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El Salvador
Risk:
Low-Moderate
Health Overview
El Salvador downgraded to Level 1 April 2025 — homicide rate 1.36/100000 in 2025. WHO malaria-free certified 2021. First US human case of New World Screwworm myiasis confirmed August 2025 from El Salvador traveler. State of Exception active since March 2022 — US citizens detained without due process. Uses USD which simplifies logistics. Be sure to consult your Dr. prior to travel to discuss
Key Health Risks
Low
New World Screwworm (NWS) Myiasis
Active Central American outbreak. First US human case August 2025 from El Salvador traveler. Cochliomyia hominivorax larvae infest open wounds/mucous membranes. 161400+ animal cases; 1560+ human cases; 7 deaths across region. Returning travelers with unusual wound pain or maggots: contact CDC dpdx@cdc.gov.
Moderate
Dengue Fever
Endemic year-round; all 4 serotypes active 2025 (4235 cases through Sept 2025). Aedes aegypti day-biting. DEET essential. Global Dengue notice March 2026.
Low-Moderate
State of Exception Detention Risk
Active since March 2022 (renewed 34+ times). Suspends normal protections. US citizens detained without trial. Cover gang-style tattoos. Foreigners prohibited from demonstrations.
Health Risk Callout
NWS is the most clinically novel finding. Clinicians seeing returning travelers with painful/foul-smelling wounds with maggots should suspect NWS and contact CDC dpdx@cdc.gov. Early treatment: physical removal of all larvae.
Other Health Risks
NWS myiasis (active outbreak); Traveler's diarrhea (significant); Rabies (dog-mediated); Chagas (rural vectors)
Regional Information
Regional Risk Callout
Risk now relatively uniform and low. San Salvador tourism infrastructure expanded. Rural areas near Honduras/Guatemala borders carry more residual risk. Inter-city night travel inadvisable. La Libertad (surf) and airport corridor: safest.
Regional Healthcare Callout
Private sector in San Salvador adequate for most emergencies. No JCI accreditation. Complex cases: medevac to US or Costa Rica (CIMA San José; JCI). SAL airport direct US connections.
Vaccine and Malaria Prevention
💉 Entry Vaccine Required
YF certificate required from YF-risk countries. No YF recommended for El Salvador.
🛡️ Recommended Vaccines
CDC recommends Routine; COVID-19; Hep A (strongly recommended); Hep B; Typhoid for local food
🦟 Malaria Information
No malaria risk.
Moderate
Moderate
Physician Note
Dr. Robert
Emergency Medicine · 25+ Years · 40+ Countries
El Salvador is one of the most dramatic safety transformation stories. Level 1 downgrade April 2025 is clinically real. Two things before security discussion: WHO malaria-free 2021 is a paradigm shift — older sources still reference rural risk; outdated.
And NWS myiasis — first US case was an El Salvador traveler August 2025. Wound with unusual pain/odor/maggots needs CDC evaluation (dpdx@cdc.gov). Dengue primary infectious disease concern; tap water not safe; State of Exception means wrong tattoo = detention.
Be sure to consult your Dr. prior to travel to discuss
Pre-Departure Checklist
8+ Weeks
- Be sure to consult your Dr. prior to travel to discuss
- CDC recommends Hep A (strongly recommended)
- Typhoid
- Routine vaccines
- NO malaria prophylaxis (WHO certified 2021)
- Review State of Exception.
2-4 Weeks
- DEET
- Bottled water plan
- Avoid inter-city night travel
- Offline maps.
Day Of
- Major highways only
- Zero alcohol driving
- Keep wounds covered (NWS risk in rural areas with livestock)
- Embassy +(503) 2501-2999.
Trip Type Guidance
Adventure
- Surfing (El Tunco
- Punta Roca
- El Zonte 'Bitcoin Beach')
- Volcano hiking (Santa Ana/Ilamatepec).
Beach
- La Libertad coast
Business
- Most stable Central American business environment
- USD currency eliminates exchange risk.
Notes
Special Evacuation Notes
No special medevac restrictions. SAL airport direct US connections. Medevac to Houston; Miami; or New Orleans. State of Exception: carry documentation; avoid gang affiliation appearance.
Safety Notes
Security transformation is real — 2025 safest year in modern history. State of Exception active — US citizens detained without due process. Zero tolerance for alcohol while driving. Embassy staff prohibited from inter-city night travel and public buses. Petty theft most common tourist crime. Uses USD.
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
Business