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Mexico (complete)
Summary of recommendationsMedicationsImmunizations
Recent outbreaksOther infectionsFood and water precautions
Insect and tick protectionPollutionSwimming
General adviceAmbulanceMedical facilities
PharmaciesBuying prescription drugsImporting Medicine to Mexico
Traveling with childrenTravel and pregnancyMaps
Registration/Embassy locationVolcanic activity Safety information

 

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Summary of recommendations:

All travelers should visit either their personal physician or a travel health clinic 4-8 weeks before departure.

Malaria: Prophylaxis with chloroquine is recommended for only for a small number of areas not usually visited by travelers, including the areas near the Guatemala and Belize borders in the states of Chiapas, Quintana Roo, and Tabasco; rural areas in the states of Nayarit, Oaxaca, Sinaloa; and the area between 24°N and 28°N latitude, and 106°W and 110°W longitude, which lies in parts of Sonora, Chihuahua, and Durango. There is no malaria risk in the major resorts along the Pacific and Gulf Coasts or along the United States-Mexico border.
Vaccinations:

Hepatitis A

Recommended for all travelers

Typhoid

Recommended for all travelers

Hepatitis B

For travelers who will have intimate contact with local residents or potentially need blood transfusions or injections, especially if visiting for more than six months

Rabies

For travelers spending a lot of time outdoors, or at high risk for animal bites, or involved in any activities that might bring them into direct contact with bats

Measles, mumps, rubella (MMR)

Two doses recommended for all travelers born after 1956, if not previously given

Tetanus-diphtheria

Revaccination recommended every 10 years

Medications

Travelers' diarrhea is the most common travel-related ailment. The cornerstone of prevention is food and water precautions, as outlined below. All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if associated with nausea, vomiting, cramps, fever or blood in the stool. A quinolone antibiotic is usually prescribed: either ciprofloxacin (Cipro)(PDF) 500 mg twice daily or levofloxacin (Levaquin) (PDF) 500 mg once daily for a total of three days. Quinolones are generally well-tolerated, but occasionally cause sun sensitivity and should not be given to children, pregnant women, or anyone with a history of quinolone allergy. Alternative regimens include a three day course of rifaximin (Xifaxan) 200 mg three times daily or azithromycin (Zithromax) 500 mg once daily. Rifaximin should not be used by those with fever or bloody stools and is not approved for pregnant women or those under age 12. Azithromycin should be avoided in those allergic to erythromycin or related antibiotics. An antidiarrheal drug such as loperamide (Imodium) or diphenoxylate (Lomotil) should be taken as needed to slow the frequency of stools, but not enough to stop the bowel movements completely. Diphenoxylate (Lomotil) and loperamide (Imodium) should not be given to children under age two.

Most cases of travelers' diarrhea are mild and do not require either antibiotics or antidiarrheal drugs. Adequate fluid intake is essential.

If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.

Though effective, antibiotics are not recommended prophylactically (i.e. to prevent diarrhea before it occurs) because of the risk of adverse effects, though this approach may be warranted in special situations, such as immunocompromised travelers.

Malaria in Mexico: prophylaxis is recommended only for a small number of areas not usually visited by travelers, including the areas near the Guatemala and Belize borders in the states of Chiapas, Quintana Roo, and Tabasco; rural areas in the states of Nayarit, Oaxaca, Sinaloa; and the area between 24°N and 28°N latitude, and 106°W and 110°W longitude, which lies in parts of Sonora, Chihuahua, and Durango. For travelers to these areas, the drug of choice is choloroquine, taken once weekly in a dosage of 500 mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after departure. Chloroquine may cause mild adverse reactions, including gastrointestinal disturbance, headache, dizziness, blurred vision, and itching, but severe reactions are uncommon. Insect protection measures are also essential for these areas.

There is no malaria risk in the major resorts along the Pacific and Gulf Coasts or along the United States-Mexico border. Most travelers to Mexico do not need to take malaria prophylaxis.

For further information about malaria in Mexico, including maps showing the risk of malaria in different parts of the country, go to the World Health Organization and the Pan American Health Organization.

