Most travelers who get sick in Costa Rica have an upset stomach, sunburn or mosquito bites, not anything exotic. To avoid getting sick in Costa Rica, drink tap water only where it’s treated (most of the country) and use bottled or filtered water in remote areas. Eat cooked food from busy places, and use insect repellent during the day as well as at dusk. Respect the sun, and stay out of rivers after heavy rain. Before you go, see a travel clinic about vaccines and malaria, and buy travel medical insurance.
This guide is for first-time visitors and families who want a short, practical health plan for a Costa Rica trip, with a note at the end for anyone continuing to Nicaragua or Panama. It covers water, food, mosquitoes, sun and water safety, and what to do if you do get sick.
| Staying healthy in Costa Rica | At a glance |
|---|---|
| Tap water | Treated and drinkable in most of the country; use bottled or filtered water in remote areas and never drink from rivers or waterfalls |
| Food | Cooked food from busy sodas and restaurants is a safe bet; take more care with raw seafood and cut fruit from street stalls |
| Mosquitoes | Dengue is the main risk, and the mosquitoes that carry it bite during the day |
| Malaria | Limited to parts of Alajuela and Limón provinces; ask a travel clinic about preventive pills |
| Sun and heat | Strong UV all year, even on cloudy days |
| Water safety | Rip currents on many beaches; river infections after heavy rain |
| Medical care | Good private hospitals in San José; pharmacies in every town; emergency number 911 |
Food and water
How to Avoid Getting Sick in Costa Rica: Food and Water
Tap water and ice
Costa Rica’s tap water is treated and safe to drink in San José, the Central Valley and most towns. Quality varies more in small rural systems and some beach and Caribbean communities, and local water operators sometimes issue temporary “don’t drink” notices. If you’re unsure, ask your hotel or use bottled or filtered water. Ice in established restaurants and hotels is generally fine where the tap water is. Never drink straight from rivers, streams or waterfalls. Our Costa Rica drinking water guide covers where to trust it in more detail.
What to eat and what to skip
Food hygiene in Costa Rica is good by regional standards. A plate of rice, beans, meat and plantains at a busy soda (a small, family-run local restaurant) is one of the safer meals you can eat. A few habits lower the risk further:
- Pick busy places. High turnover means food doesn’t sit around. See our guides to sodas and Costa Rican food.
- Eat food hot. Dishes cooked to order are safer than buffet trays that have been out for hours.
- Take care with raw seafood. Ceviche is marinated in lime juice, not cooked, so order it where it’s made fresh and sells fast.
- Peel your own fruit if you have a sensitive stomach, and skip pre-cut fruit that has been sitting in the heat.
- Wash or sanitize your hands before eating, especially after handling money or riding the bus.
Alcohol
Stick to recognized brands in sealed bottles from supermarkets and licensed bars. In 2019, liquor adulterated with methanol and sold under several low-cost brands killed more than 20 people in Costa Rica. Avoid unlabeled guaro (the local sugarcane liquor) and anything that seems suspiciously cheap.
If you get traveler’s diarrhea
Most cases pass in a few days. Drink plenty of fluids, ideally oral rehydration salts (suero oral at pharmacies), and rest. See a doctor if you have a high fever, blood in your stool, severe pain, or can’t keep fluids down, and get help sooner for young children and older travelers. Ask your doctor before the trip which medications to bring.
Mosquitoes
Mosquitoes: Dengue, Malaria and Other Bug-Borne Illness
Dengue is the mosquito-borne illness visitors are most likely to encounter in Costa Rica. It occurs year-round in the lowlands and on both coasts, and cases usually climb in the rainy season. The Aedes mosquitoes that carry dengue, chikungunya and Zika bite mostly during the day, so don’t save repellent for the evening.
- Use an effective repellent on exposed skin: DEET, picaridin, IR3535 or oil of lemon eucalyptus. Apply sunscreen first, repellent second.
- Cover up with light, loose long sleeves and pants at dawn, dusk and in forests. Clothing treated with permethrin adds protection.
- Sleep protected. Choose rooms with screens or air conditioning, or use a mosquito net.
- Watch for symptoms such as sudden fever, severe headache, pain behind the eyes, and joint or muscle pain, during your trip or in the two weeks after. See a doctor and mention where you’ve traveled.
Malaria is uncommon in Costa Rica and limited to parts of the northern and Caribbean lowlands. Preventive medication has been recommended for travelers to Alajuela and Limón provinces, which include La Fortuna, Tortuguero and Puerto Viejo on the Caribbean coast. Talk to a travel clinic well before your trip. Our Costa Rica vaccinations guide covers malaria pills and recommended shots. If you’re pregnant or planning a pregnancy, ask your doctor about Zika before you book.
Sun and water
Sun, Heat and Water Safety
Costa Rica is close to the equator, and the sun burns quickly, even through clouds. Use a high-SPF sunscreen and reapply after swimming. Wear a hat, and plan beach time and hikes for the morning and late afternoon. Drink more water than you think you need, especially in Guanacaste’s dry-season heat.
