly ventilated rural buildings remain sensible generally; hantavirus is not a Costa Rica-specific traveler risk.
Regional Information
Regional Risk Callout
Risk is relatively uniform across the country. San Jose has the best medical infrastructure. Caribbean coast (Limon province) has slightly higher dengue and crime risk. Pacific coast tourist areas (Guanacaste, Manuel Antonio) have good clinic access. Remote Osa Peninsula and Corcovado require evacuation planning for serious injuries.
Regional Healthcare Callout
Tourist areas have basic clinics (clinicas) that handle minor issues. Serious injuries or illness require transfer to San Jose. Osa Peninsula and remote Caribbean areas may need air evacuation.
Vaccine and Malaria Prevention
💉 Entry Vaccine Required
None required for entry.
🛡️ Recommended Vaccines
Hepatitis A, Typhoid, Hepatitis B, Rabies (adventure/rural), Routine (Tdap, MMR, Flu, COVID-19)
🦟 Malaria Information
- Risk Level: Low
- Areas: Focal local transmission, and the geography has shifted. The historical picture was rare focal transmission in Limón province lowlands; Ministry of Health surveillance through 2026 identifies active foci in the Huetar Norte region around Crucitas, El Roble and Chamorro, with 74 cases nationally in 2026. Predominantly P. vivax, with occasional imported P. falciparum. No transmission in the Central Valley, San José, Guanacaste, or the standard Pacific beach and rainforest-lodge circuit.
- Recommended Drug: Prophylaxis is not indicated for typical tourist itineraries. For travelers with extended stays or work in the named Huetar Norte foci, discuss prophylaxis choice with a travel medicine physician rather than assuming chloroquine — the regimen should be selected against the current species picture.
- Drug Resistance: No
Malaria prophylaxis is generally not needed for typical tourist itineraries including beach, volcano, and rainforest lodge travel. The clinically relevant change is that Costa Rica is no longer a country where malaria can simply be dismissed — local transmission foci are active and under surveillance, and a returning traveler from the Huetar Norte border region with fever warrants a malaria smear rather than reassurance.
Moderate
Physician Note
Dr. Robert
Emergency Medicine · 25+ Years · 40+ Countries
Costa Rica is one of the safest and most medically accessible countries in Latin America, and I recommend it as a great first international destination for families. CIMA Hospital in San Jose has a Baylor affiliation. The health risks are real but manageable — dengue is increasing and DEET discipline matters, but the biggest actual threat is adventure sport injuries.
Zip-line operators vary wildly in safety standards. Check reviews, check equipment, and make sure your insurance explicitly covers adventure activities — many basic travel policies exclude them.
Pre-Departure Checklist
8+ Weeks
- Be sure to consult your Dr. prior to travel to discuss
- CDC recommends Get Hep A and Typhoid if not current. Consider rabies series if jungle trekking.
2-4 Weeks
- Confirm insurance covers adventure activities
- Pack TD self-treatment kit
- Register with STEP
Day Of
- Pack DEET, sunscreen, and waterproof first-aid kit
- Confirm CIMA Hospital contact
- Carry insurance card with adventure sports coverage confirmation
Trip Type Guidance
Adventure
- Verify insurance covers zip-line, rafting, ATV
- Carry basic wound care.
Family
- Excellent destination
- CIMA Hospital provides peace of mind.
Beach
- Rip currents are deadly serious on Pacific coast
- Swim only at guarded beaches.
Mission
- Healthcare infrastructure is good by Central American standards
Business
- San Jose has reliable medical access
Notes
Special Evacuation Notes
Air ambulance to Miami is approximately 3 hours. Good in-country air ambulance services available.
Safety Notes
Petty theft and car break-ins are the main crime concern, especially in San Jose and at trailheads. Volcanic activity (Arenal, Poas, Turrialba) can close areas without warning. Earthquake-prone. Rainy season flooding can isolate roads.
partner recommendation
Medical Evacuation & Assistance
A medical crisis far from home can cost $50,000+ to evacuate. Global Rescue — the partner we personally trust — provides worldwide evacuation and round-the-clock medical assistance.
Good For
Adventure
Family
Beach
Mission
Business