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Immunizations

The following are the recommended vaccinations for Mexico:

Measles vaccine is recommended for any traveler born after 1956 who does not have either a history of two documented measles immunizations or a blood test showing immunity. A measles outbreak was reported from Distrito Federal, Estado de Mexico, and Hidalgo in early 2004 (see "Recent outbreaks".) Although measles immunization is usually begun at age 12 months, consider giving an initial dose of measles vaccine to children between the ages of 6 and 11 months who will be traveling to Mexico. Many adults who had only one vaccination show immunity when tested and do not need the second vaccination. Those born before 1957 are presumed to be immune to measles. Measles vaccine should not be given to pregnant or severely immunocompromised individuals.

Hepatitis A vaccine is recommended for all travelers over one year of age. It should be given at least two weeks (preferably four weeks or more) before departure. A booster should be given 6-12 months later to confer long-term immunity. Two vaccines are currently available in the United States: VAQTA (Merck and Co., Inc.) (PDF) and Havrix (GlaxoSmithKline) (PDF). Both are well-tolerated. Side-effects, which are generally mild, may include soreness at the injection site, headache, and malaise.

Older adults, immunocompromised persons, and those with chronic liver disease or other chronic medical conditions who have less than two weeks before departure should receive a single intramuscular dose of immune globulin (0.02 mL/kg) at a separate anatomic injection site in addition to the initial dose of vaccine. Travelers who are less than one year of age or allergic to a vaccine component should receive a single intramuscular dose of immune globulin (see hepatitis A for dosage) in the place of vaccine.

Typhoid vaccine is recommended for all travelers. It is generally given in an oral form (Vivotif Berna) consisting of four capsules taken on alternate days until completed. The capsules should be kept refrigerated and taken with cool liquid. Side-effects are uncommon and may include abdominal discomfort, nausea, rash or hives. The alternative is an injectable polysaccharide vaccine (Typhim Vi; Aventis Pasteur Inc.) (PDF), given as a single dose. Adverse reactions, which are uncommon, may include discomfort at the injection site, fever and headache. The oral vaccine is approved for travelers at least six years old, whereas the injectable vaccine is approved for those over age two. There are no data concerning the safety of typhoid vaccine during pregnancy. The injectable vaccine (Typhim Vi) is probably preferable to the oral vaccine in pregnant and immunocompromised travelers.

Hepatitis B vaccine is recommended for travelers who will have intimate contact with local residents or potentially need blood transfusions or injections while abroad, especially if visiting for more than six months. Hepatitis B vaccine is also recommended for all health care personnel. Two vaccines are currently licensed in the United States: Recombivax HB (Merck and Co., Inc.) (PDF) and Engerix-B (GlaxoSmithKline) (PDF). A full series consists of three intramuscular doses given at 0, 1 and 6 months. Engerix-B is also approved for administration at 0, 1, 2, and 12 months, which may be appropriate for travelers departing in less than 6 months. Side-effects are generally mild and may include discomfort at the injection site and low-grade fever. Severe allergic reactions (anaphylaxis) occur rarely.

Rabies vaccine is recommended for travelers spending a lot of time outdoors, for travelers at high risk for animal bites, such as veterinarians and animal handlers, for long-term travelers and expatriates, and for travelers involved in any activities that might bring them into direct contact with bats. Children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites. Most cases in Mexico are related to dog bites, but bats and other wild species remain important sources of infection. A complete preexposure series consists of three doses of vaccine injected into the deltoid muscle on days 0, 7, and 21 or 28. Side-effects may include pain at the injection site, headache, nausea, abdominal pain, muscle aches, dizziness, or allergic reactions.

Any animal bite or scratch should be thoroughly cleaned with large amounts of soap and water and local health authorities should be contacted immediately for possible post-exposure treatment, whether or not the person has been immunized against rabies.

All travelers should be up-to-date on routine immunizations, including

  • Tetanus-diphtheria vaccine (recommended for all travelers who have not received a tetanus-diphtheria immunization within the last 10 years.)
  • Varicella (chickenpox) vaccine (recommended for any international traveler over one year of age who does not have either a history of documented chickenpox or a blood test showing immunity. Many people who believe they never had chickenpox show immunity when tested and do not need the vaccine. Varicella vaccine should not be given to pregnant or immunocompromised individuals.)

Cholera vaccine is not recommended. Only one case of cholera was reported for the year 2001 and none for 2002.

Polio vaccine is not recommended for any adult traveler who completed the recommended childhood immunizations. Polio has been eradicated from the Americas, except for a small outbreak of vaccine-related poliomyelitis in the Dominican Republic and Haiti in late 2000.

