A valid passport is required to enter Costa Rica. At the discretion of Costa Rican authorities, travelers are sometimes admitted with a certified copy of their U.S. birth certificate and valid photo I.D. for tourist stays up to 90 days. Costa Rica is suffering an outbreak of dengue fever, although the incidence remains lower than in other Central American countries. The outbreak is concentrated thus far in Puntarenas, near popular tourist areas. There have also been cases reported in remote areas near the Nicaraguan border.
Dengue is transmitted by mosquito bite and there is no vaccine.
Anyone planning to travel in affected areas should take steps to avoid mosquito bites. These include wearing long sleeves and pants, using insect repellent on exposed skin, and sleeping under mosquito netting. Medical care in the capital city of San Jose is adequate. However, in areas outside of San Jose, medical care is more limited. Doctors and hospitals often expect immediate cash payment for health services.