Antigua and Tikal are two different bite trips. Here's how to plan for each.

A typical first trip to Guatemala strings together Antigua's colonial streets, a few days on Lake Atitlán and a trip north to the Maya ruins at Tikal. Antigua and Atitlán sit around 1,500 m, roughly 4,900 feet, high enough that the CDC describes mosquito exposure for highland travelers as limited. Tikal sits in the lowland rainforest of Petén, where the CDC recommends malaria prevention medicine and the forest holds sand flies that spread a skin infection. Same country, two packing lists. December to April is the dry season, which helps everywhere, and the lowland stops add a few decisions to settle before you book.

Which Guatemala are you visiting?

Most itineraries fall on one side of this line or cross it once.

Many travelers pair Tikal with Belize. Our Belize briefing covers the other side of that border.

The lowland malaria question

The CDC's destination page for Guatemala, checked on October 25, 2026, recommends malaria prevention medicine only for travelers visiting five departments: Alta Verapaz, Baja Verapaz, Escuintla, Izabal and Petén. Several of the best-known lowland sights fall inside them. Tikal and Flores are in Petén, Río Dulce and Livingston in Izabal, Semuc Champey and Cobán in Alta Verapaz, and the Pacific cruise port of Puerto Quetzal in Escuintla. Antigua, Guatemala City and Lake Atitlán are not risk areas. Where a few cases turn up outside the five departments, the CDC recommends bite precautions only.

About 99% of Guatemala's malaria is Plasmodium vivax. The CDC lists several prevention medicines, and two of them, primaquine and tafenoquine, require a G6PD blood test first. If your clinician suggests one of those, the test needs to fit into your planning time.

Whatever the clinic decides, the mosquitoes that carry malaria bite from dusk to dawn. Repellent at sunset, long sleeves and trousers, and a screened or air-conditioned room or a treated net overnight take care of most of that exposure.

Tikal at sunrise: the forest night shift

Tikal's sunrise tours put you in the rainforest at the hours when biting peaks. Malaria mosquitoes are ending their dusk-to-dawn shift, the daytime dengue mosquito is starting its morning peak, and phlebotomine sand flies, which bite from dusk to dawn, are still out. Petén is one of the CDC's malaria-prevention departments and, with Alta Verapaz and Huehuetenango, the source of most of Guatemala's reported cutaneous leishmaniasis, a skin infection those sand flies spread.

The risk is higher for ecotourists and anyone in rustic lodging. Forest sand flies are small enough to pass through ordinary mosquito netting. The CDC's advice is to avoid outdoor activity at night, wear protective clothing, use repellent and sleep in air-conditioned or screened rooms. Permethrin-treated clothing adds a layer against sand flies and mosquitoes alike; it goes on fabric at home, never on skin. See a doctor about any bite sore that won't heal after the trip.

Across the lowlands, the forest around Tikal, Lake Petén Itzá at Flores, the river at Río Dulce and Livingston, and the pools at Semuc Champey are the places likely to bite most, especially around sunrise and sunset. The dry season keeps numbers down, though it does not remove the malaria or sand-fly risk.

Dengue: well below 2025 so far

The CDC classes dengue in Guatemala as a frequent or continuous risk, higher in coastal and low-lying areas. Guatemala had a record year in 2024, when the health ministry and the social security institute counted 186,672 cases through mid-December. This year has been far calmer. The health ministry counted 9,689 cases through late July 2026, about 43% fewer than the roughly 17,000 at the same point in 2025. It credits prevention, less rain and continued circulation of the same virus type as in 2023, and warns that a change of type could push cases up. In October, the Pan American Health Organization reported dengue rising again across Central America as a whole, so treat the July figure as a snapshot.

The mosquito behind it, Aedes aegypti, bites in daylight, with peaks after sunrise and before sunset. Chikungunya and Zika use the same mosquito and have caused cases in Guatemala in recent years, with no current CDC notice for either, and the CDC says chikungunya vaccination is generally not recommended for travelers here. Repellent over sunscreen in the morning and again in the late afternoon covers all three. Our dengue & Zika daily routine has the full schedule.

Where you're staying

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

The dry season helps

Guatemala's rainy season runs roughly May to October, and dengue rises with it; the health ministry issues an alert at the start of each transmission season. December to April is the dry season, when dengue and mosquito numbers are at their lowest. The lowlands are the exception that matters for planning. Petén and the other jungle areas still carry malaria and leishmaniasis risk in the dry months, so the clinic visit and the treated clothes apply whatever month you go.

What travelers report

Paraphrased from a guest review and linked so you can read it in full. It dates from 2016, and one stay says little about this season.

• Jungle Lodge Hotel, Tikal · Review posted early April · 2016

  A guest used the mosquito netting provided but woke up with bites on any uncovered skin, without ever seeing the insects. 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 Guatemala, including which regions. Dengue usually shows up within two weeks; malaria can take longer. That one sentence is what gets you the right test quickly.

Traveler questions