Mexico Staying Healthy

Common sense is the simplest prescription for good health while you travel. Drink lots of fluids to prevent dehydration and constipation, and wear sturdy, broken-in shoes and clean socks.

Environmental Hazards

Heat exhaustion and dehydration: Heat exhaustion leads to nausea, excessive thirst, headaches, and dizziness. Avoid it by drinking plenty of fluids, eating salty foods (e.g., crackers), abstaining from dehydrating beverages (e.g., alcohol and caffeinated beverages), and wearing sunscreen. Continuous heat stress can eventually lead to heatstroke, characterized by a rising temperature, severe headache, delirium and cessation of sweating. Victims should be cooled off with wet towels and taken to a doctor. The risk of heat exhaustion exists all over Mexico, but is greatest in Baja and northern Mexico, where the combination of heat and dryness can result in rapid water loss.
Sunburn: Nowhere in Mexico are you safe from sunburn, and the risk only increases as you travel toward the equator and up in altitude. Always wear sunscreen (SPF 30 or higher) when spending excessive amounts of time outdoors. If you get sunburned, drink more fluids than usual and apply an aloe-based lotion. Severe sunburns can lead to sun poisoning, a condition that can cause fever, chills, nausea, and vomiting. Sun poisoning should always be treated by a doctor.
High Altitude: Many places in mountainous Mexico, including Mexico City, are high enough for altitude sickness to be a concern. Symptoms may include headaches, nausea, dizziness, and sleep disruption. To minimize possible symptoms, avoid rapid increases in elevation, stay well hydrated, and allow your body a couple of days to adjust to less oxygen before exerting yourself. Note that alcohol is more potent and UV rays are stronger at high elevations.
Pollution: Travelers to Mexico City should consider protective measures against pollution. The city is now the most polluted in the world, and its layer of smog can cause problems for contact lens-wearers, the allergic, the elderly, and small children. Travelers may want to bring eye drops or throat spray, and asthmatics would be wise to bring along an extra inhaler. Pollution is particularly bad during the winter, due to “thermal inversion,” a phenomenon that occurs when warm air passing above the city traps the colder, polluted air in the Valley of Mexico. The summer rainy season, on the other hand, does wonders for air cleanliness, and from May to October the air is quite breathable. Newspapers and news programs often provide daily pollution indices.

Insect-Borne Diseases

Many diseases are transmitted by insects—mainly mosquitoes, fleas, ticks, and lice. Be aware of insects in wet or forested areas, especially while hiking and camping; wear long pants and long sleeves, tuck your pants into your socks, and use a mosquito net. Use insect repellents such as DEET and soak or spray your gear with permethrin (licensed in the US only for use on clothing). Mosquitoes—responsible for malaria, dengue fever, and yellow fever—can be particularly abundant in humid, coastal areas. Travelers should be especially careful in the coastal or rural areas of Campeche, Chiapas, Guerrero, Michoacán, Nayarit, Oaxaca, Quintana Roo, Sinaloa, Tabasco, and Yucatán, and the mountainous northern region of Jalisco.

Malaria: Transmitted by Anopheles mosquitoes that bite at night. The incubation period varies anywhere between 10 days and 4 weeks. Early symptoms include fever, chills, aches, and fatigue, followed by high fever and sweating, sometimes with vomiting and diarrhea. See a doctor for any flu-like sickness that occurs after travel in a risk area. To reduce the risk of contracting malaria, use mosquito repellent, particularly in the evenings and when visiting forested areas. Make sure you see a doctor at least 4-6 weeks before a trip to a high-risk area to get up-to-date malaria prescriptions. A doctor may prescribe pills like mefloquine or doxycycline. Be aware that mefloquine can have very serious side effects, including paranoia, psychotic behavior, and nightmares.
Dengue fever: A viral infection transmitted by Aedes mosquitoes, which bite during the day rather than at night. The incubation period is 3-14 days, usually 4-7 days. Early symptoms include a high fever, severe headaches, swollen lymph nodes, and muscle aches. Many patients also suffer from nausea, vomiting, and a pink rash. If you experience these symptoms, see a doctor immediately, drink plenty of liquids, and take fever-reducing medication such as acetaminophen (Tylenol). Never take aspirin to treat dengue fever. There is no vaccine available for dengue fever.
Lyme disease: A bacterial infection carried by ticks and marked by a circular bull’s-eye rash of 2 in. or more. Later symptoms include fever, headache, fatigue, and aches and pains. Antibiotics are effective if administered early. Left untreated, Lyme can cause problems in joints, the heart, and the nervous system. If you find a tick attached to your skin, grasp the head with tweezers as close to your skin as possible and apply slow, steady traction. Removing a tick within 24hr. greatly reduces the risk of infection. Do not try to remove ticks with petroleum jelly, nail polish remover, or a hot match. Ticks usually inhabit moist, shaded environments and heavily wooded areas. If you are going to be hiking in these areas, wear long clothes and DEET.
Other insect-borne diseases: Lymphatic filariasis is a roundworm infestation transmitted by mosquitoes. Infection causes enlargement of extremities and has no vaccine. Leishmaniasis, a parasite transmitted by sand flies, can occur in Mexico, usually in rural rather than urban areas. Common symptoms are fever, weakness, and swelling of the spleen, as well as skin sores. There is a treatment, but no vaccine. In Mexico, CHAGAS disease (American trypanomiasis) is another relatively common parasite transmitted by the cone nose and kissing bug, which infest mud, adobe, and thatch. Symptoms are fever, heart disease, and an enlarged intestine. There is limited treatment.

