Health Tips You Should Know Before Travel In Peru

Are you planning a trip to Peru? Before you hike the Inca Trail to Machu Picchu, kayak the Amazon River, or eat ceviche in Lima, you’ll want to be prepared for a variety of health risks. Take it from someone who suffered through food poisoning, altitude sickness, and painful mosquito bites that you want to be prepared for the worst to have the best experience traveling in South America.

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Vaccinations You Should Get Before Traveling In Peru

First, I could not stress enough to you the importance of making sure your vaccinations are up to date before traveling abroad. Major vaccines include Dtap (tetanus), Polio, and MMR. If you are an American, you likely received these as a child, but you may be due for a booster shot.

Recommended vaccines for traveling abroad also often include Hepatitis A and B, Meningitis (often required now before attending American universities, for those of you studying abroad), and the flu shot. If you are not sure if your vaccinations are up to date, you can ask your doctor to run a test to find out.

Americans: To make sure you are getting the correct vaccinations for the areas you’ll be visiting and the activities you plan to do, you should check the CDC website and make an appointment with your travel doctor.

Recommended Vaccine For Travel In Peru: Typhoid

Most importantly for Peru, you should get a typhoid fever vaccine. The Centers for Disease Control and Prevention advises this for most travelers because it’s possible to contract typhoid through contaminated food and drink in Peru. In particular, the typhoid vaccine is recommended if you plan to visit small and rural towns, eat home cooked meals, or are an adventurous foodie.

Before traveling to Peru, I visited a travel doctor’s office, and the typhoid vaccine was available as a shot or an oral vaccine. I opted for the oral typhoid vaccine because it was less expensive than the shot and was good for five years, whereas the shot only covered three years.

Possibly Recommended Vaccine For Travel In Peru: Yellow Fever

Depending on where you’ll be traveling in Peru, you may also need a Yellow Fever vaccine. If you get the shot, ask your doctor for a certificate of vaccination. Mine is a yellow form issued by the World Health Organization. If you are Australian, I heard from several of my Aussie travel companions in Peru that they need to show the Yellow Fever certificate in Australia to return home. Check with your travel doctor and country’s requirements to be sure. As of September 2019, the CDC is reporting a limited supply of yellow fever vaccines available in the United States.

Machu Picchu in Peru

Malaria & Mosquitoes

The nurse I met with at my travel doctor’s office highly recommended taking malaria pills. Though I was assured malaria would not be an issue in Lima, I wasn’t sure every other small city I was visiting during the latter half of my trip was free of malaria. However, I’ve since learned the CDC mostly recommends malaria medication to travelers visiting the Amazon, such as the cities of Iquitos and Puerto Maldonado and the eastern regions of La Libertad. Malaria medication is also recommend for visiting the Lambayeque region in northern Peru.

I was advised to start taking one pill with dinner beginning two days before traveling and continue taking it daily through seven days after I returned from my trip. For my 21-day trip, I was prescribed 31 pills for a whopping $178. Though that is a rather steep charge for medication, I tend to err on the side of caution. Always a Girl Scout, I’d rather be over prepared than risk getting an infectious disease.

With that said, once I arrived in Peru, I realized that I only needed mosquito protection and malaria pills for the Sacred Valley and Machu Picchu. My trip did not involve the Amazon, but if you plan to travel there, your doctor will likely prescribe malaria pills and recommend DEET bug spray.

The mosquitoes at Machu Picchu are intense. As I sit in the Lima airport, just one day after visiting the lost city of the Incas, the area from my ankles to my lower calf, where my workout capris stop, is covered in red splotches of mosquito bites that absolutely throbbed last night and are just starting to itch. These bites are nothing like the North American mosquitoes’ bites. Honestly, my legs are looking a bit scary right now. Seriously, I could not recommend using this mosquito repellant and wearing long pants and sleeves enough. If there is ever a time to use DEET, it is at Machu Picchu.

Is Zika Virus A Threat In Peru?

(Updated September 2019) Cases of the Zika Virus have been reported in Peru, and the CDC doesn’t have up-to-date information about the current risk level. However, there is a lower likelihood of contracting Zika in high-elevation areas, such as in the Andes. The CDC recommends pregnant women, partners of pregnant women, and couples planning pregnancy discuss Zika prevention and possible consequences with their health care provider prior to traveling to Peru. Zika can cause serious birth defects, so the CDC recommends couples take extra precautions such as using condoms to prevent sexually transmitting the virus. For more information about Zika in Peru, please refer to the CDC Alert as information may change before I update this post again.

Machu Picchu in Peru

Altitude Sickness

Altitude sickness is a difficult ailment to avoid when traveling at a fast pace in mountainous areas. If you can, hydrate as much as possible before reaching a high elevation. Otherwise you might feel as tired and uncomfortable as I did in Puno. Do not assume that you will be OK because you never experienced altitude sickness in other destinations at high elevation beforehand. Half of my travel group missed out on dinner in Puno because we were struggling with the altitude. Personally, I’ve never had an issue with altitude sickness when traveling in the Alps or Rockies, but I certainly did in the Andes.

