Gastrointestinal complaints such as dysentery, giardia, E. coli infections, and even so-called “traveler’s diarrhea” are far less common among travelers to Panama than in most parts of Latin America.
It’s safe to drink water out of the tap almost everywhere in the country. The destination chapters alert you to the few places where that still isn’t a good idea, such as some parts of the Darién and Bocas del Toro. Never drink untreated water from a stream or lake, no matter how pristine it looks.
Hygiene standards in restaurants tend to be fairly high, particularly in Panama City. You’re unlikely to get so much as a stomachache. But if a place looks dirty or unpopular, you’re probably better off going elsewhere. Street-vendor fare is somewhat riskier. Make sure whatever you munch has just been fried at high temperature. It’s not a good idea to eat ice cream and other milk- or water-based sweets sold by street vendors.
The CDC warns that certain fish and shellfish served in tropical countries can contain biotoxins even when well cooked. Barracuda has the highest level of these toxins and should always be avoided. Other possibilities include red snapper and sea bass. I’ve never heard of anyone in Panama being poisoned by these delicious fish, but if you experience stomach distress accompanied by a sudden change of temperature, weakness, or other unusual symptoms after eating fish, get medical help.
Mild traveler’s diarrhea doesn’t usually need to be treated with anything more than fluids, rest, and a modest diet of bland foods. Anything more serious, such as bacterial or amoebic dysentery, needs to be treated with drugs and requires a visit to the doctor.
© William Friar from Moon Panama, 3rd Edition