Food- And Water-Borne Diseases

Prevention is the best cure: be sure that your food is properly cooked and the water you drink is clean. Don’t brush your teeth with tap water, don’t rinse your toothbrush under the faucet, and don’t keep your mouth open in the shower. Avoid anything including ice cubes and anything washed in tap water, like salad and fresh fruits. Watch out for food from markets or street vendors that may have been cooked in unhygienic conditions. Other culprits are raw shellfish, unpasteurized milk, and sauces containing raw eggs. Buy bottled water, or purify your own water by bringing it to a rolling boil or treating it with iodine tablets; note, however, that some parasites such as giardia have exteriors that resist iodine treatment, so boiling is more reliable. Always wash your hands before eating or bring a quick-drying purifying liquid hand cleaner.

Traveler’s diarrhea: Known in Mexico as turista. Results from drinking fecally contaminated water or eating uncooked and contaminated foods. Symptoms include nausea, bloating, and urgency. Try quick-energy, non-sugary foods with protein and carbohydrates to keep your strength up. Over-the-counter anti-diarrheals (e.g., Imodium) may counteract the problem. The most dangerous side effect is dehydration; drink 8 oz. of water with tsp. of sugar or honey and a pinch of salt, try uncaffeinated soft drinks, or eat tortillas and salted crackers. If you develop a fever or your symptoms don’t go away after 4-5 days, consult a doctor. Consult a doctor immediately for treatment of diarrhea in children.
Dysentery: Results from an intestinal infection caused by bacteria in contaminated food or water. Common symptoms include bloody diarrhea, fever, and abdominal pain and tenderness. The most common type of dysentery generally only lasts a week, but it is highly contagious. Seek medical help immediately. Dysentery can be treated with the drugs norfloxacin or ciprofloxacin. If you are traveling in high-risk (especially rural) regions, consider obtaining a prescription before you leave home.
Cholera: An intestinal disease caused by bacteria in contaminated food. Symptoms include diarrhea, dehydration, vomiting, and muscle cramps. See a doctor immediately; if left untreated, cholera can be lethal within hours. Antibiotics are available, but the most important treatment is rehydration. No vaccine is available in the US.
Hepatitis A: A viral infection of the liver acquired through contaminated water or shellfish from contaminated water. Symptoms include fatigue, fever, loss of appetite, nausea, dark urine, jaundice, vomiting, aches and pains, and light stools. The risk is highest in rural areas and the countryside, but it is also present in urban areas. Ask your doctor about the Hepatitis A vaccine or an injection of immune globulin.
Giardiasis: Transmitted through parasites and acquired by drinking untreated water from streams or lakes. Symptoms include diarrhea, cramps, bloating, fatigue, weight loss, and nausea. If untreated, it can lead to severe dehydration. Giardiasis occurs worldwide.
Typhoid fever: Caused by the salmonella bacteria; common in villages and rural areas in Mexico. While mostly transmitted through contaminated food and water, it may also be acquired by direct contact with another person. Early symptoms include high fever, headaches, fatigue, appetite loss, constipation, and a rash on the abdomen or chest. Antibiotics can treat typhoid, but a vaccination (70-90% effective) is recommended.
Leptospirosis: A bacterial disease caused by exposure to fresh water or soil contaminated by the urine of infected animals. Able to enter the human body through cut skin, mucus membranes, and through ingestion; most common in tropical climates. Symptoms include a high fever, chills, nausea, and vomiting. If left untreated it can lead to liver failure and meningitis. There is no vaccine; consult a doctor for treatment.

