* A yellow fever vaccination certificate is required from travellers over one year of age arriving from an infected area.

Tap water in Managua has been tested and declared safe to drink. Beyond the capital, it is advised to drink bottled water and avoid ice cubes. Milk in rural areas may be unpasteurised and should be boiled. Powdered or tinned milk is available and is advised. Avoid dairy products which are likely to have been made from unboiled milk. Only eat well-cooked meat and fish. Vegetables should be cooked and fruit peeled.

Vaccinations against tuberculosis and hepatitis B are sometimes recommended. There has been an increase in reported cases of dengue fever; to help avoid mosquito bites, cover up and use repellent. There are occasional cases of cholera.

Each department of Nicaragua has a public hospital. These do not charge for emergency services, but do charge for supplies and medicines. There is an extensive network of health posts and health centres in rural areas, but their resources can be limited. There are several private hospitals/clinics in Managua. Many doctors and hospitals require payment in cash before treatment, although some private hospitals may accept credit cards. International travellers are strongly advised to take out full medical insurance before departure.