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Recent outbreaks

An outbreak of H1N1 influenza ("swine flu") was reported from Mexico in April 2009. The outbreak was caused by a previously unknown strain of influenza that contained a unique combination of swine, avian, and human influenza gene segments. Initial reports indicated a high fatality rate in previously healthy young adults and older children, raising concerns that a worldwide pandemic might occur, similar to 1918. However, subsequent data from Mexico, as well as experience from the United States and other countries, indicate the H1N1 strain from 2009 is not nearly as lethal as some people initially feared. As of June 29, a total of 8279 cases and 116 deaths had been reported. The states with the highest number of confirmed cases are the Federal District, Estado de Mexico, San Luis Potosi and Hidalgo. The majority of these have occurred in previously healthy young adults. New cases continue to be reported, but the outbreak appears to be coming under control. Schools and universities have been reopened.

The World Health Organization and the Centers for Disease Control do not recommend any travel restrictions at this time. To protect yourself from H1N1 influenza, wash your hands regularly and avoid close contact with anyone who is coughing or sneezing. Routine use of face masks is not recommended. The symptoms of H1N1 influenza include fever, cough, sore throat, body aches, headache, chills and fatigue, similar to seasonal influenza. Any traveler to Mexico who develops flu-like symptoms should immediately seek medical attention. Clinicians who suspect H1N1 influenza virus infections in humans should obtain a nasopharyngeal swab from the patient, place the swab in a viral transport medium, and contact their state or local health department to facilitate transport and timely diagnosis at a state public health laboratory. Empiric treatment with Tamiflu or Relenza should be considered for suspected cases. It is not anticipated that the influenza vaccine given in the winter of 2008-2009 will be protective against the novel H1N1 virus. For further information, go to the World Health Organization and the Centers for Disease Control.

Outbreaks of dengue fever are regularly reported from Mexico. In most years, a majority of the cases are reported from the southeast of the country, mainly Veracruz and Chiapas. In July 2009, a dengue outbreak was reported from Tonala municipality in the Guadalajara Metropolitan Zone, state of Jalisco. As of May 2009, the states reporting the largest number of dengue cases for the year were Colima, Michoacan, Guerrero, and Veracruz. An increasing number of cases were being reported from Jalisco state, which includes Puerto Vallarta. Dengue fever is a flu-like illness which may be complicated by hemorrhage or shock. The disease is transmitted by Aedes mosquitoes, which bite primarily in the daytime and favor densely populated areas, though they also inhabit rural environments. No vaccine is available at this time. Insect protection measures, as below, are advised.

A dengue outbreak was reported from the southern part of Morelos state in May 2009, causing 58 cases. In January 2009, a suspected dengue outbreak was reported from the southern zone of Tamaulipas. In November 2008, a dengue outbreak occurred in Parque Hundido and surrounding neighborhoods of the Gomez Palacio municipality in Durango State. In September 2008, a dengue outbreak was reported from the coastal municipalities of Jalisco, including Zapopan, Puerto Vallarta, Guadalajara, and Tlaquepaque. As of December 2008, more than 600 cases had been identified and more were still being found, despite the cooler weather. A dengue alert was declared for Sonora in September 2008 after six cases were found. A much larger outbreak was reported from multiple areas in Mexico in the summer of 2007, resulting in more than 67,000 cases by October.

A major dengue outbreak was reported in November 2002, owing to the proliferation of mosquitoes following Hurricane Kenna from the Pacific and Hurricane Isidoro from the Gulf of Mexico. A total of almost 10,000 cases were reported for the year 2002. Mosquito control programs were initiated in the states of Sinaloa, Nayarit, and Jalisco along the Pacific coast and in the states of Campeche and Yucatan along the Gulf of Mexico. See Health Canada for further information. The number of cases started to fall but rose again in subsequent years, reaching more than 16,000 for the year 2005 and more than 27,000 for the year 2006.

An outbreak of hepatitis A was reported in September 2008 from the state of Queretaro, causing almost 300 cases (see ProMED-mail, September 28, 2008). Hepatitis A vaccine is recommended for all travelers to Mexico, as above.

West Nile virus infections have been reported from Mexico, chiefly in birds and horses. A single symptomatic human case was reported from Sonora County, south of the U.S. border, in August 2004. No other symptomatic human cases have been identified since August 2003, although blood tests suggest that a number of asymptomatic infections may have occurred. For a map showing the distribution of West Nile virus infections in Mexico, go to Resumen Epidemiologico .

