Home Information of Peru Health


Before you go

Since most vaccines can’t provide immunity until at least two weeks after they’re given, you should visit a doctor four to eight weeks before departure. Don’t forget to take your vaccination certificate with you (the yellow booklet); it’s mandatory for countries that require proof of yellow-fever vaccination on entry.

Bring your medications in their original, clearly labeled containers. A signed and dated letter from your physician describing your medical conditions and medications, including generic names, is also a good idea. If carrying syringes or needles, be sure to have a physician’s letter documenting their medical necessity.

Check if your health insurance covers you for medical expenses abroad, otherwise make sure you get extra travel insurance. Find out in advance if your travel insurance will make payments directly to providers or pay you later for overseas health expenditures (many doctors in Peru, though, expect payment in cash).

While you're there

Availability of health care

There are several high-quality medical clinics in Lima and they are open 24 hours for medical emergencies. There are also many English-speaking physicians and dentists in private practice in Lima and you can find some in Cusco too. Good medical care may be more difficult to find in other cities and impossible to locate in rural areas.

Many doctors expect payment in cash, regardless of whether you have travel insurance. It can happen that you need to be evacuated to another city or country with better medical care. Since this may cost tens of thousands of dollars, be sure you have insurance to cover this before you depart.

The pharmacies in Peru are known as farmacias or boticas, and are identified by a green or red cross in the window. They’re generally reliable and offer most of the medications available in other countries. InkaFarma and Superfarma are two well-known pharmacy chains.

Dengue fever

This is a viral infection found throughout South America. Dengue is transmitted by mosquitoes, which usually bite during the daytime and are often found close to human habitations.

Dengue usually causes flulike symptoms, including fever, muscle aches, joint pains, headaches, nausea and vomiting, often followed by a rash. The body aches may be quite uncomfortable, but most cases resolve uneventfully in a few days.

There is no treatment for dengue fever except to take analgesics such as acetaminophen/paracetamol (Tylenol) and drink plenty of fluids, don't use aspirine or ascal.

Hepatitis A

Hepatitis A is a viral infection of the liver and is usually acquired by ingestion of contaminated water, food or ice, though it may also be acquired by direct contact with infected persons. Hepatitis A is the second most common travel-related infection (after travelers’ diarrhea). This disease occurs throughout the world, but the incidence is higher in developing countries. Symptoms may include fever, malaise, jaundice, nausea, vomiting and abdominal pain. Most cases resolve without complications, though hepatitis A occasionally causes severe liver damage. There is no treatment; to aid recovery, avoid alcohol and eat simple, nonfatty foods.

The vaccine for hepatitis A is extremely safe and highly effective. If you get a booster six to 12 months later, it lasts for at least 10 years. You really should get it before you go to Peru or any other developing nation.

Hepatitis B

Like hepatitis A, hepatitis B is a liver infection that occurs worldwide but is more common in developing nations. Unlike hepatitis A, the disease is usually acquired by sexual contact or by exposure to infected blood, generally through blood transfusions or contaminated needles. The vaccine is recommended only for long-term travelers (on the road more than six months) who expect to live in rural areas or have close physical contact with the local population. Additionally, the vaccine is recommended for anyone who anticipates sexual contact with the local inhabitants or a possible need for medical, dental or other treatments while abroad, including transfusions or vaccinations.

Hepatitis B vaccine is safe and highly effective. However, a total of three injections is necessary to establish full immunity.

HIV/AIDS

The Human Immunodeficiency Virus (HIV) may develop into Acquired Immune Deficiency Syndrome (AIDS; SIDA in Spanish). HIV/AIDS has been reported in all South American countries. Exposure to blood or blood products and bodily fluids may put an individual at risk. Be sure to use condoms for all sexual contacts.

Malaria

Cases of malaria occur in every South American country except Chile, Uruguay and the Falkland Islands. It’s transmitted by mosquito bites, usually between dusk and dawn. The main symptom is high fevers, which may be accompanied by chills, sweats, headache, body aches, weakness, vomiting or diarrhea. Severe cases may affect the central nervous system and lead to seizures, confusion, coma and death.

Taking malaria pills is strongly recommended for all areas in Peru except Lima and its vicinity, the coastal areas south of Lima, and the highland areas (including around Cuzco, Machu Picchu, Lake Titicaca and Arequipa). The number of cases of malaria has risen sharply in recent years. Most cases in Peru occur in Loreto in the country’s northeast, where malaria transmission has reached epidemic levels.

There is a choice of three malaria pills, all of which work about equally well. Mefloquine (Lariam) is taken once weekly in a dosage of 250mg, starting one to two weeks before arrival in an area where malaria is endemic, and continuing through the trip and for four weeks after returning. The problem is that some people develop neuropsychiatric side effects, which may range from mild to severe. Atovaquone/proguanil (Malarone) is a newly approved combination pill taken once daily with food starting two days before arrival, and continuing through the trip and for seven days after departure. Side effects are typically mild. Doxycycline is a third alternative, but may cause an exaggerated sunburn reaction.

In general, Malarone seems to cause fewer side effects than mefloquine and is becoming more popular. The chief disadvantage is that it has to be taken daily. For longer trips, it’s probably worth trying mefloquine; for shorter trips, Malarone will be the drug of choice for most people. None of the pills is 100% effective.

