Dominican Republic

Destination overview

The Dominican Republic—the second-largest Caribbean nation, both by area and by population—covers the eastern two-thirds of the Caribbean Island of Hispaniola; Haiti comprises the western third. The capital city, Santo Domingo, is located on the southern coast of the island (Map 11.2.2.1). Spanish is the official language, although some English is spoken in most tourist areas. There are approximately 250,000 U.S. citizens living in the Dominican Republic. Average temperatures range from 23°C (73.5°F) in January to 26.5°C (80°F) in August. The island receives more rain during May–November, and tropical storms or hurricanes are possible.

In 2022, >8.5 million foreign tourists, including >2.5 million from the United States and Canada, visited the Dominican Republic, making it the most visited destination in the Caribbean. The Dominican Republic has a diverse geography of beaches, mountain ranges (including the highest point in the Caribbean, Pico Duarte [3,098 m; 10,164 ft]), sugar cane and tobacco plantations, and farmland. Most tourism is concentrated in the east of the country around Bávaro and Punta Cana, which offer all-inclusive beach resorts.

Whale watching is popular seasonally near the northeastern area, Samaná, and kitesurfing and windsurfing attract visitors to the northern areas of Puerto Plata, Sosúa, and Cabarete. Santo Domingo has an attractive colonial district that contains many historical sites dating back to Christopher Columbus's arrival in the New World. Few travelers visit other parts of the country, where tourist infrastructure is limited or nonexistent.

Map 11.2.2.1

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SOURCE:

Centers for Disease Control and Prevention

A map of the Dominican Republic highlighting its provinces, major cities, and geographical landmarks. The map shows the country bordered by Haiti to the left, with the Atlantic Ocean above and the Caribbean Sea below. Major locations such as Santo Domingo, Santiago de los Caballeros, and Punta Cana are labeled. Natural landmarks like Pico Duarte (elevation 3,098m) and Parque Nacional Jaragua are marked. The provinces, including La Altagracia, San Cristóbal, and Puerto Plata, are outlined and named. A small map at the bottom right shows the Dominican Republic’s location within the Caribbean.

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Infectious disease risks

All travelers should be up to date on routine vaccinations, including COVID-19 and seasonal influenza. Cases of vaccine-preventable diseases have been reported among the local population and unvaccinated tourists from Europe and other parts of the world. Travelers should also be vaccinated against hepatitis A.

Enteric infections and diseases

Cholera

The most recent cholera outbreak in the Dominican Republic started in 2022 in the context of a large cholera outbreak in Haiti (see Cholera chapter). In 2022, 88 suspected cases were reported (10 confirmed), and, in 2023, over 1,400 suspected cases were reported (128 confirmed). Most were imported cases in migrant communities with high cross-border mobility and poor water conditions. The 2023 outbreak was contained and the numbers in 2024 decreased. For current recommendations for travelers to the Dominican Republic, visit the CDC Travelers' Health website. The cholera vaccine is not generally recommended for travelers to the Dominican Republic.

Travelers' diarrhea

Although food hygiene at large, all-inclusive resorts and popular tourist locations has improved in the past few years, travelers' diarrhea continues to be the most common health problem for visitors to the Dominican Republic (see Travelers' Diarrhea chapter). Food purchased on the street or sold on beaches by informal sellers presents a risk for illness (see Food and Water Precautions for Travelers chapter). Advise travelers not to eat raw or undercooked seafood, and remind them to drink only purified, bottled water. Ice served in well-established tourist locations is usually made from purified water and is safe to consume. However, ice might not be safe in remote or non-tourist areas.

Typhoid fever

Travelers should be vaccinated against typhoid fever, especially anyone visiting friends or relatives (see Typhoid and Paratyphoid Fever chapter).

Respiratory infections and diseases

Coronavirus disease 2019

All travelers going to the Dominican Republic should be up to date with their COVID-19 vaccines (see COVID-19 chapter).

Tuberculosis

In 2022, the National Tuberculosis (TB) Control Program reported an incidence of 40.5 TB cases per 100,000 inhabitants (see Tuberculosis chapter). Although there is community spread of TB, no reports exist of travelers or tourists becoming infected with TB while visiting the Dominican Republic.

