The CDC Yellow Book says travelers’ diarrhea commonly affects visitors to Guatemala. If it starts, the CDC’s first steps are fluids, oral rehydration solution in serious cases, and over-the-counter loperamide for symptoms, with antibiotics kept for severe cases on a doctor’s instructions. Antimotility drugs alone are not recommended with bloody diarrhea or fever. For Guatemala specifically, the CDC names soft or fresh unpasteurized cheeses, raw or undercooked meat or fish, unwashed greens, and shellfish during Pacific-coast algal blooms.
This page covers what to do once it starts and the Guatemala-specific risks. It does not repeat water advice: for tap water, ice, garrafones and filters, see our water safety guide. It is not medical advice and gives no antibiotic dosing.
Risks the CDC names for Guatemala
From the CDC Yellow Book’s Guatemala and Belize chapter (dated April 23, 2025) and its travelers’ diarrhea chapter (updated March 24, 2026):
| Risk | What the CDC says |
|---|---|
| Tap water | Not potable in Guatemala, even in the capital; bottled water is widely available. Details in our water guide. |
| Dairy | Avoid unpasteurized dairy products, particularly soft or fresh cheeses. |
| Meat and fish | Avoid raw or undercooked meat or fish. |
| Salads and raw vegetables | Avoid leafy greens or raw vegetables unless thoroughly washed and disinfected, or cooked. |
| Shellfish on the Pacific coast | Guatemala periodically has harmful algal blooms on the Pacific coast; paralytic shellfish poisoning is a potentially serious risk from bivalves (clams, oysters, mussels, scallops) harvested then. The Ministry of Agriculture can ban harvesting and eating shellfish; alerts may come from the Ministry of Health and spread through local news. The CDC also advises against swimming during blooms. |
| Cyclospora | The travelers’ diarrhea chapter names Guatemala among the best-known risk areas for this parasite. |
| Typhoid | Occurs in Guatemala; the CDC recommends the vaccine for most travellers and says vaccinated travellers should still follow food and water precautions. See our vaccines guide. |
If it starts: the CDC’s steps
| Step | What the CDC says | Source |
|---|---|---|
| Fluids | Drink lots of fluids to stay hydrated. | CDC traveler page |
| Oral rehydration solution (ORS) | Use in serious cases; available online or in pharmacies in developing countries. For severe fluid loss, the Yellow Book says ORS is the best way to replace fluids. | Traveler page; Yellow Book |
| Loperamide | Sold over the counter; reduces frequency and urgency, and may make a bus or plane ride easier while an antibiotic takes effect. Liquid forms exist for children. | Traveler page; Yellow Book |
| Not with blood or fever | Antimotility drugs alone are not recommended for bloody diarrhea or diarrhea with fever. | Yellow Book |
| Antibiotics | Only for severe cases, taken as your doctor instructs. | Traveler page |
| After you get home | If severe diarrhea develops soon after you return, “see a doctor and ask for stool tests so you can find out which antibiotic will work for you”. | Traveler page |
How the CDC grades severity (Yellow Book): mild is tolerable and does not interfere with your plans; moderate is distressing or interferes with your plans; severe is incapacitating or stops your plans entirely, and all dysentery counts as severe. In otherwise healthy adults, the CDC’s traveler page says diarrhea is rarely serious or life-threatening.
How long it lasts, by cause
From the CDC Yellow Book’s travelers’ diarrhea chapter:
| Cause | Time from exposure to symptoms | Duration if untreated |
|---|---|---|
| Toxin-mediated | Within a few hours | — |
| Bacterial | 6-96 hours, sudden onset | 3-7 days |
| Viral | 6-96 hours, sudden onset | 2-3 days |
| Protozoal (parasites such as Giardia and Cryptosporidium) | 1-2 weeks, per the Yellow Book | Weeks to months |
| Cyclospora (the Yellow Book’s exception among protozoa) | 2-14 days | Not given separately |
The protozoal rows matter on the flight home: an infection picked up in your last days in Guatemala can start after you leave.
