Health Information for Travelers to El Salvador

Vaccines and Medicines

Check the vaccines and medicines list and visit your doctor (ideally, 4-6 weeks) before your trip to get vaccines or medicines you may need.

	Find Out Why	Protect Yourself
All travelers You should be up to date on routine vaccinations while traveling to any destination. Some vaccines may also be required for travel.
Routine vaccines	Make sure you are up-to-date on routine vaccines before every trip. These vaccines include measles-mumps-rubella (MMR) vaccine, diphtheria-pertussis-tetanus vaccine, varicella (chickenpox) vaccine, and your yearly flu shot.
Most travelers Get travel vaccines and medicines because there is a risk of these diseases in the country you are visiting.
Hepatitis A	CDC recommends this vaccine because you can get hepatitis A through contaminated food or water in El Salvador, regardless of where you are eating or staying.
Typhoid	You can get typhoid through contaminated food or water in El Salvador. CDC recommends this vaccine for most travelers, especially if you are staying with friends or relatives, visiting smaller cities or rural areas, or if you are an adventurous eater.
Some travelers Ask your doctor what vaccines and medicines you need based on where you are going, how long you are staying, what you will be doing, and if you are traveling from a country other than the US.
Hepatitis B	You can get hepatitis B through sexual contact, contaminated needles, and blood products, so CDC recommends this vaccine if you might have sex with a new partner, get a tattoo or piercing, or have any medical procedures.
Malaria	Although the risk of malaria is low in El Salvador, you should avoid mosquito bites to prevent malaria. Some travelers to certain areas who are at higher risk for complications from malaria (such as pregnant women) may need to take extra precautions, like antimalarial medicine. Talk to your doctor about how you can prevent malaria while traveling. For more information on malaria in El Salvador, see malaria in El Salvador.
Rabies	Rabies can be found in dogs, bats, and other mammals in El Salvador, so CDC recommends this vaccine for the following groups: Travelers involved in outdoor and other activities (such as camping, hiking, biking, adventure travel, and caving) that put them at risk for animal bites. People who will be working with or around animals (such as veterinarians, wildlife professionals, and researchers). People who are taking long trips or moving to El Salvador Children, because they tend to play with animals, might not report bites, and are more likely to have animal bites on their head and neck.
Yellow Fever	There is no risk of yellow fever in El Salvador. The government of El Salvador requires proof of yellow fever vaccination only if you are arriving from a country with risk of yellow fever. This does not include the US. If you are traveling from a country other than the US, check this list to see if you may be required to get the yellow fever vaccine: Countries with risk of yellow fever virus (YFV) transmission. For more information on recommendations and requirements, see yellow fever recommendations and requirements for El Salvador. Your doctor can help you decide if this vaccine is right for you based on your travel plans.

Key

•  Get vaccinated
•  Take antimalarial meds
•  Eat and drink safely
•  Prevent bug bites
•  Keep away from animals
•  Reduce your exposure to germs
•  Avoid sharing body fluids
•  Avoid non-sterile medical or cosmetic equipment

Stay Healthy and Safe

There are great private hospitals staffed by doctors trained overseas. Many speak at least a little English. Salvadorans will tell you the best hospital to go to is Hospital Diagnostico which is one of the most expensive. It does have a good reputation for cancer treatments and research. However, ex-pats living in El Salvador will often disagree and say that Hospital de la Mujer is much better, especially for minor surgeries, blood tests and anything to do with women’s health. As there are more people having babies in El Salvador than cancer treatments, you may find that the nurses and doctors are in much better practice at the Hospital de la Mujer than at Diagnostico, where few Salvadorans can afford to go!

If you are not accustomed to food sold by street vendors, you might want to stay away from food sold on the streets until you acclimate. If you want to try a pupusa, you should try to find a restaurant to taste this popular dish rather than buying them from street vendors. That said, street food that you see cooked can sometimes be safer than restaurant food that you do not see cooked.

‘Agua en bolsa’ (water in a plastic bag) is very commonly sold in the streets and corner stores of El Salvador.