Sexually transmitted infections and HIV

Although the commercial sex trade is illegal, commercial sex workers (CSW) are found throughout the Dominican Republic; Samaná, Sosúa, and Puerto Plata are known sex tourism destinations. HIV prevalence among female CSW is approximately 3.3%, and up to 4.9% in some areas; syphilis (12%), hepatitis B virus (2.4%), and hepatitis C virus (0.9%) are also concerns. Among men who have sex with men, HIV prevalence is 7% and active syphilis up to 15%. HIV disproportionately affects the Haitian and Haitian-descendant population living in the Dominican Republic. Travelers should avoid sexual intercourse with CSW and always use condoms with any partner whose HIV or sexually transmitted infection status is unknown (see Sex and Travel chapter). Hepatitis B vaccine is recommended for people who could be exposed to blood through needles, medical procedures, or body fluids during sexual intercourse with a new partner.

Soil- and water-borne infections

Leptospirosis

Leptospirosis is prevalent on the island; in 2022, 263 leptospirosis cases and 30 deaths were reported. Leptospira contamination can be attributed to climatic conditions (e.g., heavy rainfall, flooding) and to environmental factors, including agricultural practices, animal husbandry, inadequate disposal of waste, and poor sanitation. Travelers should avoid recreational activities in lakes and rivers, as well as other unprotected exposures to freshwater potentially contaminated with animal urine (see Leptospirosis chapter).

Schistosomiasis

Based on the results of a 2013 serological survey conducted in provinces with a history of schistosomiasis transmission, the Dominican Republic has likely eliminated schistosomiasis transmission (see Schistosomiasis chapter). This status has not yet been verified according to World Health Organization (WHO) criteria.

Vector-borne diseases

Vector-borne viral diseases (e.g., dengue), as well as parasitic diseases (e.g., malaria), are potential concerns for travelers to the Dominican Republic. All travelers should take precautions to prevent mosquito bites by wearing long-sleeved shirts and long pants and by using insect repellent (see Mosquitoes, Ticks, and Other Arthropods chapter).

Arboviruses: chikungunya, dengue, and Zika

Dengue is widespread in the Dominican Republic; 10,784 cases and 39 deaths were reported in 2022. Although cases of dengue are reported year-round, transmission frequently increases during the rainy season, May–November. The principal mosquito vector of the dengue virus, Aedes aegypti, is found in both rural and urban areas in the Dominican Republic (see Dengue chapter). Neither chikungunya nor Zika has been detected in the Dominican Republic for several years.

Lymphatic filariasis

The Dominican Republic is actively participating in the global program to eliminate lymphatic filariasis (LF). LF is considered endemic to some smaller foci in the east and southwest regions of the country. As of 2020, the country had achieved targets set by the WHO to stop annual treatment, suggesting low likelihood of ongoing disease transmission and minimal risk to travelers. The Dominican Republic is still working to achieve all targets demonstrating elimination of LF as a public health problem (see WHO website).

Malaria

Malaria is endemic to the Dominican Republic (see Yellow Fever Vaccine and Malaria Prevention Information, by Country and Malaria chapters; and Map 1.5.22). During 2022, a total of 335 cases of malaria were reported, none of which were fatal.

Malaria transmission occurs primarily in the provinces of Azua, Elias Piña, La Altagracia, San Juan, and Santo Domingo, including in resort areas. Transmission in Santo Domingo (Distrito Nacional) is primarily in the Los Tres Brazos and La Cienaga areas. Locally transmitted cases in other provinces are rare. The malaria species found in the Dominican Republic, Plasmodium falciparum, remains sensitive to all known antimalarial drugs, including chloroquine. The recommended malaria chemoprophylaxis in the provinces with documented transmission are atovaquone-proguanil, chloroquine, doxycycline, mefloquine, or tafenoquine. In other areas, mosquito avoidance only is recommended.

Map 1.5.22

SOURCE:

Centers for Disease Control and Prevention

This map of Dominican Republic outlines malaria prevention recommendations across the country. Areas shaded in orange show regions where chemoprophylaxis (preventive medication) and mosquito avoidance are recommended. This includes La Altagracia, Santo Domingo, Distrito Nacional, Azua, San Juan, and Elías Piña. Areas shown in brown indicate mosquito avoidance only recommended. This includes the rest of the Dominican Republic.

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Environmental hazards and risks

Animal bites and rabies

Reports of animal rabies in the Dominican Republic are not uncommon, and the last reported case of human rabies was in 2019 (see Rabies chapter). In 2022, no cases of human rabies were reported and 31 cases of animal rabies were reported. Post-exposure rabies prophylaxis is available in specialized and regional hospitals. Consider pre-exposure vaccination for travelers potentially at risk for animal bites (e.g., people spending extended time outdoors, anyone handling animals). Advise travelers to avoid petting or playing with animals.

