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

1
Yellow fever vaccination is recommended for those over nine months travelling to Darién and Kunayala (San Blas), excluding the canal zone. Travellers arriving from non-endemic zones should note that vaccination is strongly recommended for travel outside the urban areas, even if an outbreak of the disease has not been reported and they would normally not require a vaccination certificate to enter the country.

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is not a condition of entry to Panama. However, cholera may be a slight risk in this country 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.

3
Typhoid fevers are common, but polio is not present.

4
There is a low malaria risk, predominantly of the plasmodium vivax form in three provinces throughout the year: Bocas de Toro, Darién and San Blas. There is no risk in Panama City or in the former canal zone.

Food & drink
Mains water is normally chlorinated and safe. Bottled water is available. Drinking water outside main cities and towns may be contaminated and sterilisation is advised. Milk is pasteurised and dairy products are safe for consumption. Local meat, poultry, seafood, fruit and vegetables are generally considered safe to eat.

Other risks
Hepatitis A, B and E occur. Dengue fever, filariasis, leishmaniasis, onchocerciasis and American trypanosomiasis (chagas disease) may occur. Myiasis (botfly) is endemic in Central America.
Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. For more information, see the Health appendix.

Modern and reliable private medical services are available. According to current legislation covering sanitary matters, Panama offers healthcare facilities to all nationals and foreign travellers who may require them, independent of any reciprocal agreement with a particular country. International travellers are, however, advised to take out medical insurance.