Other Infectious Diseases

The following diseases exist in every part of the world. Travelers should know how to recognize them and what to do if they suspect they have been infected.

Rabies: Transmitted through the saliva of infected animals; fatal if untreated. By the time symptoms (thirst and muscle spasms) appear, the disease is in its terminal stage. If you are bitten, wash the wound, seek immediate medical care, and try to have the animal located. A rabies vaccine, which consists of 3 shots given over a 21-day period, is available and recommended for developing world travel, but is only semi-effective.
Hepatitis B: A viral infection of the liver transmitted via blood or other bodily fluids. Symptoms, which may not surface until years after infection, include jaundice, appetite loss, fever, and joint pain. It is transmitted through unprotected sex and unclean needles. A 3-shot vaccination sequence is recommended for sexually-active travelers and anyone planning to seek medical treatment abroad; it must begin 6 months before traveling.
Hepatitis C: Like Hepatitis B, but the mode of transmission differs. IV drug users, those with occupational exposure to blood, hemodialysis patients, and recipients of blood transfusions are at the highest risk, but the disease can also be spread through sexual contact or sharing items like razors and toothbrushes that may have traces of blood on them. No symptoms are usually exhibited. If untreated, Hep C can lead to liver failure.
AIDS and HIV: For detailed information on Acquired Immune Deficiency Syndrome (AIDS) in Mexico, call the 24hr. National AIDS Hotline at ☎800-342-2437.
Sexually transmitted infections (STIs): Gonorrhea, chlamydia, genital warts, syphilis, herpes, HPV, and other STIs are easier to catch than HIV and can be just as serious. Though condoms may protect you from some STIs, oral or even tactile contact can lead to transmission. If you think you may have contracted an STI, see a doctor immediately.

Other Health Concerns

Medical Care On The Road

The quality of medical care in Mexico often varies with the size of the city or town. The same applies to the availability of English-speaking medical practitioners. Medical care in Mexico City is first-class, while care in more rural areas can be limited. Standards of medical training and patient care vary greatly among beach resorts. Local pharmacies can be invaluable sources of medical help. Most pharmacists are knowledgeable about mild illnesses—particularly those that plague tourists—and can recommend shots or medicines. Wherever possible, Let’s Go lists 24hr. and late-night pharmacies.

If you are concerned about obtaining medical assistance while traveling, you may wish to employ special support services. The MedPass from GlobalCare, Inc., 6875 Shiloh Rd. East, Alpharetta, GA 30005, USA (☎800-860-1111; www.globalcare.net), provides 24hr. international medical assistance, support, and medical evacuation resources. The International Association for Medical Assistance to Travelers (IAMAT; US ☎716-754-4883, Canada 519-836-0102; www.iamat.org) has free membership, lists English-speaking doctors worldwide, and offers detailed info on immunization requirements and sanitation. If your regular insurance policy does not cover travel abroad, you may wish to purchase additional coverage .

Those with medical conditions (such as diabetes, allergies to antibiotics, epilepsy, or heart conditions) may want to obtain a MedicAlert membership (US$40 per year), which includes among other things a stainless steel ID tag and a 24hr. collect-call number. Contact the MedicAlert Foundation International, 2323 Colorado Ave., Turlock, CA 95382, USA (☎888-633-4298, outside US ☎209-668-3333; www.medicalert.org).

Women’S Health

While pads and sanitary napkins are plentiful in Mexican pharmacies and supermarkets, tampons are harder to come by and, if available at all, come only in regular sizes. It might be wise to bring a supply along, especially if you are traveling to smaller cities. Condoms can be found in most large pharmacies, but other contraceptive devices are difficult to find. Mexico City recently legalized first-trimester abortion; elsewhere in the country it is illegal except in cases of rape or to save the woman’s life. Women considering an abortion should contact the Fundación Mexicana para la Planeación Familiar, A.C. (MEXFAM), Juárez #208, Colonia Tlalpan 14000, Mexico D.F. (☎555 487 0030; www.mexfam.org.mx), for more information.