Staying Healthy in Peru

Most Peru health planning comes down to two questions: how high you are going, and whether you will spend time in the Amazon. Our Peru trips often do both. Our travel consultants are not medical professionals and cannot give medical advice, so the guidance below comes from the US CDC and other official bodies. The CDC’s advice is to see your doctor or a travel clinic at least a month before your trip.

Before You Go: Vaccines and Medicines

The CDC’s Peru page asks every traveler to be up to date on routine vaccines, including measles (MMR). It recommends hepatitis A for unvaccinated travelers aged one and older and hepatitis B for unvaccinated travelers under 60, and suggests discussing typhoid and the rabies pre-exposure vaccine with your provider.

Yellow fever. According to the CDC, Peru does not require a yellow fever certificate at the border. Separately, the CDC recommends the vaccine for travelers aged 9 months and older going to Amazon areas below 7,550 ft (2,300 m), including Iquitos and Puerto Maldonado, but not for Lima, Cusco, the Inca Trail or Machu Picchu. The Pan American Health Organization advises vaccinating at least 10 days before visiting risk areas.

Malaria. The CDC lists malaria in all areas of Peru below 8,200 ft (2,500 m) east of the Andes, including Iquitos and Puerto Maldonado, the gateways to our Peruvian rainforest tours. For the Amazon it lists prescription prevention medicines to ask your doctor about; some start several days before travel.

Altitude in Cusco, Lake Titicaca and the Andes

Some travelers to Cusco experience altitude sickness. The CDC puts the city at about 11,150 ft (3,400 m); Lake Titicaca lies at about 12,500 ft (3,812 m), and the road to the Colca Canyon crosses a high plain at about 14,800 ft (4,500 m). Lower are Arequipa, about 7,640 ft (2,330 m), the Sacred Valley towns, about 9,160 to 9,420 ft (2,790 to 2,870 m), and Machu Picchu, about 7,970 ft (2,430 m).

The CDC’s advice is to avoid going from a low elevation to above 9,000 ft (2,750 m) in one day, to skip alcohol and heavy exercise for at least the first 48 hours, and to go lower if symptoms such as headache or nausea worsen while resting. Its Yellow Book adds that in Cusco travelers can sleep lower than the airport for a night or two, and names acetazolamide as the medicine to ask your doctor about.

In the words of Juergen Keller, our co-founder, “we try not to go to Cusco and to La Paz right away.” On The Essence of Peru the climb is gradual, through Arequipa, the Colca Canyon and Puno before Cusco. When a trip flies straight into Cusco, he prefers to “take them from the airport … down to the Sacred Valley first, to stay there overnight,” as on Machu Picchu & the Amazon Jungle.

He explains why Machu Picchu comes last: “So you have Cusco with a very high altitude, then lower you have the Sacred Valley with the hotels, and then below the Sacred Valley is Machu Picchu.” The highlight belongs at the end: “It’s like a good book. You build up the tension.”

Our blog article How to Avoid Altitude Sickness in Cusco covers the first days in the city. Coca tea, mate de coca, is a highland custom; the CDC Yellow Book notes no strong evidence that coca prevents altitude illness, and that it may cause a positive drug test for cocaine metabolites.

Mosquitoes, Ticks and Fresh Water

According to the CDC Yellow Book, dengue carries no risk at high-altitude destinations such as Cusco city. As of November 2026, the CDC has a Level 1 notice for dengue worldwide, and its Peru page reports more leptospirosis cases, especially in the north and the Amazon, advising travelers to avoid fresh, unchlorinated water such as lakes and rivers.

The CDC recommends EPA-registered insect repellents with DEET, picaridin, IR3535, oil of lemon eucalyptus, PMD or 2-undecanone. For ticks as well as mosquitoes, its Peru page suggests 20% DEET or more, with permethrin on clothing and gear rather than skin.

Food and Water

The US CDC’s general advice for travelers is to choose factory-sealed drinks wherever tap water might be contaminated, and to skip ice where clean water is a concern. In restaurants, bottled water usually arrives sealed and the server opens it in front of you. To order a drink without ice, ask for it “sin hielo.”

The CDC Yellow Book adds that raw dishes such as ceviche carry a risk of foodborne illness. More in our Peru food and drink guide.

Sun, Distance and Insurance

The CDC Yellow Book warns that short sun exposures in the highlands can cause sunburn, and that health care outside Lima is not as good, so complex problems may need evacuation. Read our Peru travel insurance page before you choose a policy.

Peru Health FAQ

What vaccines are recommended for Peru?

The CDC recommends routine vaccines and hepatitis A, plus hepatitis B for unvaccinated travelers under 60. It recommends yellow fever vaccine only for lowland Amazon areas.

Is there malaria at Machu Picchu?

The CDC lists no malaria in Cusco, Machu Picchu or Lake Titicaca, mainly in the Amazon below 8,200 ft (2,500 m).

Can you drink the water in Peru?

The US CDC’s general advice for travelers is to choose factory-sealed drinks wherever tap water might be contaminated, and to skip ice where clean water is a concern.

❗ A note from our team: we plan trips, we are not doctors. This page sums up what official health bodies such as the US CDC say about travel here. It is not medical advice, and official advice changes, so please check with your doctor or a travel clinic, ideally at least a month before you go.