Entry Requirements:
Passport/Visa: Photo identification and proof of citizenship are required for entry by all U.S. citizens. A passport is the best document. A visa is required only for stays exceeding 180 days.
HIV Test: Not required.
Vaccinations: A yellow fever vaccination certificate is required from all travelers older than 9 months of age arriving from yellow fever infected areas.
Telephone Country Code: 52

Embassies/Consulates: U.S. Embassy: Paseo de la Reforma 305, Colonia Cuauhtemoc, Mexico City. Tel: 5-209-9100, within Mexico 01-5-209-9100; E-mail: ccs@usembassy.net.mx.
Consulates: Avenida Lopez Mateos 924-N, Ciudad Juarez; Tel: 16-11-3000; Progreso 175, Guadalajara; Tel: 38-25-2998); Avenida Constitucion 411 Poniente 64000, Monterrey; Tel: 83-45-2120; Tapachula 96, Tijuana; Tel: 66-81-7400; Avenida Monterrey 141, Hermosillo; Tel: 62-17-2375; Avenida Primera 2002, Matamoros; Tel: 8--12-4402; Paseo Montejo 453, Merida; Tel: 99-25-5011; Calle San Jose, Nogales, Sonoro, Nogales; Tel: 63-13-4820; Calle Allende 3330, Col, Jardin, Nuevo Laredo; Tel: 87-14-0512; Hotel Acapulco Continental, Costera M. Aleman 121-Local 14, Acapulco; Tel: 74-84-03-00 or 52-74-69-05-56; Blvd, Marina y Pedregal #1, Local No. 3, Zona Centro, Cabo San Lucas; Tel: 114-3-35-66; Plaza Caracol Two, Third Level, No. 320-323, Blvd. Kukulcan, km. 8.5, Zona Hotelera, CancunTel: 98-83-02-72; Plaza Villa Mar in the Main Square - El Centro, 2nd floor, Av. Juarez and 5th Av. Nte, Cozumel; Tel:98-72-4574; Local 9, Plaza Ambiente, Ixtapa/Zihuatanejo; Tel: 755-3-11-08 or 7-11-06); Hotel Playa Mazatlan, Rodolfo T. Loaiza #202, Zona Dorada, Mazatlan; Tel: 69-16-5889; Macedonia Alcala No. 407, Oaxaca; Tel: 951-4-30-54 or 6-28-53; Edif. Vallarta, Plaza Zaragoza 160-Piso 2 Int-18, Puerto Vallarta; Tel: 322-2-0069.
Canadian Embassy: Calle Schiller No. 529, Rincón del Bosque, Colonia Bosque de Chapultepec Mexico City; Tel: 5724-7900. when calling from within Mexico, the toll-free telephone number is 01-800-706-290; Fax: 5724-7943; E-mail: mxico@dfait-maeci.gc.ca or embassy@canada.org.mx.

Hospitals / Doctors:
In Mexico City: John F. Smyth, M.D., Campos Eliseos No. 81 Colonia Polanco; Tel. (5) 545-7861 (office) or (5) 250-0019 (home).
The British-American Hospital (160 beds); private hospital; most of the staff are U.S. or British board-certified; specialties include cardiology, ob/gyn, emergency medicine, neurology; Tel. (5) 277-5000.
In Monterrey: Hospital Jose A. Muguerza (1154 beds); private hospital; most specialties, including cardiology, ob/gyn, kidney dialysis; Tel. 460-100. Dr. Jose Gonzalez University Hospital (704 beds); Tel. 487-926.
In Guadalajara: Civil Hospital (1,000 beds); some specialties; English-speaking, U.S.-trained physicians on staff.
AT&T Dial: 95-800-462-4240 -- -- MCI Dial: 95-800-674-7000

Current Advisories & Health Risks:
AIDS/HIV: Incidence appears to be increasing rapidly. In 1989, approximately 76% of adult cases were due to bisexual or homosexual contact, 11% to heterosexual contact, and almost 12% to intravenous drug use or blood products.

