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Inka Trail
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Health Information
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care is generally good in Lima and usually adequate in other major cities, but it is less so elsewhere in Peru. Urban private health care facilities are often better staffed and equipped than public or rural ones. Public hospital facilities in Cuzco, the prime tourist destination, are generally inadequate to handle serious medical conditions. Although some private hospital facilities in Cuzco may be able to treat acute medical problems, in general the seriously ill traveler should return to Lima for further care as soon as is medically feasible. Read more…
Visitors to high-altitude Andean destinations such as Cuzco (11,000 feet), Machu Picchu (8,000 feet), or Lake Titicaca (13,000 feet) should discuss the trip with their personal physician prior to departing the United States. Travel to high altitudes could pose a serious risk of illness, hospitalization, and even death, particularly if the traveler has a medical condition that affects blood circulation or breathing. Several U.S. citizens have died in Peru from medical conditions exacerbated by altitude. Tourists or business visitors, particularly those who suffer from cardiac-related problems or high blood pressure, who wish to travel to high-altitude areas in Peru, should undergo a medical examination before traveling.
New arrivals, even healthy and fit persons, will feel symptoms of hypoxia (lack of oxygen) at high-altitude, and most will need time to adjust to the altitude. Most people will have increased respiration and heart rate. Many will have headaches, difficulty sleeping, lack of appetite, minor gastric and intestinal upsets, and mood changes. To help prevent these complications, consult your personal physician, avoid alcohol and smoking for at least one week after arrival at high altitudes, and limit physical activity for the first 36 to 48 hours after arrival at high altitudes.
In jungle areas east of the Andes mountain range (cordillera), chloroquine-resistant malaria is a serious problem. Cholera, yellow fever, hepatitis, dengue fever, and other exotic and contagious diseases are also present. Yellow fever is endemic in certain areas of Peru; in general, those areas are located on the eastern side of the cordillera and at lower elevations in jungle areas. The U.S. Centers for Disease Control and Prevention and the Peruvian government recommend that travelers to Peru receive a yellow fever vaccination and carry documentation of the vaccination with them on their trip.
Diarrhea caused by contaminated food or water is very common in Peru, and is potentially serious If suffering from persistent symptoms, seek medical attention. Local tap water in Peru is not considered potable. Only bottled or treated (disinfected) water should be used for drinking. Fruits and vegetables should be washed and/or disinfected with care, and meats and fish should be thoroughly cooked. Eggs, meat, un-pasteurized cheese, and seafood are common sources of the bacteria that can cause travelers' diarrhea, and they should be properly prepared or avoided.
Over the last few years, at least five American citizen visitors have died during liposuction operations in Peru. While some of these deaths occurred in ill-equipped, makeshift clinics, travelers are urged to carefully assess the risks of having this type of surgery performed overseas, even when opting for a treatment at one of the better-known clinics.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas (http://travel.state.gov/travel/cis_pa_tw/cis/cis_1470.html)
Stay healthy
Vaccinations and Prophylaxis 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. Consult your local doctor / authorities. Read more...
Hepatitis A Recommended for all travellers.
Typhus fever Recommended for all travellers.
Yellow fever Vaccination Center Perú 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?
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.
Malaria.
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: highly effective, few side effects, difficult to achieve in Peru, only in specialized Travel Medicine CenterTravel Medicine Peru
- 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 foodIt 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.
Precautions about of the water.
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.
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.
Rabies.
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 sun.
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 diseases.
There is a very high risk to be infected by AIDS and other sexual diseases. Please take the necessary precautions.
Accidents and injuries.
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 home, 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.
Pharmacies.
Common medicines, like antibiotics, can be bought in pharmacies (farmacias or boticas) quite cheaply and without restrictions. However, make sure the expiration date has not been reached. Pharmacists are mostly very helpful and can be consulted if needed. For less serious illnesses, they may replace a doctor.
Diarrhea.
Electrolytic drinks help guard against dehydration. You can get powders to dissolve in water in almost every pharmacy. If not, just dissolve sugar and salt in water. Bacterial diarrhea can be treated with antibiotics, if it doesn't vanish during a week. Usually, pharmacies are quite helpful.
Food and drink
If you stay in good hotels you may be able to avoid catching diarrhea, otherwise you will surely contract it. Just don't worry too much about. There are some rules that could avoid the worst:
- Avoid unboiled tap water, if possible. This can be difficult; If you eat a salad or drink some fruit juice, it will probably be prepared with tap water. Avoid ice in drinks if you can.
- If you must drink tap water, use some purification like mikropur.
- Don't eat food prepared in the street (if you can resist it).
- When going to cheap restaurants, first have a smell and listen to what your nose says.
- In some areas, refrigerators are rare. Just go to the meat section of a typical market hall and take a smell, you will understand. If you would rather vegetarian food, it can be hard to find. Chicken is worth a try, since they are mostly fresh.
- Don't eat unpasteurized milk products.
Altitude
If you do not have experience with higher altitudes (above 3,500m), don't underestimate it! Collapses of unacclimatized tourists are not unusual, If coming from sea level, stay at medium height ca. 3000m for at least one week. Then, altitudes of around 4500m should not be a risk, although you still will strongly feel the height. See also: Altitude sickness
Sunburn
Since Peru is close to the equator, the sun can become dangerous for your skin and eyes. Especially in the Sierra, the strong UV radiation due to the height in combination with the rather cold air may burn your skin before you notice it. Sun-blockers are easy to get in drug stores (boticas). If your eyes are sensitive to light, better bring good sunglasses from home. Of course, you can buy sunglasses in Peru, too, but you should really be sure that they block the whole UV spectrum, otherwise, they might be worse than none.
Sanitary facilities
Outside of obviously well-set up restaurants and hotels in cities and towns, toilets are often quite primitive and sometimes really dirty. It's a good idea to bring your own paper with you,as peruvian toilet paper maybe too rough as well as being one ply. It's usual. Toilet doors are marked with "baño", "S.H." or "SS.HH.". The latter two are abbreviations for servicio higienico, which is the rather formal expression. Expect to pay no more than 20 centimos at public restrooms for paper. You will find it handy to keep a roll of toilet paper and a small bottle of hand sanitizer in your backpack.
In hostels or budget hotels, you cannot rely on having water all the time. In the Andean region, it also can easily happen that showers have more or less hot water only in the afternoon since the water is heated by solar energy only. Electrically heated showers are widely spread, but the electric installation is sometimes really adventurous, since the water heater is mostly situated at the shower head. Have a look on it before turning on the shower, especially if you are tall enough that you could touch the cables or other metal during showering which can electrocute you. Don't be too paranoid though, an electric shock is mostly painful.
As woman, if you use tampons during your period, you should bring them with you from home, because they are not very popular in Peru. In Lima, you'll be able to find them in supermarket chains like Santa Isabel or Wong or at drug stores / chemists, known as farmacias and boticas. When you find them, buy enough for the rest of the trip, they are virtually unknown in the rest of the country. Alternatively you could pack a menstrual cup because they are reuseable and compact.
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