Diseases are a downer. Unfortunately, Puerto Rico is an environment rife with certain bug-borne bugs and other illnesses to watch out for. The Centers for Disease Control and Prevention recommends anyone traveling to Puerto Rico get vaccines for hepatitis A and B and typhoid.
Several major diseases have broken out on the island in the last decade, including viral meningitis, which began in Arroyo in the south and spread along the coast to Cieba and Aibonito.
Though the viral form of the illness is easier to handle than the bacterial kind, it's still no picnic. Symptoms include headache, a stiff neck, fever and vomiting.
Dengue fever is another illness we can blame on insects. Mosquitoes to be specific. Common in high population island areas like Puerto Rico the highest transmission rates occur between and September and November.
The island has not experienced a major outbreak since 1998, but you can help your odds by wearing insect-repellant to ward off mosquitoes.
Another illness called endemic foci of histoplasmosis is common in the Caribbean, and can show up in Puerto Rico.
Mosquitoes, scorpions, centipedes, flying cockroaches and tarantulas can all be found inside and out. If you want to avoid waking up to these nightmare-inducing creatures, waving their antennas or reaching a hairy leg at you from your pillow, keep your windows closed.
Sand bugs, also known as sand fleas and sand flies, like to bite. These bites turn into especially annoying and itchy bumps. These tiny white or red irritations can sneak up on you hours after you've been bitten. The hungry critters most like to feast on human blood in the morning and evening during middle to late summer. Topical creams and forms of ibuprofen are common treatments.
Also beware of mongooses, as these weasel-like creatures can carry rabies. Rats and stray dogs are common in areas like San Juan, and can be seen out and about at night.
Sanitation in parts of the island is lacking, and you should not be surprised by waste-dumping in local waters. However, most water on the island is safe to drink. Street food is also normally well-prepared and quite delicious. But the waters of Puerto Rico may carry worse dangers to those who want to go for a dip. Freshwater streams and rain forest ponds are safer in terms of pollution, but you can contract a parasitic infection called schistosomiasis from swimming in these areas. The condition is rampant on the island, and signs include fever, stomach cramping, loss of appetite, diarrhea and cough.
Don't ignore these symptoms, as left untreated, schistosomiasis can lead to kidney failure, enlarged liver and spleen and fluid build up in the abdominal cavity.
If you think you have been exposed to contaminated water, drying yourself with a towel can cut your chances of schistosomiasis. To prevent the illness, only use water that has been heated to 150 degrees Fahrenheit for at least five minutes or water kept in a storage tank for a minimum three days.
It's probably safest to stick to the pools at your accommodation or the big blue.
Hurricanes are the most common form of natural disaster in Puerto Rico, and the season spans nearly half the year, from June to November. September and October are the worst months for tropical storm activity, so avoid planning your trip during this time, if possible. The weather service keeps a close eye on hurricane activity and tropical storms forming in or heading toward the area. But even if this weather hits other parts of the Caribbean, it won't always strike Puerto Rico.
Natural geography can hurt. A recent traveler recommends using caution when traveling to Isabela's El Poso de Jacinto at Jobos Beach in the northwestern part of the island. A large, unfenced opening sits atop an area of sharp rocks, so avoid going too close if you don't want to become one with the roaring waves.
Use caution around reef breaks during low tide at beaches throughout the island. Rip currents at Maria's, Jobos, Surfers and Wilderness beaches can be particularly dangerous.
When hiking in places like Experience El Yunque National Forest, travelers say to beware of slippery trails and rocky paths. In addition to the rain itself, waterfalls and rivers can flood the road.
Poisonous plants exist in this area as well, so wear long pants and avoid touching any of the flora and fauna. Stick to the trails in the forest, as it is very easy to get lost with the dense plant life and rugged, steep landscape.
A final note on outdoor excursions: double-check the snorkeling company you choose. Make sure it actually takes you to areas ideal for the activity. Some tours focus more on scuba diving locations, which aren't always great for snorkeling. If you mistakenly book such a tour, you'll spend the day eating peanuts with the boat captain instead of finding Nemo in the reef.