What Guatemala’s own surveillance shows (2026)
MSPAS’s Dirección de Epidemiología publishes a weekly situation report on food- and waterborne diseases (enfermedades transmitidas por agua y alimentos, ETAs). The edition for epidemiological week 40 (4-10 October 2026), posted 26 October 2026:
| Measure, 2026 to week 40 | MSPAS figure |
|---|---|
| Food- and waterborne disease cases, national | 467,577 |
| National rate | 2,586 cases per 100,000 people |
| Share that is acute diarrhoeal disease (EDA) | 98% |
| Acute diarrhoeal disease rate | 2,540 per 100,000 |
| Share of diarrhoeal cases in children under 5 | 48% |
| Change in food- and waterborne cases vs 2025 | 5% fewer |
| Food poisoning (intoxicaciones alimentarias) | 10% more than 2025; Sacatepéquez and Sololá reported the most cases |
| Food-poisoning outbreak shown in the report | Santa Lucía Utatlán, Sololá: 421 cases, 84% attack rate |
| Norovirus | Laboratory positivity rising in recent weeks, compared with rotavirus, astrovirus and adenovirus |
| Typhoid fever | 20% fewer cases than 2025; 0.7 per 100,000 |
| Hepatitis A | 12 per 100,000; in the safety zone of the endemic channel |
| National endemic channel, week 40 | Alert zone |
These are counts of illness reported in Guatemala’s health system, not traveller attack rates. They show what is circulating: diarrhoeal disease dominates the reports, and food poisoning reports in 2026 were highest in Sacatepéquez and Sololá.
Getting help in Guatemala
- Pharmacies: the CDC says oral rehydration solution is sold in pharmacies in developing countries, and loperamide over the counter. Our directories list pharmacies in 10 cities.
- Doctors and hospitals: see our healthcare guide and, for emergencies, the emergency numbers page.
- Insurance: see travel insurance for Guatemala.
Related
- Water safety in Guatemala: tap water, ice, garrafones and filters
- Vaccines and health requirements for Guatemala: hepatitis A and typhoid
- Bringing food into Guatemala
- Leishmaniasis in 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 Yellow Book, Travelers’ Diarrhea (updated March 24, 2026): https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html (read 30-31 October 2026)
- CDC, Travelers’ Diarrhea (traveler page): https://wwwnc.cdc.gov/travel/page/travelers-diarrhea (read 31 October 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, Vigilancia epidemiológica de las ETAs, semana 40 (4-10 octubre 2026): https://epidemiologia.mspas.gob.gt/phocadownload/userupload/etas/2026/etas-semana-40-2026.pdf (read 31 October 2026)
This page is information, not medical advice. Information current as of 31 October 2026.
Frequently Asked Questions
Is travelers' diarrhea common in Guatemala?
The CDC Yellow Book’s Guatemala and Belize chapter says travelers’ diarrhea commonly affects visitors to Guatemala and Belize. Guatemala’s Ministry of Health (MSPAS) recorded 467,577 cases of food- and waterborne disease nationally in 2026 up to epidemiological week 40, 98% of them acute diarrhoeal disease.
What should I do if I get diarrhea in Guatemala?
The CDC’s traveler page says to drink lots of fluids; in serious cases, use oral rehydration solution, which it says is available in pharmacies in developing countries. Over-the-counter drugs such as loperamide reduce how often and how urgently you need the bathroom. It advises using antibiotics only for severe cases, as your doctor instructs.
When should I not take loperamide?
The CDC Yellow Book’s travelers’ diarrhea chapter says antimotility drugs alone are not recommended for bloody diarrhea or for diarrhea with fever. Speak to a doctor in those cases.
Which foods does the CDC single out for Guatemala?
Its Guatemala chapter advises avoiding unpasteurized dairy, particularly soft or fresh cheeses; raw or undercooked meat or fish; and leafy greens or raw vegetables unless thoroughly washed and disinfected or cooked. It also warns about bivalve shellfish (clams, oysters, mussels, scallops) during harmful algal blooms on the Pacific coast.
How long does travelers' diarrhea last?
Per the CDC Yellow Book, untreated bacterial diarrhea usually lasts 3-7 days and viral diarrhea 2-3 days. It gives 1-2 weeks as the usual incubation for protozoal infections (Cyclospora can start sooner, in 2-14 days) and says protozoal diarrhea can last weeks to months without treatment, so it can begin after you are home.
What if diarrhea starts after I get home from Guatemala?
The CDC’s traveler page says that if severe diarrhea develops soon after you return, see a doctor and ask for stool tests so you can find out which antibiotic will work. The CDC Yellow Book names Guatemala among the best-known risk areas for Cyclospora, a parasite whose symptoms it says can start 2-14 days after exposure.