What does altitude sickness feel like?

It really depends. My symptoms changed throughout the day, but the worst aspects for me were a headache that no amount of ibuprofen could relieve (especially in the mornings) and gas/slow digestion that constantly made me feel uncomfortable. Due to that bloated feeling, I was unable to drink the recommended amount of water for high altitudes, which only exacerbated the problem. I also experienced fatigue/sleepiness, interrupted/restless sleep, mild dizziness, and a bloody nose (not like getting hit in the face, but a little blood when I had to blow my nose.)

According to the Cleveland Clinic, altitude sickness symptoms could include dizziness, fatigue, shortness of breath, loss of appetite, sleep problems and a general loss of energy. Generally, these symptoms occur within 12 to 24 hours of arriving at a high elevation, but they will lessen within one to two days as the body adjusts to the altitude. However, if your symptoms are more severe, getting back to a lower elevation may be your best option.

How do you treat or prevent altitude sickness?

  • Hydrate – The locals recommend at least 1 liter of water per 1,000 meters elevation
  • Coca – Locals chew coca leaves or drink coca tea for energy and to aid digestion
  • Give yourself time to adjust to higher altitudes before extreme activities like hiking. For example, spend a day or two in Cusco before hiking the Inca trail or visiting Machu Picchu.

Coca Tea in Peru

Traveler’s Diarrhea/Food Poisoning

If you don’t want to miss out on any once-in-a-lifetime experiences in Peru, like I did when I missed white water rafting in the Sacred Valley, travel with anti-diarrheal medication and an antibiotic.

Which medications should you take if you get traveler’s diarrhea/food poisoning?

  • Ciprofloxacin – Before you travel to Peru, ask your doctor for a prescription for this antibiotic. It may be completely covered by your health insurance if you are an American. You can also buy this over the counter at pharmacies in Peru, but — trust me from personal experience — it would be best to have it on hand in case of emergencies.
  • Pepto Bismol – Yes, it is pink and gross, but this over-the-counter medication is a traveling eater’s best friend. Not only does it slow digestion, it also alleviates most upset stomach ailments foreign travelers are too embarrassed or too lacking in vocabulary to accurately describe to a pharmacist. I recommend the pills or chew tablets instead of the liquid.

Which foods/drinks should you avoid in Peru?

  • Fruits without skins – Any fruit with a tough peel like a banana, melon or orange is probably OK, but beware of fruits with thin to no skin like strawberries. Instead try local fruits like granadilla or chirimoya from an open-air market.
  • Salads washed in local water – Vegetables are safest when cooked thoroughly. If you want a salad, be sure to ask how the vegetables are washed. In nice restaurants that serve a high volume of tourists, you may be safe ordering a salad. If you are worried about this, stick to potatoes — Peruvians eat 3,000 varieties.
  • Raw meat – If you want to fully enjoy the culinary scene of Lima, South America’s culinary capital, you’ll want to try the ceviche made with raw seafood. The citric acid actually cooks the fish, so just stir your dish really well before eating to ensure the acid has killed all the bacteria.
  • Tap water – Order “agua sin gas” for flat water or “agua con gas” for mineral water at restaurants. I wet my toothbrush with the local water, but you should not drink the tap water due to the bacteria in it. Even the locals boil the water they drink.
  • Ice – Ensure the ice is made from boiled or bottled water before asking for it in a drink. If you aren’t sure, just drink your beverage warm like most drinks in Peru are served.
  • Mayonnaise – This is likely what gave me food poisoning in Peru, so I obviously recommend avoiding it.
  • Street Food – As a foodie, I know this is extremely tempting, and I’ll admit I indulged a couple times myself. However, you never really know the precautions these vendors have taken, so tourists are safest eating at restaurants.

Ceviche in Lima, Peru

Medications And Health Items You Should Pack For Peru

Travelers and locals walk down a street in Cusco, Peru.

Are you planning a trip to Peru?

If you are traveling to Peru, below are some of my favorite resources for your trip.

Peru Guidebooks: Lonely Planet Peru | Frommer’s EasyGuide to Lima, Cusco and Machu Picchu | Lonely Planet Best of Peru

Travel Insurance: World Nomads

Researching Hotels: Lima | Cusco | Aguas Calientes (Machu Picchu) | Sacred Valley | Arequipa | Puno | Peru

Group Tours: Contiki Peru Panorama | Contiki Inca Panorama | Contiki Peru Uncovered

Booking.com

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How to prepare for health risks in Peru

Do you feel prepared for visiting Peru? Would you add any other medications or health-related products to this packing list?