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

1
A yellow fever vaccination certificate is required from travellers over one year of age coming from countries with infected areas.

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is no longer a condition of entry into Guatemala. However, cases of cholera were reported in 1996 and precautions are essential. Up-to-date advice should be sought before deciding whether these precautions should include vaccination as medical opinion is divided over its effectiveness. See the Health appendix for further information.

3
Typhoid occurs.

4
Malaria risk exists throughout the year below 1500m (4921ft), especially in Alta Verapaz, Baja Verapan, Ixcan, Petén and San Marcos. Chloroquine is the recommended prophylaxis. There is no risk in Antigua or Lake Atitlán.

Food & drink
Bottled water is available everywhere. Other water sources may be contaminated, and water used for drinking, brushing teeth or making ice should have first been boiled or otherwise sterilised. Milk may be unpasteurised and should be boiled. Powdered or tinned milk is available and is advised, but make sure that it is reconstituted with pure water. Avoid dairy products which are likely to have been made from unboiled milk. 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
Onchocerciasis (river blindness) occurs in localised foci in rural areas. Dengue fever is endemic in Guatemala. Affected areas include Escuintla, the Pacific Coast towns, Zacapa, and Peten. Dysentery and diarrhoeal diseases are common. Visceral, cutaneous and mucocutaneous leishmaniasis occur. Filariasis and American trypanosomiasis are diseases carried by insects in the region. Myiasis (botfly) is endemic in Central America. Hepatitis A occurs and inoculation is recommended. Altitude sickness may be experienced in higher places such as volcanoes and mountains, and exertion should be avoided.
Rabies occurs. 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.

There are both public and private medical facilities in Guatemala City, but comprehensive travel and medical insurance is strongly advised before travelling. Some hotels offer doctor’s services to their guests.