An outbreak of measles was reported in May 2004 from the Federal District and the states of Mexico, Hidalgo, Campeche, and Coahuila, resulting in 64 cases as of May 17. Most cases occurred in those greater than 15 years of age, many of whom remain susceptible to measles because they never received a second dose of measles vaccine as children. All travelers born after 1956 should make sure they have had either two documented measles immunizations or a blood test showing measles immunity (see discussion above). Those born before 1957 are in general presumed to be immune to measles.

An outbreak of histoplasmosis was reported among travelers returning from Acapulco in March 2001. Symptoms included fever, chills, dry cough, chest pain, and headache. Most of those affected were American college students who had stayed at the Calinda Beach Hotel. Two cases of histoplasmosis were subsequently reported among travelers who had stayed at the same hotel in April, suggesting ongoing transmission. The hotel has been closed pending further investigation. Histoplasmosis is caused by Histoplasma capsulatum, a soil-based fungus transmitted by inhalation. The infection is not transmitted from person to person. Despite extensive investigation, no source of Histoplasma has been identified to date in the hotel environment. For further information, see MMWR.

An outbreak of coccidioidomycosis occurred in January 2000 among church members from Pennsylvania who had traveled to Hermosillo to build a church. Most had flu-like symptoms, including fever, malaise, joint pains and muscle pains, though several had pneumonia and one required brief hospitalization in an intensive care unit. For further information, see the Centers for Disease Control. In Mexico, coccidioidomycosis occurs chiefly in desert areas in the northern part of the country.

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Other infections

Gnathostomiasis has been reported in Acapulco and other parts of Mexico. The disease, which is caused by a helminth known as Gnathostoma spinigerum, is usually acquired by eating raw or undercooked freshwater fish, including ceviche, a popular lime-marinated fish salad. The chief symptom is intermittent, migratory swellings under the skin, sometimes associated with joint pains, muscle pains, or gastrointestinal symptoms. The symptoms may not begin until many months after exposure. See Rojas-Molina et al. in Emerging Infectious Diseases and Moore et al. in Emerging Infectious Diseases for further information.

Rubella (German measles) infections were reported in elevated frequency from Chihuahua and Tamaulipas states, across the border from Texas, in 1998. Rubella may cause birth defects and miscarriages if acquired by pregnant women. Rubella vaccine, which is included among routine childhood immunizations, is thought to provide lifelong immunity. A booster is not generally recommended for anyone immunized as a child. Pregnant women should have a blood test to confirm that they're immune.

HIV (human immunodeficiency virus) infection is reported, but travelers are not at risk unless they have unprotected sexual contacts or receive injections or blood transfusions.

Other infections include

  • Hepatitis E
  • Shigellosis
  • Amebiasis
  • Brucellosis (chiefly from the northern districts bordering the United States and the northwestern and west-central districts; outbreak reported in March 2009 from contaminated cheese sold in the Hidalgo Market in Guanajuato)
  • Chagas disease (American trypanosomiasis) (rural areas, chiefly in southern and coastal areas)
  • Cutaneous and mucocutaneous leishmaniasis (transmitted by sandflies)
  • Visceral leishmaniasis (rare cases reported in the Balsas River basin in the southern states of Guerrero and Pueblas)
  • Tick-borne relapsing fever (plateau regions in central Mexico; incidence is low)
  • Trench fever (limited foci)
  • Louse-borne typhus (limited foci)
  • Murine typhus
  • Tularemia (northern Mexico)
  • Rocky Mountain spotted fever (central Mexico; Yucatan peninsula; Jalisco State)
  • Onchocerciasis (highland areas in the states of Oaxaca, Chiapas, and Guerrero in southern Mexico)
  • Venezuelan equine encephalitis (transmitted by mosquitoes; small outbreaks among horses in the State of Chiapas in 1993 and in the State of Oaxaca in 1996; no confirmed human cases during either outbreak, but serologic studies indicate human infection probably does occur in these regions; see Emerging Infectious Diseases)
  • Eastern equine encephalitis
  • St. Louis encephalitis
  • Anthrax
  • Blastomycosis
  • Fascioliasis
  • Paragonimiasis (rare)

Scorpion bites are a health problem in many states.

