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MEDICAL ADVICE TO TRAVEL TO PERU
The information contained in this page offers a general vision about the sanitary risks in Peru, but it does not replace any specialist advice Editor Compilador: Juan Carlos Celis Salinas (Médico Infectólogo)- CMP 40900
Travel to Peru always is a rewarding experience that will not defraud you. But hardly the traveller will enjoy their trip if you have some problem of health. There are several sanitary risks and preventive cares that all person who travels to Peru must know.
Vaccine requiremen The quantity and type of vaccines necessary to travel to Peru depend on several factors, like medical antecedents and locations included in the trip. The most habitual vaccines needed to travel to Peru are against tétanos, difteria, typhus fever, hepatitis A and B, yellow fever (it is obligatory to present the certificate of vaccination against yellow fever to enter in some countries of Africa), rabies and meningitis.
Some of these vaccines require more than a dose or a major time to be effective. For that reason, there is recommendable to inquire on necessary vaccines with an advance of 6 to 8 weeks before your trip.
Hepatitis A
Recommended for all travellers.
Typhus fever
Recommended for all travellers.
Yellow fever
The government of Peru recommends the vaccine for all travellers who are going to visit forest areas (Amazonia) below 2300 meters (7546 ft). Travellers that only visit Lima, Cusco and Machu Picchu do not need vaccine for yellow fever.
Vaccine for yellow fever is also required for all travellers who arrive from other countries infected with yellow fever in Africa and America.
In recent years, there has been reported yellow fever in Cusco (Concepcion 2007), San Martin, Loreto, Pasco, Amazonas, Ancash, Ayacucho, Huánuco, Junín, Madre de Dios, Puno and Ucayali.
Hepatitis B
For Travellers who could have sexual relations with local people, specially if the visit is by more than 6 months.
Rabies
For travellers who could have near contact with animals and have not get access to medical services.
Measles, Parotiditis, Rubeola (SPR)
If they have not been vaccinated before, two doses for all travellers are recommended.
Tétanos - difteria
Recommended revaccination every 10 years.
What should I take in the suitcase?Top
It is recommendable to travel with a small medical kit (Traveller Kit) that includes some basic medicines like antacid, analgesic pills, NSAIDs and antihistamine drugs. Also it is necessary to take some dehydrated solutions for oral hydratation in case of severe diarrhoea. Also, It must include first aid articles as sterile strips, antiseptics and bandages. Do not forget to put some antibiotic against severe diarrhoea or disentería and other infections, as well as sterilized needles (because they are difficult to find in some isolated zones).
Finally, you must put into your luggage scissors, clamps, a thermometer, labial protector, a suntan lotion, purifying water tablets and cleanliness equipment. If you use contact lenses or glasses, take an extra game. You must also carry a small lantern and a Swiss knife. The Traveller Kit must be prepared by your physician according to your health and destiny.
MalariaTop
Malaria is a disease that can be mortal and is transmitted by a carrying mosquito. This mosquito specially pricks by night. If you are going to travel to Peru, it is very important to know what areas present a high prevalence of malaria.
The prevention of the disease is made through a medication against the malaria (prophylaxis) and the protection against the punctures of insects.
There are many antimalarial medicines. The optimal election depends on the characteristics of the trip and the traveller. So, it is important to have some medical advice about the advantages and disadvantages of each medication.
The more effective drugs are:
MEFLOQUINE (LARIAM): very extended use. Side effects include visions, and more serious neurological reactions. Those people with psychiatric and neurological problems must not take this medication.
DOXILICINE: Side effects include cutaneous reactions by contact with the sun or the risk of fungal vaginitis in the women.
MALARONE: la alta efectividad, pozo toleró y redujo efectos secundarios. Es costosa y está hasta ahora solamente disponible con la prescripción médica en centros muy especializados.
CLOROQUINE: low risk of side effects and the most useful until years ago. Nowadays, they only have 50/60% of effectiveness for malaria in Peru (specially for the south zone where malaria falciparum has not been reported).
Whatever it is your election, we want to insist in the importance of taking an antimalarial medicine if you are going to travel to a zone affected by the disease, and continue with the medication beyond your return. The risk to get malaria, or any other disease in Peru, is much greater for a tourist than for local people. Do not suspend your medication before the indicated period.
In Peru there is no risk of malaria in the big cities. No risk in Lima and surrounding areas or in areas above the 1500 meters.