Water is a bigger danger than most illnesses. Rip currents are common on many Costa Rican beaches, and lifeguards are rare. Learn to spot them before you swim; our beach safety and rip current guide explains how.
Other risks
Animals, Altitude and Small Cuts
Wildlife and rabies
Rabies is present in Costa Rica’s wildlife, including bats. Don’t touch or feed monkeys, raccoons or other animals; feeding wildlife is prohibited in national parks and makes animals bolder around people. Wash any bite or scratch with soap and water for several minutes and get medical care the same day, even if you’ve had a pre-travel rabies vaccine.
Altitude
Most of Costa Rica is too low for altitude to matter. The exceptions are Chirripó, the country’s highest peak, and the summit area of Irazú Volcano, both above 3,000 meters (about 10,000 feet). Some visitors feel short of breath or get a headache there. Go slowly, drink water and come down if symptoms get worse. See our Costa Rica hiking guide.
Hygiene and small cuts
Heat and humidity let small scrapes and insect bites get infected fast. Clean cuts right away, use an antiseptic and keep them covered and dry. Carry hand sanitizer for bus rides, roadside stops and beach days without a sink nearby.
Before you go
Before You Go: Vaccines, Insurance and a Health Kit
- See a travel clinic four to six weeks ahead. Ask about routine vaccines, hepatitis A, typhoid and malaria for your route. See our vaccinations guide.
- Buy travel medical insurance. Private hospitals expect payment or proof of coverage up front, and Medicare and many U.S. health plans cover little or nothing abroad. See our travel insurance guide.
- Pack a small kit: repellent, sunscreen, hand sanitizer, bandages and antiseptic, oral rehydration salts, pain and fever medicine, and any prescriptions in their original containers. Our Costa Rica packing list covers the rest.
If you get sick
What to Do If You Get Sick in Costa Rica
- Minor problems: start at a pharmacy (farmacia). Pharmacists can advise on common complaints, and many medicines are easy to buy. See how pharmacies work in Costa Rica.
- A doctor’s visit: private clinics in tourist towns and private hospitals in San José see walk-in patients. Expect to pay first and claim from your insurer later.
- Public care: hospitals and clinics run by the Caja (CCSS), the national health system, treat emergencies, but non-residents are charged, and waits for non-urgent care can be long.
- Emergencies: call 911. Your hotel or tour operator can also help arrange transport to the nearest clinic.
For broader safety advice, see our guide to staying safe in Costa Rica.
Central America
Continuing to Nicaragua or Panama?
The same habits apply across Central America, but water treatment, food hygiene and medical care vary from country to country and between cities and rural areas. Check the CDC destination page for each country on your route, and use bottled or filtered water until you know the local situation. Costa Rica’s yellow fever certificate rule applies to arrivals from a list of South American and African countries; our vaccinations guide explains who needs one.
Avoid these
Common Mistakes
- Using repellent only at night, when the mosquitoes that carry dengue bite during the day.
- Drinking from a waterfall or river because the water looks clean.
- Skipping sunscreen on cloudy days or during a long boat tour.
- Swimming at an unfamiliar beach without checking for rip currents.
- Traveling without medical insurance and finding out a private hospital wants payment up front.
- Ignoring a fever that starts after you get home. Tell your doctor where you traveled.
FAQ
Staying Healthy in Costa Rica: FAQ
Is it safe to drink the tap water in Costa Rica?
In most of the country, including San José and the Central Valley, yes. Use bottled or filtered water in remote areas or if your hotel advises it, and never drink untreated water from rivers or waterfalls.
Do I need malaria pills for Costa Rica?
It depends on where you’re going. Malaria is limited to parts of Alajuela and Limón provinces, and preventive medication has been recommended for travelers there. Ask a travel clinic about your itinerary.
Is there dengue in Costa Rica?
Yes. Dengue occurs year-round, mostly in the lowlands and on the coasts, with more cases in the rainy season. Use repellent during the day and see a doctor if you develop a sudden fever.
Is the food safe to eat in Costa Rica?
Generally, yes. Cooked food from busy sodas and restaurants is a good bet. Take more care with raw seafood such as ceviche and with cut fruit that has been sitting out.
What should I do if I get sick in Costa Rica?
For minor problems, start at a pharmacy. For anything more serious, go to a private clinic or hospital, or call 911 in an emergency. Travel medical insurance makes paying much easier.
Do I need vaccines to visit Costa Rica?
No vaccines are required for most visitors. A yellow fever certificate is required only if you’ve recently been in certain countries. Routine vaccines plus hepatitis A and typhoid are commonly recommended; see a travel clinic.
The short version
Drink tap water where it’s treated, eat cooked food from busy places, and skip river water.
Wear repellent during the day, respect the sun, and learn to spot rip currents.
See a travel clinic before you go, carry insurance, and start at a pharmacy if you feel unwell.