Accidents & Medical Insurance:
Accidents and injuries are the leading cause of death among travelers under the age of 55 and are most often caused by motor vehicle and motorcycle crashes; drownings, aircraft crashes, homicides, and burns are lesser causes.
Heart attacks cause most fatalities in older travelers.
Infections cause only 1% of fatalities in overseas travelers, but, overall, infections are the most common cause of travel-related illness.
MEDICAL INSURANCE: Travelers are advised to obtain, prior to departure, supplemental travel health insurance with specific overseas coverage. The policy should provide for direct payment to the overseas hospital and/or physician at the time of service and include a medical evacuation benefit. The policy should also provide 24-hour hotline access to a multilingual assistance center that can help arrange and monitor delivery of medical care and determine if medevac or air ambulance services are required.

Altitude Sickness (AMS): Travelers should be aware that there are destinations (e.g., Toluca, altitude 8,800 feet), where acute mountain sickness (AMS) can occur. Azetazolamide (Diamox) prophylaxis should be considered. The best treatment for AMS is descent.

Amebiasis: There is a high incidence of amebiasis in Mexico, especially in the southern areas where up to 8.4% of the population is seropositive for E. histolytica antibodies. To avoid amebiasis, travelers should drink only safe water and eat only well-cooked food. All fruit should be peeled before eating. Other parasitic diseases include ascariasis, trichiuriasis, and hookworm. None of these infections are common in travelers.

Chagas’ Disease: Risk occurs below 1,500 meters elevation in the rural areas of the southern and western states. Most risk is found in those rural-agricultural areas where there are adobe-style huts and houses that potentially harbor the night-biting triatomid (assassin) bugs. Travelers sleeping in such structures should take precautions against nighttime bites. Unscreened blood transfusions are also a source of infection and should be avoided. (Up to 17% of blood donations tested have been seropositive.)

Cholera: This disease is reported active in this country, but the threat to tourists is very low. Cholera vaccine is recommended primarily for people at high risk (e.g., relief workers) who work and live in highly endemic areas under less than adequate sanitary conditions.
The manufacture and availability of the injectable cholera vaccine in the United States ceased in June 2000.
Many countries, including Canada, license an oral cholera vaccine. The oral vaccine is not available in the United States.
Cholera vaccine is not "officially" required for entry into, or exit from, any country. Despite this, some countries, on occasion, require proof of cholera vaccination from travelers coming from cholera-infected countries. Anticipating such a situation, certain travelers may wish to carry a medical exemption letter from their health-care provider. Travel Medicine, Inc., recommends that travelers use the International Certificate of Vaccination (Yellow Card) for this purpose, having their health-care provider state "exempt from cholera vaccine" and validate the exemption with both their signature and their official stamp (the "Uniform Stamp" in the United States).

Dengue Fever: Dengue occurs in most areas below 1,200 meters elevation, but recently dengue has been reported in the city of Taxco, 1,700 meters elevation. The risk of dengue is currently greatest in the southern and central Pacific urban coastal areas and in extreme northeastern Mexico. Increased risk may occur during the rainy season, from July through October. This disease is transmitted by the Aedes aegypti mosquito, but the Asian “tiger mosquito” (Aedes albopictus ) may also transmit the virus. All travelers to risk areas below 1,200 meters elevation are advised to take precautions against daytime mosquito bites.
Mexico is currently experiencing increased reports of dengue following hurricane Kenna from the Pacific and hurricane Isidoro from the Gulf of Mexico. The increased rains have provided excellent breeding conditions for mosquitoes. The government of Mexico is actively responding to the current outbreak with mosquito control activities including spraying of mosquito breeding sites and increased public health education. Mosquito control measures are being implemented along the Pacific coast in the states of Sinaloa, Nayarit, and Jalisco. In the state of Sinaloa, measures are being implemented in the city of Mazatlán, and in the municipalities of Escuinapa and El Rosario. Along the Gulf of Mexico, measures are being implemented in the states of Campeche and Yucatán. To date this year, Mexico has reported 8,363 laboratory confirmed cases of dengue.

Environmental Pollution: Acute respiratory infections are a common cause of illness inv Mexico, probably aggravated by this country’s legendary air pollution, about the worst in the world. Extreme conditions can occur in Mexico City and Guadalajara, especially from December to May. Travelers with heart disease, emphysema, and asthma may need to limit or avoid travel to regions with poor air quality. Drinking water in Mexico City and other areas contains high concentrations of lead. Lead is also found in polluted air, leaded paints, in some canned foods and beverages, and leached into beverages stored in lead-glazed pottery.