For a weekly update, state by state, of many infectious diseases, including malaria, hepatitis, meningitis, dengue fever, and typhoid fever, go to the Boletin Epidemiologica (in Spanish). For in-depth public health information, go to the Pan-American Health Organization or the Secretaria de Salud (in Spanish).

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Food and water precautions

Do not drink tap water unless it has been boiled, filtered, or chemically disinfected. Do not drink unbottled beverages or drinks with ice. Do not eat fruits or vegetables unless they have been peeled or cooked. Avoid cooked foods that are no longer piping hot. Cooked foods that have been left at room temperature are particularly hazardous. Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Avoid food and beverages obtained from street vendors. Do not eat raw or undercooked meat or fish, including ceviche. Some types of fish may contain poisonous biotoxins even when cooked. Barracuda in particular should never be eaten. Other fish that may contain toxins include red snapper, grouper, amberjack, and sea bass.

All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if accompanied by nausea, vomiting, cramps, fever or blood in the stool. Antibiotics which have been shown to be effective include ciprofloxacin (Cipro), levofloxacin (Levaquin), rifaximin (Xifaxan), or azithromycin (Zithromax). Either loperamide (Imodium) or diphenoxylate (Lomotil) should be taken in addition to the antibiotic to reduce diarrhea and prevent dehydration.

If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.

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Insect and tick protection

Wear long sleeves, long pants, hats and shoes (rather than sandals). For rural and forested areas, boots are preferable, with pants tucked in, to prevent tick bites. Apply insect repellents containing 25-50% DEET (N,N-diethyl-3-methylbenzamide) or 20% picaridin (Bayrepel) to exposed skin (but not to the eyes, mouth, or open wounds). DEET may also be applied to clothing. Products with a lower concentration of either repellent need to be repplied more frequently. Products with a higher concentration of DEET carry an increased risk of neurologic toxicity, especially in children, without any additional benefit. Do not use either DEET or picaridin on children less than two years of age. For additional protection, apply permethrin-containing compounds to clothing, shoes, and bed nets. Permethrin-treated clothing appears to have little toxicity. Don't sleep with the window open unless there is a screen. If sleeping outdoors or in an accomodation that allows entry of mosquitoes, use a bed net, preferably impregnated with insect repellent, with edges tucked in under the mattress. The mesh size should be less than 1.5 mm. If the sleeping area is not otherwise protected, use a mosquito coil, which fills the room with insecticide through the night. In rural or forested areas, perform a thorough tick check at the end of each day with the assistance of a friend or a full-length mirror. Ticks should be removed with tweezers, grasping the tick by the head. Many tick-borne illnesses can be prevented by prompt tick removal.

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Pollution

Air pollution in Mexico City and Guadelajara may be severe, especially from December to May. Air pollution reached unacceptable levels in Mexico City in 1998 due to smoke from forest fires in southern Mexico and low rainfall. Travelers with respiratory or cardiac conditions and those who are elderly or extremely young are at greatest risk for complications from air pollution, which may include cough, difficulty breathing, wheezing, or chest pain. The risk may be minimized by staying indoors, avoiding outdoor exercise, and drinking plenty of fluids.

Up-to-date information concerning air quality in Mexico City and the environs is available from the Climate Institute.

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Swimming (reproduced from the U.S. State Dept. Consular Information Sheet)

The quality of water along some beaches in or near Acapulco or other large coastal communities may be unsafe for swimming because of contamination. Swimming in contaminated water may cause diarrhea and/or other illnesses. Mexican government agencies monitor water quality in public beach areas but their standards and sampling techniques may differ from those in the United States.

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General advice

Bring adequate supplies of all medications in their original containers, clearly labeled. Carry a signed, dated letter from the primary physician describing all medical conditions and listing all medications, including generic names. If carrying syringes or needles, be sure to carry a physician's letter documenting their medical necessity.Pack all medications in hand luggage. Carry a duplicate supply in the checked luggage. If you wear glasses or contacts, bring an extra pair. If you have significant allergies or chronic medical problems, wear a medical alert bracelet.

Make sure your health insurance covers you for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation, should be seriously considered. If illness occurs while abroad, medical expenses including evacuation may run to tens of thousands of dollars. For a list of travel insurance and air ambulance companies, go to Medical Information for Americans Traveling Abroad on the U.S. State Department website. Bring your insurance card, claim forms, and any other relevant insurance documents. Before departure, determine whether your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures. The Medicare and Medicaid programs do not pay for medical services outside the United States.

