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General Map

General map of Panama

Medical Summary

The health risk information presented here is summarized from Shoreland Travax®, a decision-support tool used by health care providers to perform a detailed health risk analysis based on specific locations, individual travel styles, and traveler risk behaviors. Travax provides practitioners current, independently researched malaria risk and prevention recommendations in a map-based format that goes beyond the annual WHO and CDC statements included here. Not included here are current reports from Travax of disease outbreaks or environmental events that may pose elevated risks to travelers’ health and safety. The Providers section of this site offers a directory of health care providers who utilize Shoreland Travax for travel health counseling. Learn more about the detailed reports and maps available from these practitioners (includes links to samples).

General Information

Panama is a developing nation but is in the upper half of the world's economies. Located on the isthmus connecting Central and South America, its climate is tropical marine.

Immunizations

Yellow Fever

See also: Library article for Yellow Fever

An official yellow fever vaccination certificate may be required depending on your itinerary. Vaccination is usually recommended if you’ll be traveling in areas where there is risk of yellow fever transmission.

  • Requirement: A vaccination certificate is required for travelers aged ≥ 1 year coming from countries with risk of YF transmission.
  • Official Status: listed by WHO as a country where YF transmission risk is present.

Other Vaccines

Depending on your itinerary, your personal risk factors, and the length of your visit, your health care provider may offer you vaccination against hepatitis A, hepatitis B, influenza, measles, mumps, rubella, rabies, or typhoid fever. Routine immunizations, such as those that prevent tetanus/diphtheria or "childhood" diseases, should be reviewed and updated as needed.

Malaria

See also: Library article for Malaria

The following is current information as reported by the World Health Organization (WHO) and the U.S. Centers for Disease Control (CDC):

WHO—International Travel and Health (current online update, Country List)

(2017) Malaria risk due predominantly to P. vivax (> 99%) exists throughout the year in provinces and comarcas along the Atlantic coast and the borders with Costa Rica and Colombia: Bocas del Toro, Chiriquí, Colón, Darién, Kuna Yala, Ngäbe Buglé, Panama and Veraguas. In Panama City, in the Canal Zone and in the other provinces there is no or negligible transmission risk.
  • Recommended prevention in risk areas: B – Risk of P. vivax malaria only. Mosquito bite prevention plus chloroquine chemoprophylaxisa
  • Recommended prevention in eastern endemic areas bordering Colombia: C – Risk of P. falciparum malaria, in combination with reported chloroquine and sulfadoxine–pyrimethamine resistance. Mosquito bite prevention plus atovaquone–proguanil or doxycycline or mefloquine chemoprophylaxis (select according to reported side effects and contraindications) a
    aAlternatively, for travel to rural areas with low risk of malaria infection, mosquito bite prevention can be combined with stand–by emergency treatment (SBET).

WHO Country List footnote: When available, the date of the most recent update or confirmation is indicated in parentheses in the country list. If no date is indicated, the most recent update or confirmation was provided before 2013.

CDC—Health Information for International Travel (current online edition)

Areas with malaria: Present in the provinces of Darien, Kuna Yala (also spelled Guna Yala), Ngäbe-Buglé, and eastern Panama province. None in Panama Oeste, the Canal Zone, and Panama City (see Map 3-35).
  • Estimated relative risk of malaria for US travelers: Low.
  • Drug resistance4: Chloroquine (east of the Panama Canal)
  • Malaria species: P. vivax 99%, P. falciparum 1%
  • Recommended chemoprophylaxis: Provinces of Darien, Guna Yala, and eastern Panama province: Atovaquone-proguanil, doxycycline, mefloquine, or primaquine. Ngäbe-Buglé: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or primaquine.5
    4 Refers to P. falciparum malaria unless otherwise noted.
    5 Primaquine can cause hemolytic anemia in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Patients must be screened for G6PD deficiency before starting primaquine.

Other Concerns

Travelers' Diarrhea

See also: Library article for Travelers' Diarrhea

High risk exists throughout the country, with minimal risk in deluxe accommodations. Food and beverage precautions may reduce the likelihood of illness.

