Dengue fever and Venezuelan equine encephalitis may occur in all countries. The foodborne and waterborne diseases , including amebic and bacillary dysenteries and other diarrheal diseases and typhoid fever are very common throughout the area. All countries except Panama reported cases of cholera in 1996. Hepatitis A occurs throughout the area, and hepatitis E has been reported in Mexico. Helminthic infections are common.
Brucellosis occurs in the northern part of the area.
Many Salmonella typhi infections from Mexico and Shigella dysenterteriae type 1 infections from mainland Middle America as a whole have been caused by drug-resistant enterobacteria. Snakes may be a hazard in some areas.