Gnathostomiasis: The number of cases gnathostomiasis is increasing as Mexicans are eating more freshwater, as opposed to saltwater, fish. This food-borne disease is acquired through ingesting a parasite found in raw or undercooked freshwater fish (usually eaten in the form of tilapia, or ceviche, a famous Mexican raw fish dish). High-risk areas are primarily in northwestern Mexico, particularly in the States of Sinaloa, Oaxaca, Veracruz, Tamaulipas, Naryarit, and Guerrero, which includes the city of Acapulco. All travelers to these regions should avoid eating raw freshwater fish.

Helminthic Infections: Hookworm, roundworm, and whipworm infections, and also strongyloidiasis, are highly prevalent in most rural areas. (Hookworm disease infects up to 90% of some rural villagers.) Travelers should wear shoes to prevent the hookworm and strongyloides larvae from penetrating the skin. All food should be thoroughly cooked to destroy roundworm, whipworm, and pork tapeworm eggs. Pork tapeworm disease is common and can be prevented by eating only thoroughly cooked pork.

Hepatitis: Hepatitis A is highly endemic. All nonimmune travelers should receive hepatitis A vaccine, especially if planning travel outside the usual resort areas.
Hepatitis E infections have been reported among visitors to northern Baja, Guerrero, and Morelos States, as well as in the Mexico City and Tijuana. To help prevent hepatitis E, travelers should avoid potentially contaminated water, especially well water. The consumption of bottled, boiled, or chemically treated water is strongly recommended, especially for pregnant women.
The hepatitis B carrier rate in the adult population range from 0.3% to 1.6%. Carrier rates up to 4% have been reported from Chiapas State. Vaccination against hepatitis B should be considered for stays over 3 months and by short-term travelers desiring maximum protection. Travelers should be aware that hepatitis B can be transmitted by unsafe sex and the use of contaminated needles and syringes.

Influenza: Risk extends from November to March in areas north of the Tropic of Cancer and throughout the year in areas south of that. The flu vaccine is recommended for all travelers over age 50; all travelers with chronic disease or a weakened immune system; travelers of any age wishing to decrease the risk of this illness; pregnant women after the first trimester.

Insects: All travelers should take measures to prevent both daytime and nighttime insect bites. Insect-bite prevention measures include a DEET-containing repellent applied to exposed skin, insecticide (permethrin) spray applied to clothing and gear, and use of a permthrin-treated bednet at night while sleeping.

Leishmaniasis: Cutaneous leishmaniasis is endemic in rural areas in the southern territory of Quintana Roo, eastern Yucatan, Campeche, eastern Tabasco, Chiapas, Oaxaca, and eastern Veracruz. Mucocutaneous leishmaniasis (espundia) has occurred in Jalisco State, and visceral leishmaniasis (kala azar) has occurred in Guerrero and Morelos States. Diffuse cutaneous leishmaniasis occurs in both the northeast and southeast regions. Mucocutaneous leishmaniasis has occurred in Jalisco State. This disease is transmitted by sandflies, which are most active between sunset and dawn. All travelers should take measures to prevent insect bites, specially in forested areas. Slow- or non-healing skin infections should alert travelers to this possible diagnosis.

Malaria: Malaria is endemic in rural areas under 1,000 meters elevation, and is more widespread than most travelers realize. The disease, however, has been eliminated from large urban areas and the major international resorts. The incidence of malaria is highest in the south, including the states of Chiapas, Oaxaca, Guerrero, Quintana Roo, and Campeche, and in Sinaloa State on the Pacific Coast. Lesser-risk areas include Michoacan and Tabasco states. Most cases reported from tourist centers occur in the vicinity of Huatulco Bay (Pochutla region of Oaxaca). P. vivax accounts for more than 99% of infections, the remainder attributed to P. falciparum. No cases of chloroquine-resistant malaria have been reported. Falciparum infections appear to be limited to rain forest areas near the borders with Belize and Guatemala.
Malaria precautions are recommended for overnight stays in many rural areas at low altitude, especially in southern Mexico. Persons staying overnight at the following archaeological sites should take consider chloroquine prophylaxis: Palenque, Bonampak, Uxmal, Kabah, Labna, Sayil, Edzna, Coba, and Tulum.
Chloroquine is not recommended when visiting the major resort areas of Acapulco, Ixtapa, Mazatlan, Cancun, Cozumel, and Merida on the Pacific and Gulf coasts. travelers to these areas should take measures to prevent insect bites. These protective measures will also help prevent dengue fever and leishmaniasis.