Pharmacies are easily found all over the country, and antibiotics are plentiful without the need for a prescription. Pain killers (such as Vicodin) are impossible to come by legally as the US found that a high level of painkillers being brought into the country came from El Salvador. Even morphine is unavailable in hospitals due to this crackdown by the US.

Be sure to have a first-aid kit if you travel to the countryside and to archaeological sites. There is very little chance of catching malaria in El Salvador – a much bigger threat is Dengue Fever, for which there is no protection other than mosquito repellant. Luckily doctors and hospitals are well-versed in treating and testing for Dengue.

Ameobas and other parasites are commonly in tap and well water, so beware of where you buy your drinks and what your ice looks like. A good rule of thumb is that if the ice is molded (i.e. round cylinders with a hole in the middle, or perfect squares) it is usually purified water bought from a store and therefore safe to have in your drink. If it looks like it has been broken apart with an ice pick it’s suspect. In Puerto La Libertad, many commodores (local restaurants often operating out of someone’s house) get their ice from the fishing co-op on the beachfront street. When you see what else that ice comes in contact with, you will change your mind about drinks with chipped ice in them!

Learn actions you can take to stay healthy and safe on your trip. Vaccines cannot protect you from many diseases in El Salvador, so your behaviors are important.

Eat and drink safely

Unclean food and water can cause travelers’ diarrhea and other diseases. Reduce your risk by sticking to safe food and water habits.

Eat

• Food that is cooked and served hot
• Hard-cooked eggs
• Fruits and vegetables you have washed in clean water or peeled yourself
• Pasteurized dairy products

Don’t Eat

• Food served at room temperature
• Food from street vendors
• Raw or soft-cooked (runny) eggs
• Raw or undercooked (rare) meat or fish
• Unwashed or unpeeled raw fruits and vegetables
• Unpasteurized dairy products
• “Bushmeat” (monkeys, bats, or other wild game)

Drink

• Bottled water that is sealed
• Water that has been disinfected
• Ice made with bottled or disinfected water
• Carbonated drinks
• Hot coffee or tea
• Pasteurized milk

Don’t Drink

• Tap or well water
• Ice made with tap or well water
• Drinks made with tap or well water (such as reconstituted juice)
• Unpasteurized milk

Take Medicine
Talk with your doctor about taking prescription or over-the-counter drugs with you on your trip in case you get sick.

Prevent bug bites

Bugs (like mosquitoes, ticks, and fleas) can spread a number of diseases in El Salvador. Many of these diseases cannot be prevented with a vaccine or medicine. You can reduce your risk by taking steps to prevent bug bites.

What can I do to prevent bug bites ?

• Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
• Use an appropriate insect repellent (see below).
• Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents). Do not use permethrin directly on skin.
• Stay and sleep in air-conditioned or screened rooms.
• Use a bed net if the area where you are sleeping is exposed to the outdoors.

What type of insect repellent should I use?

• FOR PROTECTION AGAINST TICKS AND MOSQUITOES: Use a repellent that contains 20% or more DEET for protection that lasts up to several hours.
• FOR PROTECTION AGAINST MOSQUITOES ONLY: Products with one of the following active ingredients  can also help prevent mosquito bites. Higher percentages of active ingredient provide longer protection.
  • DEET
  • Picaridin (also known as KBR 3023, Bayrepel, and icaridin)
  • Oil of lemon eucalyptus (OLE) or PMD
  • IR3535
• Always use insect repellent as directed.

What should I do if I am bitten by bugs?

• Avoid scratching bug bites, and apply hydrocortisone cream or calamine lotion to reduce the itching.
• Check your entire body for ticks after outdoor activity. Be sure to remove ticks properly.

What can I do to avoid bed bugs?
Although bed bugs do not carry disease, they are an annoyance. See our information page about avoiding bug bites for some easy tips to avoid them. For more information on bed bugs, see Bed Bugs.

For more detailed information on avoiding bug bites, see Avoid Bug Bites.

Stay safe out doors

If your travel plans in El Salvador include outdoor activities, take these steps to stay safe and healthy during your trip.

