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Nicaragua Malaria General Malaria Information: Predominantly P

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Nicaragua Malaria General Malaria Information: Predominantly P Nicaragua Malaria General malaria information: predominantly P. vivax (P. falciparum transmission is mostly limited to northern and western Issues to Consider Atlántico Norte). Transmission occurs throughout the year and is highest from May through October. Factors favoring chemoprophylaxis Location-specific recommendations: • Adventure travel Risk-averse and vulnerable travelers Chemoprophylaxis is recommended for all travelers: certain municipalities in the departments of Atlántico Norte (including • Areas subject to infrequent epidemics the Mosquito Islands), Atlántico Sur, Jinotega, Matagalpa, Chinandega, and León (see map); all cities and towns within these • Immigrants visiting friends and relatives areas except the central urban area of Chinandega. • • Flexible itineraries Chemoprophylaxis is recommended for certain travelers (see Issues to Consider inset): certain municipalities in the • Travel longer than 1 month departments of Atlántico Norte, Atlántico Sur, Nueva Segovia [1], Jinotega, Esteli [3], Matagalpa, Boaco, León, Managua [4], • Unreliable medical expertise and/or and Masaya [5] (see map); all cities and towns within these areas except the central urban areas of Matagalpa and León. treatment drugs at destination Insect precautions only are recommended (negligible transmission is reported): rural areas of certain municipalities (see map) Factors against chemoprophylaxis in the departments of Nueva Segovia [1], Madriz [2], Matagalpa, Chinandega, León, Boaco, Managua, Carazo [6], and Rio • Air-conditioned hotels only San Juan (including the Solentiname Islands); all cities and towns within these areas; the central urban areas of Matagalpa, • Urban areas only Chinandega, and León. • Non-transmission season No preventive measures are necessary (no evidence of transmission exists): the city of Managua; the Corn Islands; all other • Minimal nighttime exposure areas not mentioned above. • Travel shorter than 3 days Preventive measures: Evening and nighttime insect precautions are essential in areas with any level of transmission. See the Technical Explanation of Malaria Chloroquine and other antimalarials (atovaquone-proguanil, doxycycline, and mefloquine) are protective in this country. Mapping document for more information. 87°W 86°W 85°W 84°W 83°W 15°N # Mountain Place of interest Lake Bismuna Administrative boundary Mosquito National park or reserve HONDURAS Islands Wawa oco EL C A" 14°N SALVADOR Puerto Cabezas ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! P ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! r ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! in ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !1! ! ! ! ! ! ! z Atlántico Ocot!a! l! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! a ! ! !A"! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! p ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! o ! ! ! ! ! ! ! ! ! ! ! l Norte ! ! ! ! ! ! ! ! ! ! ! k ! ! ! ! ! ! ! ! ! ! ! a ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! A" ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 2! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Somo! t! o! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Jinotega ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 3 ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Estelí Jinotega ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! m! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! " A" u ! ! a! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! A ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! T ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Caribbean ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 13°N ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Sea ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Matagalpa ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! MatagalpaG" ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! e de ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! d M ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! n a ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ra t Chinandega! ! ! ! ! ! ! ! ! ! ! ! ! ! ! G ag ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! io alp Chinandega R a Lake G" León Atlántico Perlas ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Sur ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Boaco ! ! ! ! ! ! ! ! !C! !e! r! r!o! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! #! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! B! ! o! ! a! !c! !o! ! ! A" Leó! n! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !A"! ! ! ! ! ! ! ! ! N! ! e! !g! r! o! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! G" ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Corinto ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 4 ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !Lake ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !M! ! a! nagua ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Juan Venado ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Island Reserve ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! "! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Rama A! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ndid ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! " o o Corn ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! A sc Puerto! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Juigalpa E ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 7 A" ico Islands ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ^_ M ! ! ! ! ! ! M! ! ! !a! !n! ! a! gua Sandino! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! " 12°N 5 BluefieldsA A" ! ! ! ! ! ! ! ! ! ! ! ! ! ! Granada ! ! ! ! ! ! ! ! ! ! ! ! ! ! " Chontales ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! A El Bluff ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Zapatera ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Island ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !A"! ! ! ! ! ! ! ! ! ! ! ! ! !M! !o! !mbacho ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Masachapa ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! N.P. ! ! ! ! ! ! !6! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Ometepe ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Río ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Island Punta Gorda ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 8 # Concepción San Juan Pacific # ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !L! a! !k! e! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! NUMBERED DEPARTMENTS ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Ocean Maderas N! i!c! a! !r!a! g! !u! !a! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Río Indio ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 1 - Nueva Segovia ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Maíz N.P. ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! A" ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Solen! !ti!n! !a!m! ! e! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 2 - Madriz ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! S! ! !a! n! ! ! ! ! ! ! ! ! ! San Juan ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Isla! !n! !d! s! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !C! !a! !r!lo! ! s! ! ! ! ! ! ! ! 3 - Estelí ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !"! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Indio del Sur ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !A! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 4 - Managua ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 11°N ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 5 - Masaya ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !L! o! !s! ! ! ! ! ! ! ! ! ! !.
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