Costa Rica (Lonely Planet, 9th Edition) - Matthew Firestone [504]
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Leptospirosis
Leptospirosis is acquired by exposure to water contaminated by the urine of infected animals. White-water rafters are at particularly high risk. In Costa Rica most cases occur in Puerto Limón, Turrialba, San Carlos and Golfito. Cases have been reported among residents of Puerto Limón who have bathed in local streams. Outbreaks can occur at times of flooding, when sewage overflow may contaminate water sources. The initial symptoms, which resemble a mild flu, usually subside uneventfully in a few days, with or without treatment, but a minority of cases are complicated by jaundice or meningitis. There is no vaccine. You can minimize your risk by staying out of bodies of fresh water that may be contaminated by animal urine. If you’re engaging in high-risk activities, such as river rafting, in an area where an outbreak is in progress, you can take 200mg of doxycycline once weekly as a preventative measure. If you actually develop leptospirosis, the treatment is 100mg of doxycycline twice daily.
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Malaria
Malaria occurs in every country in Central America. It’s transmitted by mosquito bites, usually between dusk and dawn. The main symptom is high spiking fevers, which may be accompanied by chills, sweats, headache, body aches, weakness, vomiting or diarrhea. Severe cases may involve the central nervous system and lead to seizures, confusion, coma and death.
Taking malaria pills is recommended for the provinces of Alajuela, Limón (except for Puerto Limón), Guanacaste and Heredia. The risk is greatest in the cantons of Los Chiles (Alajuela province), and Matina and Talamanca (Limón province).
For Costa Rica the first-choice malaria pill is chloroquine, taken once weekly in a dosage of 500mg, starting one to two weeks before arrival and continuing through the trip and for four weeks after departure. Chloroquine is safe, inexpensive and highly effective. Side effects are typically mild and may include nausea, abdominal discomfort, headache, dizziness, blurred vision or itching. Severe reactions are uncommon.
Protecting yourself against mosquito bites (Click here) is just as important as taking malaria pills, since no pills are 100% effective.
If you may not have access to medical care while traveling, you should bring along additional pills for emergency self-treatment, which you should take if you can’t reach a doctor and you develop symptoms that suggest malaria, such as high spiking fevers. One option is to take four tablets of Malarone once daily for three days. If you start self-medication, you should try to see a doctor at the earliest possible opportunity.
If you develop a fever after returning home, see a physician as malaria symptoms may not occur for months.
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Rabies
Rabies is a viral infection of the brain and spinal cord that is almost always fatal. The rabies virus is carried in the saliva of infected animals and is typically transmitted through an animal bite, though contamination of any break in the skin with infected saliva may result in rabies.
Rabies occurs in all Central American countries. However, in Costa Rica only two cases have been reported over the last 30 years. Rabies vaccine is therefore recommended only for those at particularly high risk, such as spelunkers (cave explorers) and animal handlers.
All animal bites and scratches must be promptly and thoroughly cleansed with large amounts of soap and water. Local health authorities should be contacted to determine whether or not further treatment is necessary (Click here).
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