Inoculation regulations can change at short notice. Please take medical advice in the case of doubt.

1
Typhoid may be a risk in rural areas. Vaccination against typhoid and polio is recommended.

2
Malaria risk, exclusively in the malignant falciparum form, exists throughout the year in rural areas of the western provinces of Castañuelas, Hondo Valle and Pepillo Salcedo, which border Haiti. Chloroquine is the recommended prophylaxis.

Food & drink
All water should be regarded as being potentially contaminated and sterilisation should be considered essential. Water used for drinking, brushing teeth or making ice should have first been boiled or otherwise sterilised. Milk is pasteurised. Powdered or tinned milk is available. Only eat well-cooked meat and fish, preferably served hot. Pork, salad and mayonnaise may carry increased risk. Vegetables should be cooked and fruit peeled.

Other risks
Bilharzia (schistosomiasis) is endemic. Avoid swimming and paddling in fresh water; swimming pools which are well chlorinated and maintained are safe. Diffuse cutaneous leishmaniasis has been reported. Hepatitis A and B may occur. Outbreaks of dengue fever occur in the area. Longer-term travellers may contract lymphatic filariasis.
Rabies may be present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. For more information, consult the Health appendix.

Health insurance (to include emergency repatriation) is strongly recommended. Medical care is limited and variable in quality. An emergency service is available in Santo Domingo.