Panama

Medical Summary

General Information

Panama is a developing nation classified as high income. Located in Central America along the Caribbean Sea and the North Pacific Ocean (south of Costa Rica and north of Colombia), the climate classifications range from humid equatorial (long dry season) to humid equatorial (short dry season).

Vaccinations

Routine vaccinations are essential due to a persistent rise of vaccine-preventable diseases (especially markedly high rates of diphtheria, pertussis, and measles) globally. Prior to travel, travelers should be up-to-date with the age-appropriate routine vaccinations recommended by their home country, which may include: COVID-19; H. influenzae type B (Hib); hepatitis A; hepatitis B; herpes zoster; human papillomavirus; influenza; measles, mumps, rubella; meningococcal; pneumococcal; polio; rotavirus; tetanus, diphtheria, pertussis (Tdap preferred; consider an early pertussis booster for high-risk travelers); varicella.

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 certificate proving yellow fever vaccination is required for travelers aged ≥ 1 year coming from countries with risk of YF transmission. This does not apply to airport transit stops (no exit through immigration checkpoint) in risk countries.
• 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 chikungunya, mpox, rabies, or typhoid fever.

Malaria

See also: Library article for Malaria

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

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

(2020) Malaria risk due predominantly to P. vivax (97%) exists throughout the year in the following 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, the Canal Zone, and other provinces, the risk of malaria transmission is negligible or non-existent.

• Recommended prevention in risk areas: B – Risk of P. vivax malaria only. Mosquito bite prevention plus chloroquine chemoprophylaxis^a
• 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
  a}Alternatively, 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 2-22).

• Drug resistance³ : 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, primaquine,⁴ or tafenoquine.⁴ Ngäbe-Buglé: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine,⁴ or tafenoquine.^{4
  3} Refers to P. falciparum malaria unless otherwise noted.
  ⁴ Primaquine and tafenoquine can cause hemolytic anemia in people with G6PD deficiency. Patients must be screened for G6PD deficiency before starting primaquine or tafenoquine. See Tafenoquine Approved for Malaria Prophylaxis and Treatment for more information.

Other Concerns

Travelers' Diarrhea

See also: Library article for Travelers' Diarrhea

High risk exists throughout the country, with minimal risk in deluxe accommodations. Community sanitation and food safety measures are generally inadequate. Some itineraries (e.g., remote destinations, austere accommodations) and activities (e.g., ecotourism, eating street or local-market food) further increase risk.

Travelers should observe food and beverage precautions, which 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.

Other Food-Borne Illnesses

Precautions to prevent brucellosis may be needed.

Insect- and Arthropod-Borne Diseases

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

Other Disease and Health Risks

Additional concerns include air pollution, hantavirus, helminths, leptospirosis, marine hazards, melioidosis, sexually transmitted infections, snakebites, tuberculosis.

Safety and Security

See also: Library article for Safety and Security

Key Safety Risks

• Road conditions and traffic collisions
• Petty crime
• Heightened crime risk for women

Key Security Threats

• Risk of violent protests
• Risk of security forces responding to protests with excessive force
• Cross-border threats in areas bordering Colombia
• Occasional violent crime
• Random acts of armed violence

Emergency Phone Number

The police emergency number is 104.