Pack a personal medical kit, customized for your trip (see description). Take appropriate measures to prevent motion sickness and jet lag, discussed elsewhere. On long flights, be sure to walk around the cabin, contract your leg muscles periodically, and drink plenty of fluids to prevent blood clots in the legs. For those at high risk for blood clots, consider wearing compression stockings.

Avoid contact with stray dogs and other animals. If an animal bites or scratches you, clean the wound with large amounts of soap and water and contact local health authorities immediately. Wear sun block regularly when needed. Use condoms for all sexual encounters. Ride only in motor vehicles with seat belts. Do not ride on motorcycles.

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Ambulance

For an ambulance in Mexico, call 065. Response times may be slow and the ambulance personnel may not be fully trained.

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Medical facilities

There are a number of first-rate hospitals in Mexico City, including the following:

  • ABC (American British Cowdray) Hospital (Calle Sur 136, on corner of Avenida Observatorio, Col. Las Ametricas, opposite the American School; tel. 5230-8000; emergency tel. 5230-8161; website http://www.abchospital.com/)
  • Hospital Angeles del Pedregal (Camino a Santa Teresa 1055, Col. Heroes de Padierna,; tel. 5652-2011; emergency tel. 5449-5500)
  • Hospital Angeles de Interlomas (Av. Vialidad de la Barranca S/N, Col. Valle de las Palmas 52763, Huixquilucan Edo. de Mexico; tel. 5246-5000, 5246-5093, emergency tel. 5246-5092)
  • Hospital Espanol (Av. Ejercito Nacional No. 613, Col. Granada; tel. 5255-9600, 5255-9645; website http://www.hespanol.com/)
  • Medica Sur (Puente de Piedra 150, Col. Toriello Guerra, Tlalpan, D.F.; tel. 5606-6011, 5606-2277, 5606-6222, emergency tel. 5424-7273)

For a list of other hospitals in Mexico City, go to the U.S. Embassy website at http://mexico.usembassy.gov/mexico/eacs_hospitals.html. For an extended list of English-speaking physicians (with their training and credentials), see the Embassy website at http://mexico.usembassy.gov/mexico/eacs_doctors.html. In general, private facilities offer better care, though at greater cost, than public hospitals.

Adequate medical care is available in other major cities, but facilities in rural areas may be limited. The quality of care at beach resorts is highly variable. According to the U.S. State Department, some U.S. citizens in recent years have complained that certain health-care facilities in beach resorts have taken advantage of them by overcharging or providing unnecessary medical care. In many areas, the U.S. consulate provides an online directory to local physicians and hospitals:

  • Ciudad Juarez - http://ciudadjuarez.usconsulate.gov/wwwhacil.html
  • Guadalajara - http://guadalajara.usconsulate.gov/GeDoctors.htm
  • Hermosillo - http://usembassy.state.gov/hermosillo/citizen_services/medical_info.html
  • Nogales - http://nogales.usconsulate.gov/NE_ACS_con1.htm

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Pharmacies

Most pharmacies in Mexico are well-supplied. In the major cities, it isn't difficult to find a pharmacy which is open around-the-clock. In smaller towns, the pharmacies take turns staying open 24 hours. In Mexico City, many travelers go to one of the Sanborn's pharmacies, which are usually open late.

There are a number of medications considered controlled substances in Mexico which are not controlled in the United States. To find out if a medication is considered controlled in Mexico, you can ask a Mexican pharmacist or go to http://www.cofepris.gob.mx/pyp/estpsic/es.htm.

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Buying prescription drugs (reproduced from the U.S. State Dept. Consular Information Sheet)

The U.S. Embassy recommends that U.S. citizens not travel to Mexico for the sole purpose of buying prescription drugs. U.S. citizens have been arrested and their medicines confiscated by Mexican authorities when their prescriptions were written by a licensed American physician and filled by a licensed Mexican pharmacist. There have been cases of U.S. citizens buying prescription drugs in border cities only to be arrested soon after or have money extorted by criminals impersonating police officers. Those arrested are often held for the full 48 hours allowed by Mexican law without charges being filed, then released. During this interval, the detainees are often asked for bribes or are solicited by attorneys who demand large fees to secure their release, which will normally occur without any intercession as there are insufficient grounds to bring criminal charges against the individuals. In addition, U.S. law enforcement officials believe that as many as 25 percent of the medications available in Mexico are counterfeit and substandard. Such counterfeit medications may be difficult to distinguish from the real medications and could pose serious health risks to consumers. The importation of prescription drugs into the United States can be illegal in certain circumstances. U.S. law generally permits persons to enter the United States with only an immediate supply (i.e., enough for about one month) of a prescription medication.