There is a risk:
On the coast north of the country (Tumbes, Piura, Lambayeque).
In the Amazon region: Loreto department (Iquitos) with 97% of cases of falciparum country, San Martin, Ucayali, Just as Amazon (chachapoyas), Cajamarca (Jaen)
It was also reported cases of vivax malaria (falciparum not) in Cuzco Department (Province of Concepción away from the tourist area of Machu Picchu) and Madre de Dios.
It is recommended that:
The precautions to protect themselves from being bitten by mosquitoes are essential especially in the evening and night (especially when visiting rural or peripheral).
Use a repellent (on exposed skin) containing DEET (N, N-diethylmetatoluamide to 30% -50% are effective for several hours) or Picaridina (7-15%).
Basic cares about hygiene and foodTop It is difficult to guarantee the security of food and drink, specially in developing countries. Nevertheless you may continue enjoying local meals, this is part of the pleasures of an international trip. Be selective. The diseases that you could get go from a small diarrea or disentería, to one more serious disease (eg. Parasitic infection) that could ruin your trip. Therefore you should take certain precautions:
Try to eat only cooked foods
Avoid buffet or any other food that has been reheated and exposed to the contact with flies
Avoid seafood in unknown places
Crude fruits and vegetables are very difficult to sterilize: do not eat them unless you have the security that they have been washed in drinkable water or if they are possible to peel without touching the pulp. In the tropic the safest fruits are bananas and papayas.
Be careful, you could reject any food you consider not safe, if it is necessary, ask for cooked food specially for you. Do not eat any food that offers few guarantees to you.
Drink water only when you have the certainty that it is safe. Do not drink water from the faucet or wash your teeth with it.
Always use mineral water and check the bottles to make sure that it has not been opened yet and filled up (to avoid this, you can drink gasified mineral water)
In restaurants, you should request to open the bottle in your presence and never take ice in your drinks (the ice cubes often are made with water from the faucet). And remember, alcohol does not make drinkable the water!
Water from the faucet is made drinkable by boiling it during 5 minutes, or with chlorine or iodine drops or with special tablets/drops for it.
Punctures of insects Top
Avoid punctures of insects reduces the risk of contracting diseases transmitted by mosquitos like the yellow fever, dengue, leishmaniosis and, by all means, malaria, in 90%.
By night you should use long sleeves, long trousers, long socks and pijamas to sleep. Always use clear colors, since they attract, in less extent than dark colors, to the mosquitos. Use Insect Repellent that contains DEET. Directly apply it on your skin and clothes. Use a mosquito sleeping net impregnated of repellent, as well as other anti-mosquitos stuff in your room (spirals or electrical mosquito repellents). Use them all the nights.
RabiesTop
In Peru there have been reported cases of rabies in animals even in small zoo parks, so you should avoid to touch or to play with any type of animal. Rabies is not only transmitted through biting, but also by scratches and licks.
In case of wound, it is necessary to clean it with an antiseptic lotion. If the wound is deep it is recommendable to examine it by a doctor. Take some advice about antirabic vaccines before starting off, mainly if your trip is long.
Heat and sunTop
Do not expect to become quickly aclimated to the heat (specially in Amazonia). It will take at least 3 weeks to obtain it.
During this period, avoid physical fatigue, use fresh clothes, mainly during the warmest hours of the day. Avoid direct exhibition to the sun.
Use a solar cream and a hat.
Thirst is a very poor indicator of the amount of water that human needs. It is very important to take a sufficient amount from liquid (not alcohol, coffee or tea, because they are diuretics and causes a greater loss of water). The best probe that you are well hydrated is when your body produces clear abundant urine.
AIDS and other diseasesTop
There is a very high risk to be infected by AIDS and other sexual diseases. Please take the necessary precautions.
Accidents and injuriesTop
Accidents and injuries produce more deaths of travellers than diseases.
Please be in constant alert.
Do not drive in bad illuminated streets by night
Do not drive a bicycle or a moto
Do not drive in a drunk condition and moderate your speed.
If you take a taxi, ask the driver to go slowly. Use the security belt and, if you travel with children, use an adaptable chair
Take a small medicinal kit: small wounds can become infected very easily. If the wound is deep it is recommendable to examine it by a doctor.
Back to homeTop If you have contracted malaria or another tropical disease, it is possible that the symptoms do not become evident until much after your return to home and you may not even associate them to your trip. Visit your physician and remember to tell him about your trip to Peru.
