Guatemala is endemic for cutaneous leishmaniasis, a skin infection spread by sand flies. The CDC Yellow Book says most Guatemalan cases come from Alta Verapaz, Huehuetenango and Petén, and that risk is higher for people with outdoor exposure, including ecotourists and travellers staying in rustic settings. Guatemala’s Ministry of Health (MSPAS) counted 591 cases in 2024 (preliminary), 99% of them cutaneous. There is no vaccine; prevention is avoiding sand-fly bites, especially from dusk to dawn.
This page sets the Guatemala data beside what the CDC, PAHO and WHO say about the disease. It is not medical advice and does not cover treatment regimens: for a skin sore after a trip, see a doctor. The kissing-bug disease is a different infection, covered in our Chagas guide.
What each authority says
| Source | What it says |
|---|---|
| CDC Yellow Book, Guatemala and Belize chapter (dated April 23, 2025) | Guatemala is endemic for cutaneous leishmaniasis. Risk is greater with outdoor exposure, such as ecology workers, ecotourists and travellers in rustic settings. “In Guatemala, most cases are reported from the departments of Alta Verapaz, Huehuetenango, and Petén.” |
| CDC Guatemala destination page | Lists leishmaniasis among the diseases in Guatemala, spread by sand-fly bite; advice: avoid bug bites. |
| PAHO | Cutaneous leishmaniasis is endemic in 19 countries of the Americas, Guatemala among them. In the Americas it spreads mainly through sand flies of the genus Lutzomyia. No vaccine is available. |
| WHO | WHO says there are three main forms: cutaneous (which it calls the most common, causing skin ulcers in most cases), mucocutaneous (mouth, nose and throat) and visceral (which WHO says is almost always fatal without treatment). |
| MSPAS (February 2026, via the government news agency AGN) | The sand fly is under 3 mm, golden brown and hairy, and its bite can hurt. Lesions start as small skin-coloured or pink bumps (papules) that can become ulcers; MSPAS says ears are especially affected. Early medical evaluation matters; go to a hospital or a dermatology outpatient clinic. |
Where the cases are: MSPAS 2023 and 2024
Cases by MSPAS health area (Dirección Departamental de Redes Integradas de Servicios de Salud, DDRISS), weeks 1 to 52. MSPAS marks the figures as preliminary.
| Health area (DDRISS) | 2023 | 2024 | Share of 2024 cases |
|---|---|---|---|
| Alta Verapaz | 492 | 306 | 51.78% |
| Petén Norte | 156 | 122 | 20.64% |
| Petén Sur Oriental | 117 | 54 | 9.14% |
| Petén Sur Occidental | 39 | 43 | 7.28% |
| Huehuetenango | 70 | 36 | 6.09% |
| Ixcán | 21 | 7 | 1.18% |
| Zacapa | 1 | 5 | 0.85% |
| All others | 10 | 18 | |
| Guatemala total | 906 | 591 | 100% |
The same MSPAS report gives two 2023 totals: 908 in its commentary, its 2011-2023 chart and the total row of its 2019-2024 health-area table, but 906 in the 2023-2024 table above (whose rows also add up to 906). We show both rather than pick one. The All others row adds together the remaining health areas in the 2023-2024 table.
What MSPAS draws out of the 2024 data:
- Municipalities: Melchor de Mencos had the highest incidence rate in the country and 49 of Petén Norte’s 122 cases. Flores had the second-highest rate nationally and 33 of Petén Norte’s cases. Lanquín had the highest rate in Alta Verapaz.
- Concentration: Alta Verapaz and Petén Norte together carry 72% of the burden, and five health areas account for 95% of cases.
- Form: 99% of 2024 cases were cutaneous. Visceral cases were 0.85% of the total (five cases). The last two mucocutaneous cases were reported in Alta Verapaz in 2022.
- Who: 66% of cases were men; the 25-39 age group had the most cases (147 of 591).
- Season: across 2019-2024, MSPAS says cases rise from the first weeks of the year, hold until about epidemiological week 35 and then fall gradually, which it reads as a possible seasonal pattern.
Annual totals
| Year | Cases (MSPAS) |
|---|---|
| 2019 | 1,168 |
| 2020 | 1,070 |
| 2021 | 880 |
| 2022 | 1,235 |
| 2023 | 908 (commentary, chart and 2019-2024 table) / 906 (2023-2024 table) |
| 2024 | 591 (preliminary) |
What this means for a trip
The places named in the MSPAS data include travel bases: Flores in Petén and Lanquín in Alta Verapaz. The CDC ties risk to outdoor exposure and rustic lodging, and PAHO’s prevention advice centres on dusk to dawn: night walks and camping in the departments named above fit that description, for example at Las Conchas waterfalls in Chahal, Alta Verapaz.
| Situation | What the sources advise |
|---|---|
| Outdoors after dark (night walks, camping) | Avoid outdoor activities at night (CDC) or from dusk to dawn (PAHO) where you can; cover up and use repellent |
| Clothing | Protective clothing (CDC, PAHO); long sleeves, gloves and hats (MSPAS) |
| Repellent | Insect repellent (CDC, PAHO, MSPAS) |
| Sleeping | Air-conditioned or well-screened rooms (CDC); bed nets (PAHO) |
| Vaccine | None available (PAHO) |
The CDC’s general bug-bite steps on its Guatemala page also include permethrin-treated clothing and gear, which it says must not be applied to skin.
