Rabies is probably the oldest recorded infection of humankind, and one of the deadliest. But despite its wealth and abundance of wildlife, Costa Rica had no clear rabies protocol, no stock of the vaccine, and no urgency to help me find it. If I hadn’t been able to leave the country, I wouldn’t have had access to treatment at all.
- The Dog Bite: A Race Against Time
- Nowhere to Be Found: Costa Rica’s Vaccine Shortage
- Conflicting and Dangerous Medical Advice
- Mexico to the Rescue
- Meanwhile, in the U.S…
- Costa Rica’s Hidden Risk for Tourists and Locals
- The Symptoms You Need to Watch For
- What Needs to Change?
- Lessons for Travelers
The Dog Bite: A Race Against Time
It happened in a small town outside of Cartago. The dog had been a street dog just two months before, had never been vaccinated, and was known to be aggressive. I was walking down the street when he attacked me from behind. When he bit me, I was in shock but I knew I needed to act fast.
Rabies is a serious disease with no cure once symptoms appear. The only way to survive after exposure is to start post-exposure prophylaxis (PEP) immediately, which includes a series of four rabies vaccines over a few weeks.
Nowhere to Be Found: Costa Rica’s Vaccine Shortage
I went to the closest clinic I could find. The doctor cleaned the wound and then prescribed a tetanus shot along with the rabies vaccines. It felt like a relief, at least I had a plan. He told me that any pharmacy should have them.
But when I went to the pharmacy they told me they only had tetanus available. I took the tetanus shot but was told to keep looking for the rabies vaccine.
I went from hospital to hospital, private clinics, public emergency rooms, and even called hospitals across the country. Everyone said the same thing: they didn’t have it.
The public hospitals (CAJA), which are supposed to stock the vaccine, were completely out. No one knew how to find it.
Conflicting and Dangerous Medical Advice
I spoke to multiple doctors, and their information was all over the place.
- One told me I needed the vaccine immediately.
- Another said rabies wasn’t a concern in Costa Rica and I shouldn’t worry about it.
- A third told me the tetanus shot I got was “stupid” and wouldn’t help. Then in the same breath, he told me to “relax” about rabies because it was probably fine. But when I asked, “If the dog shows symptoms, I’m screwed, right?”—he admitted, “Yeah, that’s true.”
At one point, an epidemiologist at the Ministry of Health said I didn’t even need the vaccine because Costa Rica “hasn’t had urban rabies transmission since the 1970s.”
That’s not how rabies works. Here’s the email stating I didn’t need the vaccine:
email stating I didn’t need the vaccine.
Latin American organizations such as Rabies in the Americas (RITA) and the Meeting of Rabies Program Directors of the Americas (REDIPRA) align with international guidelines recommending post-exposure prophylaxis (PEP) for individuals bitten by animals with uncertain rabies vaccination status. This consensus is supported by:
- The World Health Organization (WHO) – WHO states that any bite from an unvaccinated dog in a rabies-endemic country requires immediate post-exposure prophylaxis (PEP), regardless of the dog’s behavior. (Source)
- The Centers for Disease Control and Prevention (CDC) – The CDC also states that rabies PEP should always be given after a bite from a potentially rabid animal unless the animal is confirmed healthy after a 10-day quarantine. (Source)
- The Pan American Health Organization (PAHO) – PAHO reinforces that all potential rabies exposures should be treated as urgent medical cases, and rabies should never be ruled out based on assumptions. (Source)
Costa Rica’s lack of a protocol, a centralized information system or national communication among hospitals made it even harder, it was simply no one’s problem and no one had a clue what to do. They had taken the “Pura Vida” approach a bit too far.
None of this made sense. I was losing time, and no one seemed to care. In those moments, the weight of the situation hit me hard. I was alone in a foreign country, fighting for something as basic as access to a life-saving vaccine. I found myself crying at the situation, while the doctors treated me like I was overreacting.
Even the U.S. embassy couldn’t help. They tried calling hospitals but found no clear protocol for treatment or the vaccine. Their advice? Leave the country.
I’m fluent in Spanish, and even then, navigating this system was overwhelming. I can’t imagine how impossible this would be for someone who didn’t speak the language.
Mexico to the Rescue
By this point, I had already lost nearly three days searching for a rabies vaccine. You’re supposed to get it within 24-48hrs, since after that, chances of survival go down if the dog has rabies. I knew Mexico had a strong track record in rabies prevention, especially in cities like Cancún and Mexico City. Given the urgency of my situation, I booked the shortest available flight which was to Cancún, hoping for a solution.
Even there, I encountered challenges. Mexico was experiencing a national shortage of the vaccine. However, unlike my previous experiences, the hospitals in Cancún didn’t turn me away; they took proactive steps to assist me and treated it like an emergency.
Mexico has a comprehensive rabies protocol. Although it took a few days, the medical staff remained committed to finding it. Their dedication was evident.
What truly impressed me was the care I received at the General Hospital in Cancún. I walked in, was attended to by both the general doctor and an epidemiologist and walked out with my vaccine. Remarkably, I paid absolutely nothing. Mexico provides vaccines and treatment free of charge to everyone, regardless of their status in the country.
It’s important to note that only government-run hospitals in Mexico can administer the rabies vaccine; private clinics are not authorized to offer it. This centralized approach ensures equitable access to critical treatments and allows for effective monitoring of rabies outbreaks.
I was fortunate to speak fluent Spanish, which made navigating the system much easier. However, for those who don’t speak the language, it’s advisable to have someone who can assist with translation and understanding local procedures. Even with my language skills, the process was occasionally overwhelming, so I can appreciate how much more challenging it would be without them.
