Health and vaccine advice

If you're considering a long-term relocation to Mexico, addressing your health care needs should be an integral part of your advance planning.

Make sure you visit or speak to your local health care provider at least four to six weeks prior to departure for general advice on travel health. They will also advise you on any precautions you can take to help protect yourself and your family against common health risk factors, and when to begin courses of any required vaccinations.

Common health concerns

Malaria

While malaria is considered a low risk across the majority of Mexico, the states of Oaxaca and Chiapas in southern Mexico are deemed sufficiently high-risk areas to warrant the use of prescribed anti-malarial drugs (please see here for an updated map of risk areas). As both of these states are home to cultural sites and popular tourist attractions, it’s important to consider the implications of any in-country travel plans prior to departure.

Protecting yourself

According to the U.K. government’s advice site, travelhealthpro, travellers anywhere within Mexico are advised to follow the ABCD guide to minimising malarial infection risk:

• Awareness of the risk – risk factors are dependent on specific location, season of travel, length of stay, activities undertaken and type of accommodation used.
• Bite prevention – travellers should always practise bite avoidance techniques (wearing long sleeves and trousers, and applying DEET-based repellent in order to minimise the risk of insect and tick bites).
• Chemoprophylaxis – travellers should take prescribed anti-malarial drugs if travelling into an area known to be high risk (see below for specific information). While no anti-malarial drugs provide guaranteed protection against infection, using them in combination with bite prevention techniques provides the best possible protection currently available.
• Diagnosis – any traveller who develops a fever of 38°C (100°F) or higher more than a week after visiting a known malarial high-risk area, or who develops malarial symptoms up to a year after possible exposure, should seek immediate medical attention, alerting medics to the possibility of a malarial infection.

Other potential health risks:

Altitude sickness

With Mexico offering cultural sites and tourist destinations along the Trans-Mexican Volcanic Belt at heights of more than 2,000 metres above sea level, including Mexico City at an elevation of 2,250 metres, travellers should be aware of the potential risks associated with altitude sickness. It’s a condition sometimes experienced by people ascending to heights of 1,500 metres and above and is caused by the body’s slow acclimatisation to reduced oxygen levels at such heights.

While the risk of developing altitude sickness at heights of up to 2,500 metres is low, the possibility increases significantly at heights of 2,500 metres and above. Rapid ascent (i.e. without gradual acclimatisation) presents the greatest threat to health, particularly when you consider that many cities at this altitude have international airports.

The different levels of altitude (and their associated risk) are defined in the following way:

• High altitude describes elevations of 1,500–3,500 metres (Mexico City falls in this bracket as does the highest large city, the culturally rich Toluca de Lerdo at 2,663 metres).
• Very high altitude describes those between 3,500 and 5,500 metres.
• Extreme altitude is considered to be any elevation of more than 5,500 metres above sea level (the highest peak in Mexico, Citlaltépetl or Pico de Orizaba, stands at 5,636 metres).

There are three syndromes associated with high altitude:

• Acute mountain sickness (AMS) is the most common of the syndromes and causes symptoms of nausea/vomiting, headache, dizziness, disturbed sleep/fatigue and a sense of physical weakness.
• High-altitude cerebral oedema (HACE) is a swelling of the brain caused by fluid accumulation; symptoms include confusion, fever, loss of physical coordination, rapid heart rate, light sensitivity and an altered mental state.
• High-altitude pulmonary oedema (HAPE) is caused when fluid is forced into the lungs; symptoms include difficulty breathing, rapid heart rate, cough (first dry, then wet), physical weakness and wheezing/crackling chest.

HACE and HAPE are both associated with elevations of 2,500 metres and above; they occur infrequently but represent serious threats to life, requiring immediate descent and medical treatment. 

Altitude sickness — protecting yourself

The most effective guards against altitude sickness in any form are:

• Gradual ascent to heights of 2,500 metres or more.
• Awareness of symptoms.
• Close monitoring of any symptomatic travellers and arrangement for rapid descent if symptoms do not improve/get worse.
• Regular rest/acclimatisation days.
• Avoiding increase of elevation of more than 500 metres at altitudes of 3,000 metres and above.

