Colombia's city circuit has no malaria. Settle the yellow fever question early.

A first trip to Colombia usually strings together Cartagena on the Caribbean coast, Medellín at about 1,500 m and Bogotá at about 2,600 m. Some trips add a beach leg east to Santa Marta, Tayrona and Palomino, a few days in the coffee region, or the Amazon at Leticia. This winter's complications are a yellow fever entry rule that is stricter than the health advice, an active outbreak notice, and a dengue season that picked up again in late summer.

Yellow fever: the entry rule and the outbreak

The CDC recommends yellow fever vaccine for most travelers to Colombia aged 9 months and older. It generally does not recommend it for travel limited to Cartagena, Medellín, Cali or Barranquilla, and it does not recommend it for Bogotá, San Andrés and Providencia, or areas above 2,300 m.

The entry rule is broader. The CDC's destination page lists Colombia as requiring proof of yellow fever vaccination from all arriving travelers aged 1 and older. Entry rules can change, so confirm the current requirement with the Colombian embassy or a consulate before you book. That can make the shot necessary even for a city-only trip.

The CDC also has an active Level 2 travel notice, last updated October 16, 2026, for a yellow fever outbreak centered on the department of Tolima. It includes newly affected areas next to the zones where vaccination has historically been recommended. The notice says to get vaccinated at least 10 days before travel, and travelers headed to higher-risk settings may need a booster if their last dose was 10 or more years ago.

The city circuit and the add-ons

Dengue reached outbreak level in September

Colombia is on the CDC's Global Dengue travel notice, and the national health institute classified dengue as being in outbreak status in 2026. In its October 20 update, the Pan American Health Organization counted 83,905 suspected dengue cases in Colombia so far this year, 28,677 of them confirmed, and 51 deaths. The year is still about 20% below 2025, but the trend has turned. Cases rose 14% in the latest four weeks of data, and in September they crossed into outbreak range against historical trends. PAHO noted increases in Cartagena and in Antioquia, Medellín's department, in late August and September.

The Aedes mosquito behind dengue bites in daylight, with peaks after sunrise and before sunset. Our dengue & Zika daily routine has the full schedule; in Cartagena or Santa Marta it comes down to three habits.

The CDC also lists an elevated chikungunya risk for Colombia, part of a regional surge. The same daytime routine covers it, and the CDC says its vaccine may be considered for stays of about six months or more.

Santa Marta, Tayrona, Palomino and the coffee region

The CDC says malaria transmission occurs in all areas of Colombia below 1,700 m (5,600 ft), with none in the cities of Bogotá, Cartagena or Medellín. P. falciparum, the more dangerous species, accounts for about half of cases, and chloroquine resistance occurs, so the CDC lists other medicines for the areas where it recommends prevention.

Santa Marta, Tayrona and Palomino on the Caribbean coast sit well below that line. The coffee-region towns range from about 1,400 m to 2,150 m, so the lower ones sit below the malaria line, and all of them are below the 2,300 m yellow fever cutoff. None of these places is among the CDC's yellow fever exceptions. Bring either leg to your yellow fever appointment, with towns and nights spelled out. Our malaria-zone checklist covers the rest.

On those legs, repellent at sunset, long sleeves for dinner and a screened or air-conditioned room cover the dusk-to-dawn malaria hours.

The Amazon and jungle treks

Leticia and the Amazon are the highest-risk part of a Colombia trip. The CDC lists malaria prevention medicine and recommends yellow fever vaccine there, and in 2024 the Amazon was Colombia's main Oropouche area. Oropouche has no vaccine, and the CDC advises avoiding bites during travel and for three weeks afterward.

The CDC's Yellow Book also lists Colombia among the common sources of cutaneous leishmaniasis in travelers, a skin infection spread by tiny forest sand flies that bite from dusk to dawn. It matters for Amazon lodges and jungle treks such as the Ciudad Perdida trek. Permethrin-treated clothing, nets or screens at night and repellent at dusk and dawn are the basics. See a doctor about any bite sore that won't heal after the trip.

Sand flies on the Caribbean beaches

On the coast, many of the bites travelers notice come from biting midges, called jejenes locally and sand flies in English. They tend to be worst at dusk on the beaches and islands around Cartagena, including the Rosario Islands and Barú, and at Tayrona. They are weak fliers, so a breeze keeps them down, and they go for ankles and lower legs. Repellent on feet, ankles and calves before sunset and light trousers for beach dinners prevent most bites. Our sand fly guide explains the insect.

Where you're staying

Here is how the main stops compare for a December–April trip.

December to March on the coast

December to March is the dry, windier season on the Caribbean coast, which usually means fewer mosquitoes in Cartagena and Santa Marta. This year, though, dengue was still rising on the coast going into the fall, and PAHO warns that El Niño may prolong transmission. The yellow fever and malaria advice doesn't change with the season.

What travelers report

Paraphrased from forum threads and reviews and linked so you can read them in full. Neither is dated to this season, and individual trips vary with weather, wind and where you stay.

• Cartagena (walled city, Getsemaní, Bocagrande)

  Replies said there are few or no mosquitoes in the old city, Getsemaní and Bocagrande, and that sand flies at the beach after sunset are the bigger nuisance. Posters said coastal pharmacies sell repellent, including a local DEET product, that picaridin also works on sand flies, and that bugs get worse heading east from Santa Marta. TripAdvisor ↗

• Costeño Beach (between Tayrona and Palomino)

  A hostel guest called Costeño probably the best beach on the stretch between Tayrona and Palomino, with bad sand flies and mosquitoes as the one downside and something they felt could not be avoided in the area. TripAdvisor ↗

One more rule outlasts the trip. Any fever during or after your trip means a doctor visit, and you tell them you were in Colombia, naming the coast, the coffee region or the Amazon if you went. Dengue usually shows up within two weeks; malaria can take longer.

Traveler questions