Climate and sun exposure

Visitors to the Dominican Republic often underestimate the strength of the sun and the dehydrating effect of the humid environment. Encourage travelers to take precautions to avoid sunburn by wearing hats and suitable clothing, along with proper application of a broad-spectrum sunscreen with SPF ≥15 that protects against both ultraviolet A and B (see Sun Exposure in Travelers chapter). Travelers should drink plenty of hydrating fluids throughout the day.

Toxic exposures

Methanol

Poisonings from consuming methanol-contaminated ethanol in fermented beverages occur in both resort areas and in the community in the Dominican Republic (see Poisonings, Envenomations, and Toxic Exposures During Travel chapter). The most recent outbreak was in January–April 2021. The outbreak involved >300 people, predominantly in the northern and northeastern regions of the country, and was traced to drinking adulterated ethanol; >100 died. Most cases occurred the week after the long Easter weekend. Since the 2021 outbreak, there have been only sporadic cases reported.

Safety and security

Crime

The risk for crime in the Dominican Republic is like that of major cities in the United States. Although most crime affecting tourists involves robbery or pickpocketing, more serious assaults occasionally occur, and perpetrators might react violently if resisted (see Safety and Security Overseas chapter). Visitors to the Dominican Republic should follow normal safety precautions (e.g., going out in groups, especially at night; using only licensed taxi drivers; drinking alcohol in moderation; and being cautious of strangers). Criminal activity often is higher during the Christmas and New Year season, and additional caution during that time is warranted.

Traffic-related injuries

Driving in the Dominican Republic is hazardous (see Injury and Death During Travel chapter). Traffic laws are rarely enforced, and drivers commonly drive while intoxicated, text while driving, exceed speed limits, disrespect red lights or stop signs, and drive without wearing seat belts or helmets. According to WHO statistics, the Dominican Republic has the highest number of traffic deaths per capita in the world (110 per 100,000 population in 2019).

Many fatal or serious traffic crashes involve motorcycles and pedestrians. Motorcycle taxis, used throughout the country, including in tourist areas, frequently carry ≥2 passengers riding without helmets. Remind visitors to avoid motorcycle taxis, to use only licensed taxis, and to always wear a seat belt.

Availability and quality of medical care

In the Dominican Republic, public medical clinics lack basic resources and supplies, and few or no English-speaking staff are available. In addition, only minimal staff are available overnight in non-emergency wards; if hospitalized, travelers should consider hiring a private nurse to spend the night.

Private hospitals and doctors might offer a more comprehensive range of services but typically require advance payment or proof of adequate insurance (see Travel Insurance, Travel Health Insurance, and Medical Evacuation Insurance chapter) before providing medical services or admitting a patient. Some hotels and resorts have pre-established, exclusive arrangements with select medical professionals; these can have additional, associated costs and might also limit choices for emergency medical care.

Psychological and psychiatric services are limited, even in the larger cities, with hospital-based care available only through government institutions.

Medical tourism

The market for medical tourism, including plastic surgery and dental care, is growing in the Dominican Republic (see Medical Tourism chapter). Thousands of patients travel to the country each year to access medical services that cost a fraction of what they do in the United States. Several companies and clinics offer package deals that include post-surgical recovery at local tourist resorts. Most healthcare facilities catering to medical tourists have not, however, met the standards required by international accrediting bodies.

Some medical tourists to the Dominican Republic have experienced a substandard quality of care, healthcare-associated infections, and even death. A total of 93 cosmetic surgery–related deaths of U.S. citizens in the Dominican Republic occurred during 2009–2022. Many of these deaths were in patients who underwent multiple body lifts and fat-reduction procedures and were related to surgical complications from fat emboli or blood-clotting issues like venous thromboembolism. Several outbreaks of nontuberculous mycobacteria among women undergoing cosmetic surgery in the Dominican Republican have also been reported.

Anyone considering the Dominican Republic as a destination for medical procedures should consult with a U.S. healthcare professional before travel and should research whether the healthcare professionals and facilities in the Dominican Republic meet accepted standards of care. Legal options in case of malpractice are very limited in the Dominican Republic. International travel insurance that covers medical evacuation back to the United States and repatriation of remains is recommended (see Travel Insurance, Travel Health Insurance, and Medical Evacuation Insurance chapter).