Some medications are available that may help to moderate the onset of altitude sickness, although these should only be considered in pre-planned moderate to high-risk situations and should always be used in conjunction with gradual ascent practices. Speak to your health care provider in advance of your trip if you plan to undertake moderate or high-risk altitude elevation activities, and follow their advice.

Even if you’re relatively fit and healthy and not suffering severe effects, the smog, heat and height of some cities may take their toll. Following these tips should help you acclimatise and feel a little more comfortable:

• Stay out of the sun or protect yourself from too much exposure.
• Drink plenty of bottled water.
• Take it easy while your body adjusts.
• Ease up on alcohol intake.

Dengue fever

Dengue fever is a viral infection that, like malaria, is contracted through the bites of infected mosquitoes. The mosquitoes responsible for dengue fever are known to feed during daylight hours, i.e. between dawn and dusk, and are most commonly found in urban areas; symptoms of infection are flu-like, sometimes becoming life-threatening.

Dengue fever — protecting yourself

There is currently no vaccination or medication available to prevent infection, so travellers are strongly advised to practise bite prevention (as outlined above — see malaria) in order to minimise risk.

Zika virus (ZIKV)

Mexico is currently considered to be an active ZIKV transmission zone, with increasingly widespread infection being reported. There is no preventative vaccine or medication for ZIKV and, while many infected people will suffer few or even no symptoms, there is an acknowledged and significant risk to pregnant women (or women trying to conceive/at risk of getting pregnant) associated with ZIKV, which can cause foetal developmental problems and microcephaly.

The virus is most commonly contracted through the bite of an infected mosquito. The species of mosquito that carries the virus feeds nocturnally, meaning that there is increased risk of infection between dusk and dawn. As with the majority of mosquito-borne infections, the risk is substantially reduced at altitudes of over 2,000 metres, so travel that occurs within a risk zone (but at elevations continuously above 2,000 metres) is considered low risk. Nevertheless, pregnant women should avoid all ZIKV-risk areas. If a woman contracts the virus, it’s recommended that she waits at least eight weeks after full recovery before trying to get pregnant.

When symptoms do appear, the most common are rash, itchiness, mild fever, headache, red eyes and muscle/joint pains. Other less common symptoms include loss of appetite, diarrhoea, constipation, abdominal pain and dizziness.

While the major risk associated with the virus is to women, it can remain active in the semen of some infected men for up to two months after initial infection, which could pose an ongoing risk to their female partners, as ZIKV is also sexually transmitted. It’s recommended that pregnant women avoid all non-essential travel to areas with an active ZIKV transmission status and seek medical assistance as a matter of urgency if they develop any symptoms after having visited or passed through a risk area.

ZIKV virus – protecting yourself

In the absence of a vaccine or medication to prevent ZIKV, travellers to risk zones are advised to follow current advice on tick and mosquito bite prevention. This includes:

• Awareness – when and where the risks are.
• Prevention – wearing long sleeves and using mosquito nets.
• Chemoprophylaxis – appropriate anti-malarial drugs.
• Diagnosis – seeking advice if you develop symptoms up to a year after returning home.

See here for more information and the ABCD bite prevention strategies outlined above for malaria.

Other risks

Advice for those wishing to relocate overseas can vary depending on your country of origin. The best course of action is to discuss the current situation with your physician to get the most up-to-date information. The following advice is from the U.S. Department of Health and Human Services.

• Hepatitis A – vaccination against this disease is advised. It can be transmitted in contaminated food or water, regardless of the standard of accommodation you have chosen.
• Typhoid – also spread through contaminated food and water, but it’s more likely in rural areas and smaller settlements or if you’re likely to be staying with friends or relatives.
• Hepatitis B – spread by blood and body fluids (for example contaminated needles and sexual contact), so you should exercise the usual precautions. It can also be a problem if you’re likely to undergo medical procedures or to unavoidably be at risk. In these circumstances, vaccination is advisable.
• Rabies – not a risk to most travellers but is present in dogs, bats and other animals in the country. 

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