I couldn’t help but feel a profound sense of gratitude. After numerous setbacks and frustrating moments, it was a relief to encounter a system that, although far from perfect, ensured I received the necessary treatment. In that moment, I truly understood the strength of a healthcare system that doesn’t turn its back on anyone.
Meanwhile, in the U.S…
While the doctors in Cancun were looking for the vaccine, I also looked in the U.S., thinking at least there, I’d be able to get treated even if I paid without insurance. But when I looked into my options, the reality was shocking:
- The Hillsborough County Health Department in Tampa FL, one of the shortest flights from where I was, had the vaccine for $300 per shot, but they refused to treat me because I wasn’t a county resident.
- Hospitals in Florida had it—but at completely unaffordable costs: some quoted rates as high as $5,500 for a consultation, $800 per vaccine dose, plus the rabies immune globulin (HRIG) shot administered at the wound site required by the CDC. Other hospitals refused to give us a ballpark quote on cost until I was admitted into their facility and would incur the cost without knowing. Make it make sense.
Even as a U.S. citizen seeking urgent medical care, my own country’s system shut me out.
Costa Rica’s Hidden Risk for Tourists and Locals
Costa Rica claims to have no urban rabies transmission (dog-to-dog) since the 1970s, and because of that, doctors there told me I didn’t even need the vaccine. But rabies is rare, not nonexistent—and pretending the risk is zero puts lives in danger.
Rabies is still present in Costa Rica, particularly in wildlife and livestock. The country is home to 6% of the world’s biodiversity, including bats, raccoons, monkeys, and other rabies carriers that tourists frequently encounter.
Rabies is rare, but rare isn’t zero:
- A man in Costa Rica died of rabies from a bat bite just a few years ago. (QCR)
- Bovine rabies outbreaks continue to occur, with vampire bats transmitting the disease to cattle. (Liebert Pub)
- Deforestation is increasing rabies risk, as vampire bats seek new food sources in human-occupied areas. (PMC)
- A 9-year-old child and an elderly woman died from rabies after cat scratches in Costa Rica. (CDC)
Even though these cases exist, Costa Rica does not stock rabies vaccines, and many doctors dismiss the risk. What if an animal more likely to be infected with rabies like a bat or monkey bites you in Costa Rica?
Since rabies in humans has an incubation period of weeks to months (sometimes even years), a tourist could be exposed in Costa Rica, leave, and not show symptoms until much later. Many countries don’t routinely test for rabies unless there’s a clear history of an animal bite. If someone dies of respiratory failure, paralysis, or encephalitis, and rabies isn’t considered, how would they ever know?
I’m not saying Costa Rica is intentionally covering up rabies cases, but there’s a lack of testing, tracking, and awareness. The country benefits from maintaining a “rabies-free” reputation, but ignoring the risk doesn’t make it go away.
Tourists and locals deserve better information and access to vaccines—before it’s too late.
The Symptoms You Need to Watch For
Rabies symptoms in humans typically appear 1-3 months after the bite, but they can develop as soon as 10 days or take up to a year or more to show. Early symptoms often resemble a mild flu, including:
- Fever
- Headache
- Malaise (general feeling of unwellness)
- Nausea
As rabies progresses, you might experience more severe neurological symptoms, including:
- Anxiety and agitation
- Hallucinations
- Difficulty swallowing (often due to spasms)
- Hydrophobia (fear of water)
- Paralysis and seizures
- Eventually, coma and death
Rabies in animals, including dogs, can take two weeks to several months to incubate before symptoms appear. During this incubation period, the virus is present in the body but not yet contagious—meaning the animal cannot spread rabies through a bite.
Once symptoms begin, the virus enters the saliva, and the animal becomes contagious. At this point, infected dogs may display:
- Aggression or unusual behavior (acting more tame or more aggressive than normal)
- Foaming at the mouth or excessive drooling
- Difficulty swallowing (causing a fear of water, or “hydrophobia”)
- Loss of coordination, staggering, or paralysis
Because rabies progresses quickly once symptoms start, if a dog was already contagious at the time of the bite, it would develop symptoms and die within 10 days. Most rabid dogs start showing symptoms within 3-5 days of being contagious, so the 10-day observation window is a conservative safety measure.
That’s why it’s critical to monitor the dog for 10 days after a bite. If the dog is healthy and shows no signs of rabies within that time, the disease was not transmitted.
What Needs to Change?
Costa Rica can afford to stock rabies vaccines. It’s a country that thrives on tourism and prides itself on its healthcare. Animals that can transmit rabies are regularly encountered by tourists and locals alike. There is no excuse for it being impossible to find treatment for one of the deadliest diseases in the world.
If you get bitten in Costa Rica, you’re on your own.
At the very least, Costa Rica needs:
- A clear rabies treatment protocol so that hospitals and clinics know what to do.
- Readily available vaccine stock—especially in major cities and tourist hubs.
- Accurate medical advice—telling a patient they “don’t need the vaccine” is wildly irresponsible.
Lessons for Travelers
If you’re bitten in Costa Rica, the healthcare system won’t help you. Have a plan to leave the country immediately if you need rabies treatment.
Th best place to go depends on your situation. You want to get it as soon as possible.
Mexico was a good nearby option for me and might be for you if you live a long flight(s) away. Cancún (~2hrs) and Mexico City (~3hrs) both stock vaccines, even during shortages.
Consider travel insurance. We recommend World Nomads —it could literally save your life. They offer comprehensive plans that cover medical emergencies, evacuation, and treatment. Without insurance, getting the care you need can be financially overwhelming, especially if you have to travel on short notice or cross borders to access treatment.
I was lucky. I had the resources, passport, and ability to travel to get the care I needed. But what happens to the people who can’t?
Costa Rica, it’s time to do better.
I will keep you posted about how I’m doing. Of course, the AI-image generator assumed I was a dude 🙂