• Stay alert to changing weather conditions and adjust your plans if conditions become unsafe.
• Prepare for activities by wearing the right clothes and packing protective items, such as bug spray, sunscreen, and a basic first aid kit.
• Consider learning basic first aid and CPR before travel. Bring a travel health kit with items appropriate for your activities.
• Heat-related illness, such as heat stroke, can be deadly. Eat and drink regularly, wear loose and lightweight clothing, and limit physical activity during high temperatures.
  • If you are outside for many hours in heat, eat salty snacks and drink water to stay hydrated and replace salt lost through sweating.
• Protect yourself from UV radiation: use sunscreen with an SPF of at least 15, wear protective clothing, and seek shade during the hottest time of day (10 a.m.–4 p.m.).
• Be especially careful during summer months and at high elevation. Because sunlight reflects off snow, sand, and water, sun exposure may be increased during activities like skiing, swimming, and sailing.
• Very cold temperatures can be dangerous. Dress in layers and cover heads, hands, and feet properly if you are visiting a cold location.

Stay safe around water

• Swim only in designated swimming areas. Obey lifeguards and warning flags on beaches.
• Practice safe boating—follow all boating safety laws, do not drink alcohol if driving a boat, and always wear a life jacket.
• Do not dive into shallow water.
• Do not swim in freshwater in developing areas or where sanitation is poor.
• Avoid swallowing water when swimming. Untreated water can carry germs that make you sick.
• To prevent infections, wear shoes on beaches where there may be animal waste.

Leptospirosis, a bacterial infection that can be spread in fresh water, is found in El Salvador. Avoid swimming in fresh, unchlorinated water, such as lakes, ponds, or rivers.

Keep away from animals

Most animals avoid people, but they may attack if they feel threatened, are protecting their young or territory, or if they are injured or ill. Animal bites and scratches can lead to serious diseases such as rabies.

Follow these tips to protect yourself:

• Do not touch or feed any animals you do not know.
• Do not allow animals to lick open wounds, and do not get animal saliva in your eyes or mouth.
• Avoid rodents and their urine and feces.
• Traveling pets should be supervised closely and not allowed to come in contact with local animals.
• If you wake in a room with a bat, seek medical care immediately. Bat bites may be hard to see.

All animals can pose a threat, but be extra careful around dogs, bats, monkeys, sea animals such as jellyfish, and snakes. If you are bitten or scratched by an animal, immediately:

• Wash the wound with soap and clean water.
• Go to a doctor right away.
• Tell your doctor about your injury when you get back to the United States.

Consider buying medical evacuation insurance. Rabies is a deadly disease that must be treated quickly, and treatment may not be available in some countries.

Reduce your exposure to germs

Follow these tips to avoid getting sick or spreading illness to others while traveling:

• Wash your hands often, especially before eating.
• If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
• Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
• Try to avoid contact with people who are sick.
• If you are sick, stay home or in your hotel room, unless you need medical care.

Avoid sharing body fluids

Diseases such as HIV infection can be spread through body fluids, such as saliva, blood, vomit, and semen.

Protect yourself:

• Use latex condoms correctly.
• Do not inject drugs.
• Limit alcohol consumption. People take more risks when intoxicated.
• Do not share needles or any devices that can break the skin. That includes needles for tattoos, piercings, and acupuncture.
• If you receive medical or dental care, make sure the equipment is disinfected or sanitized.

Know how to get medical care while traveling

Plan for how you will get health care during your trip, should the need arise:

• Carry a list of local doctors and hospitals at your destination.
• Review your health insurance plan to determine what medical services it would cover during your trip. Consider purchasing travel health and medical evacuation insurance.
• Carry a card that identifies, in the local language, your blood type, chronic conditions or serious allergies, and the generic names of any medications you take.
• Some prescription drugs may be illegal in other countries. Call El Salvador’s embassy to verify that all of your prescription(s) are legal to bring with you.
• Bring all the medicines (including over-the-counter medicines) you think you might need during your trip, including extra in case of travel delays. Ask your doctor to help you get prescriptions filled early if you need to.

Many foreign hospitals and clinics are accredited by the Joint Commission International. A list of accredited facilities is available at their website (www.jointcommissioninternational.org).

In some countries, medicine (prescription and over-the-counter) may be substandard or counterfeit. Bring the medicines you will need from the United States to avoid having to buy them at your destination.