However, cholera is a risk in this country and precautions are essential. See the Health appendix. In the other 26 municipalities, in the departments of Madriz, Carazo and Masaya, transmission risk is low or negligible.
Malaria risk is higher during the rainy season.
Water used for drinking, brushing teeth or making ice should have first been boiled or otherwise sterilised. Milk in rural areas may be unpasteurised and should be boiled. Powdered or tinned milk is available and is advised, but make sure that it is reconstituted with pure water. Avoid dairy products which are likely to have been made from unboiled milk. Only eat well-cooked meat and fish, preferably served hot.