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Importing Medicine to Mexico (reproduced from the U.S. State Dept. Consular Information Sheet)

To import prescription medication into Mexico for personal use, a foreigner must obtain a permit from the Mexican Health Department prior to importing the medicine into Mexico. Additional information in Spanish is available at http://www.cofepris.gob.mx/. For a fee, a customs broker can process the permit before the Mexican authorities on behalf of an individual. If using the services of a customs broker, it is advisable to agree upon the fees before telling the broker to proceed. Current information on local customs brokers (agencias aduanales) is available at the Mexico City yellow pages at http://www.seccionamarilla.com.mx/.

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Traveling with children

Before you leave, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency medical care if needed (see "Physicians and hospitals" above).

All children should be up-to-date on routine childhood immunizations, as recommended by the American Academy of Pediatrics. Children who are 12 months or older should receive a total of 2 doses of MMR (measles-mumps-rubella) vaccine, separated by at least 28 days, before international travel. Children between the ages of 6 and 11 months should be given a single dose of measles vaccine. MMR vaccine may be given if measles vaccine is not available, though immunization against mumps and rubella is not necessary before age one unless visiting a country where an outbreak is in progress. Children less than one year of age may also need to receive other immunizations ahead of schedule (see the accelerated immunization schedule).

The recommendations for malaria prophylaxis are the same for young children as for adults, except that the dosage of chloroquine is lower. DEET-containing insect repellents are not advised for children under age two, so it's especially important to keep children in this age group well-covered to protect them from mosquito bites.

When traveling with young children, be particularly careful about what you allow them to eat and drink (see food and water precautions), because diarrhea can be especially dangerous in this age group and because the vaccines for hepatitis A and typhoid fever, which are transmitted by contaminated food and water, are not approved for children under age two. Baby foods and cows' milk may not be available in developing nations. Only commercially bottled milk with a printed expiration date should be used. Young children should be kept well-hydrated and protected from the sun at all times.

Be sure to pack a medical kit when traveling with children. In addition to the items listed for adults, bring along plenty of disposable diapers, cream for diaper rash, oral replacement salts, and appropriate antibiotics for common childhood infections, such as middle ear infections.

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Travel and pregnancy

International travel should be avoided by pregnant women with underlying medical conditions, such as diabetes or high blood pressure, or a history of complications during previous pregnancies, such as miscarriage or premature labor. For pregnant women in good health, the second trimester (18–24 weeks) is probably the safest time to go abroad and the third trimester the least safe, since it's far better not to have to deliver in a foreign country.

Before departure, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency obstetric care if necessary (see "Physicians and hospitals" above). In general, pregnant women should avoid traveling to countries which do not have modern facilities for the management of premature labor and other complications of pregnancy.

As a rule, pregnant women should avoid visiting areas where malaria occurs. Malaria may cause life-threatening illness in both the mother and the unborn child. None of the currently available prophylactic medications is 100% effective. If travel to malarious areas is unavoidable, chloroquine must be taken once a week and insect protection measures must be strictly followed at all times. The recommendations for DEET-containing insect repellents are the same for pregnant women as for other adults.

Strict attention to food and water precautions is especially important for the pregnant traveler because some infections, such as listeriosis, have grave consequences for the developing fetus. Additionally, many of the medications used to treat travelers' diarrhea may not be given during pregnancy. Quinolone antibiotics, such as ciprofloxacin (Cipro) and levofloxacin (Levaquin), should not be given because of concern they might interfere with fetal joint development. Data are limited concerning trimethoprim-sulfamethoxazole, but the drug should probably be avoided during pregnancy, especially the first trimester. Options for treating travelers' diarrhea in pregnant women include azithromycin and third-generation cephalosporins. For symptomatic relief, the combination of kaolin and pectin (Kaopectate; Donnagel) appears to be safe, but loperamide (Imodium) should be used only when necessary. Adequate fluid intake is essential.

