Malaria in Guatemala by Destination: Tikal, Semuc Champey, Río Dulce, Monterrico and Antigua (What CDC Says)

In short: The CDC lists malaria prevention medicine for five departments of Guatemala: Alta Verapaz, Baja Verapaz, Escuintla, Izabal and Petén. That puts Tikal (Petén), Semuc Champey (Alta Verapaz) and Río Dulce (Izabal) inside the list. Antigua, Guatemala City and Lake Atitlán have no transmission, per the CDC. For every other area with reported cases, the CDC lists insect bite precautions only, no medicine. The malaria in Guatemala is 99% P. vivax with no drug resistance listed. The WHO and the UK draw the map differently, and those differences are set out below.

This page reports what public health authorities publish. It is not medical advice: it gives no doses, no schedules and no view on your personal risk. Which medicine, if any, is a decision for a travel-health provider who knows your itinerary and history.

Your destination, and what the CDC lists for it

The CDC writes its Guatemala malaria guidance by department, so the first step is knowing which department each stop is in. The department column below comes from the listed official source for each place.

The CDC’s medicine row is headed “Departments of Alta Verapaz, Baja Verapaz, Escuintla, Izabal, and Petén” and lists six drugs: atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine and tafenoquine. For everywhere else with cases: “Other areas with reported malaria transmission: No chemoprophylaxis recommended (insect bite precautions and mosquito avoidance only)” (CDC Guatemala destination page, malaria block updated April 23, 2025, read 30 September 2026).

The CDC Yellow Book’s Guatemala chapter, written for clinicians, says the same thing in one sentence: “Alta Verapaz, Baja Verapaz, Escuintla, Izabal, and Petén account for most cases, and prophylaxis against Plasmodium vivax malaria is recommended only for travelers visiting these departments.”

Itineraries that only touch Antigua, Guatemala City and Lake Atitlán sit entirely outside the CDC list. A trip that adds Tikal, Semuc Champey or Río Dulce has at least one stop inside it.

The CDC’s Guatemala malaria profile

Two notes from the CDC Yellow Book’s malaria chapter bear on that medicine list:

• Chloroquine is on it because the parasites here respond to it. The chapter says “Chloroquine-sensitive P. falciparum is present in the Caribbean and Central American countries west of the Panama Canal”, and that “In countries where P. vivax predominates, primaquine is also an option.”
• Two of the six need a blood test first. “Because both tafenoquine and primaquine can cause hemolytic anemia in persons with glucose-6-phosphate-dehydrogenase (G6PD) deficiency, quantitative G6PD testing must be done before prescribing primaquine or tafenoquine.”

On timing, the CDC tells travellers: “Depending on the medicine you take, you will need to start taking this medicine multiple days before your trip, as well as during and after your trip. Talk to your doctor about which malaria medication you should take.” It also says to fill the prescription before leaving and take enough for the whole trip.

Where the CDC, the WHO and the UK disagree

Three bodies publish a Guatemala malaria map, and they use three different methods.

The WHO entry reads, in full on tiers: risk is “highest in the departments of Escuintla (especially in the municipalities of Gomera, Masagua, Santa Lucia Cotzumalguapa and Tiquisate) and Alta Verapaz (in the municipalities of Telemán, Panzós and La Tinta)”; moderate in Suchitepéquez, Retalhuleu and Izabal; and low in Chiquimula, Zacapa, Baja Verapaz, San Marcos, Petén, Jutiapa, Jalapa, El Progreso, Santa Rosa, Guatemala, Chimaltenango, Huehuetenango and Quiché.

The real disagreement is Petén. The CDC lists preventive medicine for the department that holds Tikal. The WHO’s 2021 entry puts Petén in its lowest tier, and the UK treats it as low risk with medicine only in exceptional cases. This page does not pick between them. A traveller headed to Tikal from the UK and one headed there from the US can be reading two different official answers. Bring both to the travel-health appointment.

The CDC and the UK both name Antigua, Guatemala City and Lake Atitlán as free of malaria. The WHO entry does not name them; it draws its line at 1,500 m.

Bite prevention: what the CDC lists for every destination

Medicine is listed only for five departments, but the CDC’s bite advice on its Guatemala page is not limited to them. It lists:

• “Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.”
• “Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents). Do not use permethrin directly on skin.”
• “Stay and sleep in air-conditioned or screened rooms.”
• “Use a bed net if the area where you are sleeping is exposed to the outdoors.”
• Repellent: “Use a repellent that contains 20% or more DEET for protection that lasts up to several hours.”

The CDC Yellow Book adds that “No antimalarial drug is 100% protective”, so people who take medicine still need these measures.

The same page lists dengue among the mosquito-borne risks in Guatemala, and the Yellow Book notes that “warmer, lower altitude departments such as Baja Verapaz, Escuintla, Petén, Santa Rosa, and Zacapa report cases annually” and that “an increasing number of dengue cases have been reported in Sacatepéquez (where Antigua Guatemala is located) and Guatemala City.” So Antigua is outside the malaria map but not outside the dengue one. We track national case counts on the dengue Guatemala 2026 page.

After you get home

The CDC’s Guatemala page says: “If your doctor prescribed antimalarial medicine for your trip, keep taking the rest of your pills after you return home.” And: “If you become ill with a fever either while traveling in a malaria-risk area or after you return home (for up to 1 year), you should seek immediate medical attention and should tell the doctor about your travel history.”

Combining Guatemala with Belize

If your Tikal trip crosses from Belize: the CDC Yellow Book’s Guatemala and Belize chapter says: “Belize was certified malaria-free by the World Health Organization in 2023. No malaria prevention measures are recommended for travelers to Belize.” The Guatemalan side of that trip, Petén, is still in the CDC’s five-department list.

Related

• Vaccines for Guatemala: what is required vs recommended — yellow fever entry rule and the CDC and UK vaccine lists
• Travelling to Guatemala while pregnant: Zika, malaria and altitude
• Tikal sunrise tour · Semuc Champey logistics · Río Dulce to Livingston by boat · Monterrico mangrove tour
• Is Guatemala’s tap water safe?
• Travel insurance for Guatemala

Sources

Health information current as of 30 September 2026. Not medical advice.