I came back from Costa Rica somewhat recently. CR is considered fairly safe in the health area, lot's of sites say you can drink most of the water, eat some raw foods in most places, etc.
Well, i swear i picked something up, because when i came back, after a few days of being back i started to develop increasing cramps in my stomach that would go in waves. The first day, wasn't so bad, 2nd day intensity increased, 3rd day increased some more and i started to get worried about parasites or something. Each day i had the cramps, it would go in waves, wherein for a little while wouldn't feel much and then bam cramps hit.
I went into super alkalize (lot's of green drinks, fresh lemon juice [acidic, but because of the high potassium content, quite alkalizing when digested–needs to be taken alone though]) and semi fast mode, and drank very strong antimicrobial tea (with lot's of clove and cinnamon, two of the strongest broad spectrum, plant based antimicrobials), and then would follow later on with lot's of probiotics. Thankfully, for me it cleared up pretty quick–after a couple of days of treatment following increasing symptoms over the 3 days.
Moral of the story, be on the cautious side. How that translates to water purifiers, well i personally would do a combo of Steripen and a decent carbon filter (like one of the better "straw" filters that has carbon), and of course with some pre filter first (i like linen for this use) at the very least. Hell, i so value my health and i'm paranoid enough that i might throw in a mini sawyer squeeze prefilter after the 1st prefilter if traveling all through Central or South America. Course that doesn't protect one from contamination from food or other things.
Off hand, i would say you don't need to be as cautious when in higher elevation places as a general rule of thumb, because it's usually cooler, more UV, and tends to be cleaner as a trend.
(and if i ever go back to CR, i definitely will be more cautious. I wasn't at all when i was there).


