Staying Healthy in South America

Which South America travel vaccinations and precautions your doctor suggests depends on your route. Cusco raises different questions from an Amazon lodge, a Galápagos boat or Patagonia, and many of our trips combine several of these. Below, from the US CDC and other official bodies, is how planning changes by trip, with a health page for each destination.

How health planning differs by trip

Altitude in the Andes

Cusco sits at about 11,150 ft (3,400 m), La Paz at about 12,000 ft (3,650 m), Quito at 9,350 ft (2,850 m) and Bogotá at about 8,660 ft (2,640 m). Lake Titicaca, on the border of Peru and Bolivia, lies at about 12,500 ft (3,810 m); see our Peru and Bolivia tours.

The CDC says travel above 8,000 ft can put you at risk of altitude illness. Its altitude guidance: avoid going from a low elevation to above 9,000 ft (2,750 m) in one day, skip alcohol and heavy exercise for the first 48 hours, and go lower if symptoms get worse while resting. It asks travelers with heart or lung disease, and pregnant travelers, to talk to a doctor first, and warns that diabetes may be harder to manage at high elevation. Some travelers ask their doctor about acetazolamide, which the CDC Yellow Book names.

Juergen Keller, our co-founder, likes travelers to start at intermediate altitudes, such as Arequipa, “and then go from there to the highlands of the Andes.” Our guide to avoiding altitude sickness in Cusco covers the first days there.

Jungle and lowlands

The Amazon, the Guianas, the Pantanal and Iguazú Falls bring a different list. The CDC recommends yellow fever vaccine for all four and lists malaria in parts of the Amazon and the Guianas. For Brazil, Peru and Venezuela, among others, it advises against swimming in fresh, unchlorinated water.

Boats and remote places

On a Galápagos cruise or an Antarctic voyage, the sea is the main question. The CDC Yellow Book says seasickness affects up to 25% of cruise travelers despite modern stabilizers, and that medicine works best taken before the motion starts, so ask your doctor before you sail. It adds that medical facilities on ships vary widely. The CDC suggests considering medical evacuation insurance; see our South America travel insurance page.

The temperate south

For Chile, Argentina, Uruguay and Patagonia, the CDC’s lists are short: according to the CDC, none of the three countries requires yellow fever vaccine for entry. Sun and wind matter more: the CDC recommends sunscreen of SPF 15 or higher and shade from 10 a.m. to 4 p.m. It also lists hantavirus, spread by rodents, for all three countries.

Yellow fever: entry rules and recommendations

Yellow fever raises two separate questions. An entry requirement is whether a country asks for a vaccination certificate, the yellow card, at the border, often only from travelers arriving from a country with yellow fever risk. A recommendation is where the CDC advises the vaccine for your own protection, usually by region and altitude. According to the CDC, Peru and Brazil ask for no certificate, yet it recommends the vaccine for Peru’s Amazon and most of Brazil.

Multi-country routes are where the certificate tends to come up. According to the CDC, Paraguay asks for proof from travelers aged one and older arriving from Bolivia, Brazil, Peru or Venezuela, and French Guiana asks it of every arriving traveler aged one and older. For Bolivia, the CDC lists proof for all arrivals aged one and older, while UK government sources describe a rule for arrivals from risk countries only. The CDC lists the same proof for Colombia, whose Ministry of Health treats it as a recommendation at entry. The CDC notes that entry rules change and that the certificate is valid from 10 days after vaccination, for life.

Check each country on your route with its embassy or consulate and the CDC’s destination pages. Our South America visa requirements page covers the rest of the paperwork, and our multi-country trips show which borders a route crosses.

Malaria and mosquitoes

The CDC lists malaria for lowland areas of Brazil, Peru, Bolivia, Ecuador, Colombia and Venezuela, and for parts of the Guianas, with the altitude line drawn differently in each country.

Dengue and Zika appear on the CDC’s pages for most of the countries on our routes, and the CDC notes that Zika can pass from a pregnant woman to her baby. Its bite guidance: an EPA-registered repellent with DEET, picaridin, IR3535, oil of lemon eucalyptus, PMD or 2-undecanone; long sleeves and long pants; permethrin-treated clothing, never on skin; and a mosquito net outdoors or where rooms are not screened.

Food and water

To reduce the chance of traveler’s diarrhea, the US CDC’s general advice is to choose factory-sealed drinks wherever tap water might be contaminated and to skip ice where clean water is a concern. In Spanish-speaking countries, to order a drink without ice, ask for it “sin hielo.” The CDC’s food advice also says to avoid fresh salads and other raw foods. More in our South America food and drink guide.

Health pages by destination

Frequently asked questions

What vaccinations do I need for South America?

The CDC lists routine vaccines, including measles, and hepatitis A and B for many unvaccinated travelers; yellow fever depends on where you go (see the table).

Is there malaria in South America?

According to the CDC, yes, in lowland areas of several countries and parts of the Guianas, but not in highland cities such as Cusco, La Paz, Quito or Bogotá.

How can I prevent malaria?

The CDC’s advice is to avoid mosquito bites and, where it recommends one, to take a prescription prevention medicine your doctor chooses.

Our travel consultants are not medical professionals and cannot give medical advice. The CDC advises seeing your doctor or a travel clinic at least a month before your trip; take your full itinerary. The regions and routes are in our South America travel guide.

❗ 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.