Marine Hazards: • Swimming related hazards include jellyfish, spiny sea urchins, and coral.
Ciguatera poisoning is prevalent and can result from eating coral reef fish such as grouper, snapper, sea bass, jack, and barracuda. The ciguatoxin is not destroyed by cooking.
Scuba Diving-Hyperbaric Chamber Referral: Divers' Alert Network (DAN) maintains an up-to-date list of all functioning hyperbaric chambers in North America and the Caribbean. DAN does not publish this list, since at any one time a given chamber may be non-functioning, or its operator(s) may be away or otherwise unavailable. Through Duke University, DAN operates a 24-hour emergency phone line for anyone (members and non-members) to call and ask for diving accident assistance. Dive medicine physicians at Duke University Medical Center carry beepers, so someone is always on call to answer questions and, if necessary, make referral to the closest functioning hyperbaric chamber. In a diving emergency, or for the location of the nearest decompression chamber, call 919-684-8111.

Onchocerciasis: This blackfly-transmitted disease is limited to areas along rivers between 600 and 1,500 meters elevation in Chiapas and Oaxaca States. Highest risk is from October through April. Travelers should take measures to prevent insect (blackfly) bites.

Other Diseases/Hazards: Anthrax (small outbreaks reported in Zacatecas, central Mexico), brucellosis (90% of cases associated with contact with goats; greatest risk occurs in the northern and central states), coccidiomycosis (fungal respiratory infection [“valley fever”] endemic in the dry north of Baja California Norte, Sonora and Chihuahua States, and along the Pacific Coast; outbreaks have occurred in church groups from U.S. doing construction work; cough and fever are main symptoms), cysticercosis and neurocysticercosis (caused by the ingestion of pork tapeworm eggs; common, especially in Guanajuato and Michocan States), histoplasmosis (contact with bat guano transmits this fungal disease), leptospirosis, Lyme disease (presumably occurs), relapsing fever (tick-borne; endemic in northern and central Mexico), typhus (both louse- and flea-borne; reported in Chiapas State), and tick-borne rickettsioses (spotted fever group; reported in some rural areas; one case of human monocytic ehrlichiosis was reported in Yucatan).

Rabies: Several dozen or more human cases are reported annually. Ninety percent of cases are acquired from contact with rabid dogs, usually in rural areas. Rabid vampire bats reportedly are a problem in Sinaloa State. Travelers should especially avoid stray dogs and seek immediate treatment of any animal bite. Rabies vaccination is especially indicated following the unprovoked bite of a dog, cat, bat, or monkey.

Seabather's Eruption: Reported in and near Cancun. This condition is caused by sea anemone larvae trapped under the bathing suit. Released toxin causes skin irritation, rash, and fever.

Travelers' Diarrhea: High risk country-wide (outside major resorts and first-class hotels). More illness occurs during the rainy season, May through October. Bacterial organisms, in the following order—enterotoxigenic E. coli, campylobacter, salmonella, and shigella—account for more than 80% of cases of travelers’ diarrhea. About 10% of cases are caused by viruses (mostly Norwalk virus), and 3%–4% are due to parasites, mainly amebae, giardia, cyclospora, and cryptosporidia. A quinolone antibiotic, plus loperamide (Imodium), is recommended for the treatment of acute diarrhea.

Tuberculosis: This disease is highly endemic, particularly among the native Indian populations in southern Mexico and Baja California; drug-resistant strains are common.
Typhoid Fever: This disease is widespread and more cases of typhoid fever are reported in travelers returning from Mexico than from any other Latin American country. There is increased risk of typhoid from June through October, countrywide. Vaccination against typhoid fever is recommended for: travelers venturing outside of tourist areas; long-term travelers; adventure travelers; those wishing maximum disease protection. Because the typhoid vaccines are only 60% to 70% effective, safe food and drink selection remain important.