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Maps

Helpful maps are available in the University of Texas Perry-Castaneda Map Collection and the United Nations map library. If you have the name of the town or city you'll be visiting and need to know which state or province it's in, you might find your answer in the Getty Thesaurus of Geographic Names.

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Registration/Embassy location (reproduced from the U.S. State Dept. Consular Information Sheet)

Americans living or traveling in Mexico are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website, https://travelregistration.state.gov, and to obtain updated information on travel and security within Mexico. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, you'll make it easier for the Embassy or Consulate to contact you in case of emergency. The U.S. Embassy is located in Mexico City at Paseo de la Reforma 305, Colonia Cuauhtemoc, telephone from the United States: 011-52-55-5080-2000; telephone within Mexico City: 5080-2000; telephone long distance within Mexico 01-55-5080-2000. You may also contact the Embassy by e-mail at: ccs@usembassy.net.mx. The Embassy's Internet address is http://www.usembassy-mexico.gov/.

In addition to the Embassy, there are several United States Consulates and Consular Agencies located throughout Mexico:

Consulates:

Ciudad Juarez: Avenida Lopez Mateos 924-N, telephone (52)(656) 611-3000. Guadalajara: Progreso 175, telephone (52)(333) 825-2998. Monterrey: Avenida Constitucion 411 Poniente, telephone (52)(818) 345-2120. Tijuana: Tapachula 96, telephone (52)(664) 622-7400. Hermosillo: Avenida Monterrey 141, telephone (52)(662) 217-2375. Matamoros: Avenida Primera 2002, telephone (52)(868) 812-4402. Merida: Paseo Montejo 453, telephone (52)(999) 925-5011. Nogales: Calle San Jose, Nogales, Sonora, telephone (52)(631) 313-4820. Nuevo Laredo: Calle Allende 3330, Col. Jardin, telephone (52)(867) 714-0512.

Consular Agencies:

Acapulco: Hotel Continental Emporio, Costera Miguel Aleman 121 - Local 14, telephone (52)(744) 484-0300 or (52)(744) 469-0556. Cabo San Lucas: Blvd. Marina Local C-4, Plaza Nautica, Col. Centro, telephone (52)(624) 143-3566. Cancun: Plaza Caracol Two, Second Level, No. 320-323, Boulevard Kukulcan, km. 8.5, Zona Hotelera, telephone (52)(998) 883-0272. Ciudad Acuna, Ocampo # 305, Col. Centro, telephone (52)(877) 772-8661 Cozumel: Plaza Villa Mar en El Centro, Plaza Principal, (Parque Juarez between Melgar and 5 th Ave.) 2nd floor, Locales #8 and 9, telephone (52)(987) 872-4574. Ixtapa/Zihuatanejo: Hotel Fontan, Blvd. Ixtapa, telephone (52)(755) 553-2100. Mazatlan: Hotel Playa Mazatlan, Playa Gaviotas #202, Zona Dorada, telephone (52)(669) 916-5889. Oaxaca: Macedonio Alcala No. 407, Interior 20, telephone (52)(951) 514-3054 (52)(951) 516-2853. Piedras Negras: Prol. General Cepeda No. 1900, Fraccionamiento Privada Blanca, telephone (52) (867) 788-0343 Puerto Vallarta: Zaragoza #160, Col. Centro, Edif. Vallarta Plaza, Piso 2 Int.18, telephone (52)(322) 222-0069. Reynosa: Calle Monterrey #390, Esq. Sinaloa, Colonia Rodriguez, telephone: (52)(899) 923 - 9331 San Luis Potosi: Edificio Las Terrazas, Avenida Venustiano Carranza 2076-41, Col. Polanco, telephone: (52)(444) 811-7802/7803. San Miguel de Allende: Dr. Hernandez Macias #72, telephone (52)(415) 152-2357 or (52)(415) 152-0068.

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Volcanic activity (reproduced from the U.S. State Dept. Consular Information Sheet)

Two volcanoes in Mexico have been active in recent years: Popocatepetl, or El Popo, situated 38 miles southeast of Mexico City, and the Volcan de Colima, located on the Jalisco-Colima border. Updated information on these volcanoes may be found at www.cenapred.co.mx and www.ucol.mx/volcan.

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Safety information

For information on safety and security, go to the U.S. Department of State, United Kingdom Foreign and Commonwealth Office, Foreign Affairs Canada, and the Australian Department of Foreign Affairs and Trade.

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