Symptoms, timing and what to do
- Incubation: two to three months on average, from two weeks to two years (PAHO).
- The sore: PAHO describes a mark at the bite that becomes a raised bump, then a round, painless nodule that grows and ulcerates; the typical ulcer is round with raised edges and is painless. MSPAS says the lesions do not usually hurt and grow over time.
- Healing: a dermatologist quoted by MSPAS says some lesions heal on their own, but slowly, and can leave permanent marks.
- Where to go in Guatemala: MSPAS points patients to a hospital or a dermatology outpatient clinic; it says the dermatology unit of Hospital General San Juan de Dios offers diagnosis and treatment. See our healthcare guide for hospitals.
Related
- Chagas disease in Guatemala: the kissing-bug infection, also on the CDC’s avoid-bug-bites list
- Malaria in Guatemala
- Vaccines and health requirements for Guatemala
- Travel insurance for Guatemala
Sources
- CDC Yellow Book, Guatemala and Belize (dated April 23, 2025): https://www.cdc.gov/yellow-book/hcp/americas-caribbean/guatemala-and-belize.html (read 30 September 2026)
- CDC, Guatemala destination page (visiting friends and relatives version): https://wwwnc.cdc.gov/travel/destinations/traveler/vfr/guatemala (read 31 October 2026)
- MSPAS, Dirección de Epidemiología y Gestión del Riesgo, Situación epidemiológica de leishmaniasis a la semana 52 (22-28 dic) 2024: https://epidemiologia.mspas.gob.gt/phocadownload/userupload/leishmaniasis/leishmaniasis-sem-52-2024.pdf (read 31 October 2026)
- PAHO, Cutaneous and mucosal leishmaniasis: https://www.paho.org/en/topics/leishmaniasis/cutaneous-and-mucosal-leishmaniasis (read 31 October 2026)
- WHO, Leishmaniasis fact sheet: https://www.who.int/news-room/fact-sheets/detail/leishmaniasis (read 31 October 2026)
- Agencia Guatemalteca de Noticias (AGN), Especialista comparte recomendaciones sobre enfermedad tropical leishmaniasis (25 February 2026, MSPAS information): https://agn.gt/especialista-comparte-recomendaciones-sobre-enfermedad-tropical-leishmaniasis/ (read 31 October 2026)
This page is information, not medical advice. Information current as of 31 October 2026.
Frequently Asked Questions
Is there leishmaniasis in Guatemala?
Yes. The CDC Yellow Book classifies Guatemala as endemic for cutaneous leishmaniasis, and PAHO lists Guatemala among the 19 countries in the Americas where cutaneous leishmaniasis is endemic. Guatemala’s Ministry of Health (MSPAS) recorded 591 cases in 2024, a preliminary figure.
Where in Guatemala is leishmaniasis found?
The CDC Yellow Book says most Guatemalan cases are reported from Alta Verapaz, Huehuetenango and Petén. MSPAS’s 2024 data put Alta Verapaz first (306 cases), then Petén Norte (122), Petén Sur Oriental (54), Petén Sur Occidental (43) and Huehuetenango (36). MSPAS says Melchor de Mencos had the highest incidence rate in the country, Flores the second highest, and Lanquín the highest in Alta Verapaz.
How is leishmaniasis spread?
By the bite of infected female phlebotomine sand flies, per WHO. MSPAS describes the sand fly as very small, under 3 millimetres, golden brown with small hairs, and says its bite can be painful.
Is there a vaccine for leishmaniasis?
No. PAHO says no vaccines are available to prevent infection. Prevention means avoiding sand-fly bites.
How long after a bite do symptoms appear?
PAHO gives an average incubation of two to three months, but says it can be as short as two weeks or as long as two years. A sore can therefore appear well after you are home.
What does a leishmaniasis sore look like?
PAHO describes a mark at the bite that becomes a raised bump and then a round, painless nodule that grows and ulcerates. MSPAS says the lesions do not usually hurt, grow over time and can become ulcers, and that ears are often affected; in some places it is called oreja del chiclero.
How do I avoid sand-fly bites in Guatemala?
The CDC Yellow Book advises avoiding outdoor activities at night, wearing protective clothing, using insect repellent and sleeping in air-conditioned or well-screened areas. PAHO adds avoiding outdoor activity from dusk to dawn and using bed nets.
