Fortunately, most Americans in Costa Rica dont have to fear Montezumas revenge. Intestinal problems are not nearly as widespread as they are elsewhere in Latin America, primarily because Costa Ricas water supply is good and perfectly safe to drink in San Jose and in most of the countrys other cities and towns. Still, even in Costa Rica you should be careful not to drink water in very rural areas. To be on the safe side, drink bottled water.
Although Costa Rica is considered to have a high standard of sanitation and health care, its always a good idea to take some of the same simple precautions as youd take if you were traveling in any other Central American country. For example, dont eat fresh fruits or vegetables unless they are thoroughly washed with a supply of safe water. Peel raw fruits and vegetables. Avoid lesser- known brands of dairy products. Instead, try pasteurized products from Dos Pinos and Borden, two reputable companies. Milk sold in boxes or cartons is safe. Avoid fruit drinks sold in plastic bags, homemade popsicles, and in rural areas fresh fruit drinks made with water. If water is suspect, order soft drinks and bottled water sin hielo, pronounced seen yellow, meaning without ice.
When it comes to immunizations, none are required to enter Costa Rica. However, if you will be traveling to rural areas, some doctors may advise a tetanus booster, and polio and typhoid-paratyphoid vaccinations. Ive traveled throughout Costa Rica, was never told to get any immunizations, and made it just fine. Still, you might want to call the Centers for Disease Control and prevention (CDC) before you go to get and up-to-date account regarding diseases and vaccinations; phone 404-332-4555. The CDC International Travelers Hotline is another good source; phone 404-332-4559.

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