Our roving medical expert, Dr. Erik McLaughlin MD, talks through the pills, potions and jabs you'll need for a trip to exotic Costa Rica.
Start evaluating your immunizations at least 8 weeks prior to travel and longer if possible. A very important step and a good place to start this process is by obtaining a copy of your childhood vaccine records.
Most travelers from developed nations have received a primary childhood series of “routine“ immunizations. These immunizations should include protection against measles, mumps, rubella, polio, pneumococcal, H. Influenza, diphtheria, pertussis and varicella (chicken pox). Most travelers under the age of thirty years have also received their vaccine against hepatitis B, as well.
For those without access to their childhood vaccine records, speaking with your doctor well in advance of your trip can allow time for a simple blood test to check for titers. Titers are markers in your blood that indicate immunity against a certain illness and those with previous vaccinations will have high titers, indicating protection. This is a way to confirm if you've had vaccines in the past but do not have records, on paper.
Recommended vaccines for a traveler to Costa Rica include a series to protect against Hepatitis A, Hepatitis B, typhoid and rabies (if you'll have contact with animals).
Hepatitis A (liver infection) is a common problem for travelers and should be considered a required immunization. Once you have completed the series of three shots, given 6 months apart, you are considered immune to this for life.
Generally a mild illness in healthy adults, this infection can still ruin a trip and be serious in those with chronic health problems.
Hep. A is generally acquired through a fecal-oral route; meaning improper hygiene. Those visiting less-developed nations used to be the primary concern for this illness, but not anymore. A common story for Hepatitis A is a food worker who hasn't washed their hands and 5-star restaurants can run this risk the same as the road-side food stands.
Hepatitis B is another infection that affects the liver but can cause life-long complications.
This viral, liver infection is commonly transmitted through contact with body fluids. Unprotected sex, sharing needles and unsanitary medical equipment are frequent culprits.
Hepatitis B vaccine should be strongly considered by all travelers, regardless of their risks. Once you have completed the three-shot series you are considered immune for life.
Even travelers who do not plan to have unprotected sex or share needles can be at risk. Traffic accidents still represent one of the largest threats to travelers and severe accidents can often land one in the local emergency room. This traumatic injury can lead to a need for transfusion of blood products or at the very least getting an IV/drip. Unfortunately, not all countries screen their blood products well and blood infected with Hep. B may be inadvertently used. Another unfortunate situation that is all too common is the re-use of needles and IV/drips between patients. This is done simply due to a lack of medical supplies.
Typhoid is a bacterial infection (Salmonella Typhi) that is found worldwide but is more common in developing nations. The most common method of infections is through ingestion of contaminated food and/or water. Rash, fever and bloody diarrhea are common symptoms.
An oral, pill form of vaccine is generally the preferred method versus the older injectable version. The series of pills is taken over 5 days and can include some minimal side effects of nausea or headaches. Completion of the series provides protection for up to 5 years.
Unfortunately the typhoid vaccine only provides 40-80% immunity and even those who have completed the vaccine course should exercise caution with their eating habits.
Rabies is a viral infection acquired from the bite of an infected mammal. This is a 100% fatal disease if acquired and left untreated. Travelers who are at risk for coming into contact with stray dogs, mammalian wildlife or virtually any animal should consider this vaccine. Children are an especially vulnerable population as their natural curiosity in animals may lead to “trying to pet“ a stray dog and a subsequent bite.
There is currently a world-wide rabies vaccine shortage and this can be difficult to obtain. Most locations are attempting to reserve their supplies for use on those who have already been bitten.
Should any traveler be bitten by an unknown animal they should immediately seek medical care and strongly consider completing a series of injections known as “post-exposure prophylaxis“. Do not delay in seeking treatment as this illness can be rapidly fatal. First aid for a bite includes controlling blood loss and a thorough cleaning with soap and water.
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