Travelers should carry loperamide for self-treatment of diarrhea and, if risk is moderate to high, an antibiotic to add if diarrhea is severe. Consult a knowledgeable health care provider regarding which antibiotic is appropriate for you and most effective for your destination.

Insect- and Arthropod-Borne Diseases

Chagas' disease (American trypanosomiasis), chikungunya, dengue, leishmaniasis, Rocky Mountain spotted fever, Zika may pose a risk. Personal protective measures are important.

Other Disease and Health Risks

Additional concerns include air pollution, hantavirus, helminths, marine hazards, snakebites, tuberculosis.

Consular Advice

The material below includes information from the U.S. Department of State (DOS), U.K. Foreign & Commonwealth Office (FCO), Global Affairs Canada (GAC), and Australia's Department of Foreign Affairs and Trade (DFAT), as well as from additional open-source material. Standard safety precautions that apply to all international travel can be found in the Library article Safety and Security.

Consular Travel Advice

Due to ongoing security concerns, U.S. (DOS) advises avoiding travel to Darién Province and remote areas of the Caribbean coast between the towns of Boca del Rio Chiriquí and Coclé del Norte. Canada (GAC) and Australia (DFAT) have more limited warnings. U.K. (FCO) has no current warning.

Terrorism Risk

Risk of attack by domestic terrorist groups exists in remote areas of Darién Province (including areas bordering Colombia). Targets may include public places and events, including those frequented by tourists.

Crime

Risk of violent crime (armed robbery and murder) and petty crime exists throughout the country, especially in Panama City (particularly in San Miguelito, El Chorillo, Juan Díaz, and Veracruz Beach neighborhoods; areas in and surrounding Via España, Avenida Central, Calidonia, Casco Viejo, and Panamá Viejo), and the provinces of Colón and Chiriquí.

Kidnappings by criminal groups may occur in Darién Province.

Express kidnappings to force cash withdrawals at ATMs may occur throughout the country.

Civil Unrest

Protests and demonstrations occur in Panama City, especially in areas surrounding the University of Panama, and have the potential to turn violent without warning. Bystanders are at risk of harm from violence or from the response by authorities.

Unsafe Areas

A dangerous security environment exists, and armed groups are present in Darién Province.

Water Safety

Hazardous water conditions (including currents, tides, and undertows) may occur, especially in Bocas del Toro Province. Heed posted warnings, and avoid beaches that are not patrolled. Do not swim alone or after dark, and do not walk on any beach after dark.

Rent water sports equipment from reputable operators. Scuba dive only with personnel certified by PADI or NAUI, and use equipment only from PADI- or NAUI-certified dive operators.

Transportation Safety

Risk of traffic-related injury or death exists. The road-traffic death rate is 7 to 12 per 100,000 population. The rate is less than 10 in most high-income countries. Speed laws are poorly enforced.

Traffic flows on the right-hand side of the road. Travelers (including drivers and pedestrians) accustomed to traffic moving on the opposite side should be vigilant when navigating traffic.

Many taxis are unsafe. Use taxis from official ranks or dispatched via smart phone app or radio from a reputable company and ascertain the license or identification number of the dispatched vehicle.

Airline Safety

U.S. Federal Aviation Administration has determined that the civil aviation authority of this country oversees its air carriers in accordance with minimum international safety standards.

Natural Disasters

The hurricane season is from June through November. The rainy season is from April through December. Floods, mudslides, and landslides may occur.

Seismic and volcanic activity occur, especially in western areas.

Consular Information

Selected Embassies or Consulates in Panama

  • United States: [+507] 317-5000; pa.usembassy.gov
  • Canada: [+507] 294-2500; www.panama.gc.ca
  • United Kingdom: [+507] 297-6550; www.gov.uk/world/organisations/british-embassy-panama-city
  • Australia: Australia does not have an embassy or consulate in Panama.

Panama's Embassies or Consulates in Selected Countries

  • In the U.S.: www.embassyofpanama.org
  • In Canada: www.embassyofpanama.ca
  • In the U.K.: www.panamaconsul.co.uk
  • In Australia: [+61] 2-9150-8409

Visa/HIV Testing

HIV testing may be required to obtain a work or residence visa.