If you may not have access to medical care while traveling, you should bring along additional pills for emergency self-treatment, which you should take if you can’t reach a doctor and you develop symptoms that suggest malaria, such as high spiking fevers.

Ensure that you take precautions to minimize your chances of being bitten by mosquitoes by wearing clothers that cover your skin and by using a good insect repellent, preferably one containing DEET, which should be applied to exposed skin and clothing, but not to eyes, mouth, cuts, wounds or irritated skin.

Rabies

Rabies is a very dangerous viral infection of the brain and spinal cord and is almost always fatal unless treated promptly. The rabies virus is carried in the saliva of infected animals and is typically transmitted through an animal bite. Rabies occurs in all South American countries. In Peru, most cases are related to bites from dogs or vampire bats.

The rabies vaccine is safe, but the full serie requires three injections and is quite expensive. People who are at high risk for rabies, such as animal handlers and cave explorers, should certainly get the vaccine. In addition, those at lower risk for animal bites should also consider asking for the vaccine if they are going to travel to remote areas and might not have access to appropriate medical care if needed. When you get bitten by a possibly infected animal, you have to be treated with the rabies vaccine with rabies immune globulin. It’s effective, but must be given promptly.

All animal bites and scratches must immediately be cleaned very thoroughly with large amounts of soap and water, and local health authorities should be contacted to determine whether or not further treatment is necessary.

Tetanus

This potentially fatal disease is found in undeveloped tropical areas. It is difficult to treat, but it is preventable with immunization. Tetanus occurs when a wound becomes infected by a germ that lives in the feces of animals or people, so clean all cuts, punctures or animal bites.

Typhoid fever

This fever is caused by ingestion of food or water contaminated by a species of salmonella known as Salmonella typhi. Fever is one of the main symptoms. Other symptoms may include headache, malaise, muscle aches, dizziness, loss of appetite, nausea and abdominal pain. Either diarrhea or constipation may occur.

Unless you expect to take all your meals in good expensive hotels and restaurants, getting typhoid vaccine is a good idea. It’s usually given orally, but is also available as an injection.

Yellow fever

Yellow fever is a life-threatening, but rare tropical disease and is transmitted by mosquitoes in forested areas. The illness starts with flulike symptoms, which may include fever, chills, headache, muscle aches, backache, loss of appetite, nausea and vomiting. These symptoms usually subside in a few days, but one person in six enters a second, toxic phase. This phase is characterized by recurrent fever, vomiting, listlessness, jaundice, kidney failure and hemorrhage, leading to death in up to half of the cases. There is no treatment except for supportive care, that can slow down the progression of the disease.

Yellow-fever vaccine is strongly recommended for all people who visit any jungle areas of Peru at altitudes less than 2300m (7546ft). Most cases occur in the departments in the central jungle. Proof of vaccination is required from all travelers arriving in Peru from an area where yellow fever is endemic in Africa or America.

The yellow-fever vaccine should be given at least 10 days before entering the yellow fever area and it remains effective for about 10 years.

Travelers’ diarrhea

You can get diarrhea from taking contaminated food or water. If you develop diarrhea, you need to drink plenty of fluids, preferably an oral rehydration solution containing lots of salt and sugar. A few times of diarrhea don’t require treatment but if you start having more than four or five stools a day, you should start taking an antibiotic and an antidiarrheal agent. If diarrhea is bloody, persists for more than 72 hours or is accompanied by fever, shaking chills or severe abdominal pain you should seek medical advice from a doctor.

You can prevent attacks of diarrhea by drinking clean water from bottles or to clean your water with purification drops or by boiling it for a minute or three.

Also fruits and salads have to be washed with clean water. The best solution is to eat fried or cooked food and choose clean restaurants to eat.

Altitude sickness

Those who ascend rapidly to altitudes greater than 2500m (8100ft) may develop altitude sickness. Altitude sickness is caused by a lack of oxygen. You have to breath faster and this causes an decreased level of carbon dioxide in your blood. Your kidneys need some time to recover from this. Places where you can suffer from altitude sickness in Peru are Cuzco (3326m), Machu Picchu (about 2500m), and Lake Titicaca (3820m). Being physically fit offers no protection. The risk increases with faster ascents, higher altitudes and greater exertion. Symptoms may include headaches, nausea, vomiting, dizziness, malaise, insomnia and loss of appetite.

The best prevention for altitude sickness is taking 2 days for every ascending of 1000 meters. There are also tablets available against altitude sickness.

When traveling to high altitudes, it’s also important to avoid overexertion, eat light meals and abstain from alcohol. Altitude sickness should be taken seriously; it can be life threatening when severe.

Food

In Peru you have to be careful with food. Salads and fruit should be washed with clean water or peeled when possible. Ice cream is usually safe if it is a reputable brand name, but beware of ice cream that has maybe melted and been refrozen. Thoroughly cooked or fried food is safest. Shellfish such as mussels, oysters and clams should be avoided, as should undercooked meat, particularly in the form of minced or ground beef. Although eating this kind of food is rarely a problem, as long as it is served fresh in a reputable restaurant.

If a place and the vendors looks clean and healthy, the food is probably safe. In general, places that are packed with travelers or locals will be fine, while empty restaurants are risky.

Water

Tap water in Peru is not safe to drink. Boiling the water for one minute is the most effective means of water purification. At altitudes greater than 2000m (6500ft), you need to boil it for three minutes.

Another option is to use iodine or water purification pills.

 

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