We are going to CR next week (Manuel Antonio area). Have those of you who know Costa Rica and Manuel Antonio in particular ever gotten the HEP A and taken the Malaria pills for prevention or is this from your experience unnecessary? I'd like to avoid such medication if possible. I recognize you may not be medical doctors but was wondering based on your own experiences what you think. We are traveling with our 2 kids (10 and 14). Thanks!

Of course it's a personal decision, but we've never done it and felt comfortable with our decision; it's definitely not required. We were careful to wear bug spray every day.

Not positive of the length, but pretty sure Hep A has to be 6 weeks prior to being aby use, and malaria meds I believe start about 2 weeks prior, so if you're leaving next week probably a moot point for both.

Anyway, I've been to CR several times and have not rec'd any jabs or pills. It's just a personal decision and I never persoannly felt it warranted.

I'm a peds nurse and we have recently started recommending Hep A vaccine to everyone. Two doses,six months apart. For now they're saying lifetime immunity, but there may be a booster in the future. People died in Pittsburgh a few years ago from Hep A. Traced, if my memory isn't failing, to green onions (scallions) from Mexico.

I think you get some protection a couple weeks after your first injection.

I took anti-malarial meds when we traveled south to the Osa, didn't bother when we were just in Manual Antonio. While we were in Manual Antonio there were several cases of malaria reported in Jaco.

Even if you take the meds, you still need good mosquito repellant to prevent dengue fever. No vaccine for that.

Short answer is, I'd get the Hep A. The disease is endemic all over Central America, and some parts of the US.

Manuel Antonio us in Puntarenas province and the CDC says that is not a high risk area for Malaria. Based on that I'm leaning towards us not taking the meds but I still have some uneasiness because we're taking our kids and don't want them to get anything horrible like Malaria. Gosh I'm getting myself in a tither here...

Don't take this as dismissive, cause I'm really not trying to be, but I think with the weather, malaria, et al you're worrying way too much right before you leave - vacations are supposed to be fun! Start packing and make sure you have some mosquito repellent with you, that's one of the best & easiest preventive measures you can take. Millions of people travel to CR every year and (though I obviously haven't talked to them all!) I've yet to come across someone during my CR travels that was taking malaria meds. I'm sure people do but it doesn't seem like many do. Honestly on the pacific side of CR I've never been bothered by moquitos much anyway. MA is a very touristed spot, I'm sure if a case of two or more had come up it would've been picked up by amcostarica.com or somewhere in the news.

And, if I can (re)post my mini rant about the CDC's advice: It is not personalized enough by area to be very helpful IMHO. They only determine risk/no risk by province - which is way too broad. Case in point - Alajuela province is considered an 'at risk' area; Alajuela is where the airport is and is of course in Alajuela province - so basically you're 'at risk' just by landing at the airport! But they don't offer up the info that the few cases that are reported are up by the CR/Nica border (where few tourists visit) they just label the whole province as at risk, which is my big beef.

So, I would just start packing and getting ready to go on a fantastic vacation to a beautiful place and number #1 rule - enjoy!

Tully, you are totally right. I am being really compulsive and it's spoiling the fun of getting ready to go. I am so excited, bags are being packed and i am going to stop being crazy with all of this. I will take deet, make sure the kids wear long pants in the rainforest, etc.. Thanks for putting this in perspective!

I was talking to one of our guides in the Osa and I asked him what meds he takes for Malaria, Dengue, etc. and he said he doesn't take anything. He's been there several years, so that put things in perspective for me. Be sure to spray the ankle area between shoes and pants with bug spray - that's where I got a couple of bites. Have fun!

I went to Costa Rica in 1999. I took malaria pills and had the Hep A shot. More likely you wont need to do this. There are a ton of bugs. I am especially prone to getting bitten more so than others. Its more peace of mind. I also recently went to Belize and Guatemala and took the malaria pills again. It is a pain in the but to take pills daily. It is a personal decision but I decided to take it since it didn't take much time and did not cost much. I figure I better be safe than sorry.