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General Map

General map of Ecuador

Medical Summary

The health risk information presented here is summarized from Shoreland Travax®, a decision-support tool used by health care providers to perform a detailed health risk analysis based on specific locations, individual travel styles, and traveler risk behaviors. Travax provides practitioners current, independently researched malaria risk and prevention recommendations in a map-based format that goes beyond the annual WHO and CDC statements included here. Not included here are current reports from Travax of disease outbreaks or environmental events that may pose elevated risks to travelers’ health and safety. The Providers section of this site offers a directory of health care providers who utilize Shoreland Travax for travel health counseling. Learn more about the detailed reports and maps available from these practitioners (includes links to samples).

General Information

Ecuador is a developing nation but is in the upper half of the world's economies. Located along the equator on the west coast of South America, its climate is tropical along the coast and in jungle lowlands, and cooler inland at higher elevations.

Immunizations

Yellow Fever

See also: Library article for Yellow Fever

An official yellow fever vaccination certificate may be required depending on your itinerary. Vaccination is usually recommended if you’ll be traveling in areas where there is risk of yellow fever transmission.

  • Requirement: A vaccination certificate is required for travelers aged ≥ 1 year coming from countries with risk of YF transmission. Note: In practice, proof of YF vaccination is seldom if ever required for travelers coming from Peru despite Ecuador's published declaration to the contrary under the International Health Regulations.
  • Official Status: listed by WHO as a country where YF transmission risk is present.

Other Vaccines

Depending on your itinerary, your personal risk factors, and the length of your visit, your health care provider may offer you vaccination against hepatitis A, hepatitis B, influenza, measles, mumps, rubella, rabies, or typhoid fever. Routine immunizations, such as those that prevent tetanus/diphtheria or "childhood" diseases, should be reviewed and updated as needed.

Malaria

See also: Library article for Malaria

The following is current information as reported by the World Health Organization (WHO) and the U.S. Centers for Disease Control (CDC):

WHO—International Travel and Health (current online update, Country List)

(2017) Malaria risk – P. vivax (67%), P. falciparum (33%) – exists throughout the year below 1500 m, with moderate risk in coastal provinces. The risk is low in Quito and in provinces that are part of the Inter-Andean or Sierra region. The risk of P. vivax malaria is present in some provinces of the country, predominantly in the Amazon region, especially the provinces of Morona Santiago, Pastaza, Orellana and Sucumbíos. Malaria risk due to P. falciparum is present in some provinces of the country with predominance on the coast, especially the province of Esmeraldas as well as in the Amazon region, especially the provinces of Pastaza and Morano Santiago.
  • Recommended prevention in risk areas: C – Risk of P. falciparum malaria, in combination with reported chloroquine and sulfadoxine–pyrimethamine resistance. Mosquito bite prevention plus atovaquone–proguanil or doxycycline or mefloquine chemoprophylaxis (select according to reported side effects and contraindications) a
    aAlternatively, for travel to rural areas with low risk of malaria infection, mosquito bite prevention can be combined with stand–by emergency treatment (SBET).

WHO Country List footnote: When available, the date of the most recent update or confirmation is indicated in parentheses in the country list. If no date is indicated, the most recent update or confirmation was provided before 2013.

CDC—Health Information for International Travel (current online edition)

Areas with malaria: Areas at altitudes < 1,500 m (4,921 ft) in the provinces of Carchi, Esmeraldas, Morona Santiago, Orellana, and Pastaza. Rare cases in other provinces in areas < 1,500 m (4,921 ft). Not present in the cities of Guayaquil and Quito or the Galápagos Islands (see Map 3-26).
  • Estimated relative risk of malaria for US travelers: Very low.
  • Drug resistance4: Chloroquine
  • Malaria species: P. vivax 66%, P. falciparum 34%
  • Recommended chemoprophylaxis: Areas with malaria in Carchi, Esmeraldas, Morona Santiago, Orellana, and Pastaza Provinces: Atovaquone-proguanil, doxycycline, or mefloquine. Other areas with rare cases of malaria: Mosquito avoidance only.
    4 Refers to P. falciparum malaria unless otherwise noted.

Other Concerns

Travelers' Diarrhea

See also: Library article for Travelers' Diarrhea

High risk exists throughout the country, with moderate risk in deluxe accommodations. Food and beverage precautions may reduce the likelihood of illness.

Travelers should carry loperamide for self-treatment of diarrhea and, if risk is moderate to high, an antibiotic to add if diarrhea is severe. Consult a knowledgeable health care provider regarding which antibiotic is appropriate for you and most effective for your destination.

Insect- and Arthropod-Borne Diseases

Bartonellosis, Chagas' disease (American trypanosomiasis), chikungunya, dengue, leishmaniasis, Zika may pose a risk. Personal protective measures are important.

Other Disease and Health Risks

Additional concerns include air pollution, altitude illness, helminths, leptospirosis, marine hazards, plague, snakebites, tuberculosis.

Consular Advice

The material below includes information from the U.S. Department of State (DOS), U.K. Foreign & Commonwealth Office (FCO), Global Affairs Canada (GAC), and Australia's Department of Foreign Affairs and Trade (DFAT), as well as from additional open-source material. Standard safety precautions that apply to all international travel can be found in the Library article Safety and Security.

Consular Travel Advice

Due to drug trafficking and other ongoing security concerns, Canada (GAC) advises avoiding travel to areas bordering Colombia and Peru and advises reconsidering travel (or avoiding nonessential travel) to Montañita (Santa Elena Province). U.S. (DOS), U.K. (FCO), and Australia (DFAT) have more limited warnings.

Terrorism Risk

No intrinsic risk of attack by terrorist groups exists, but unforeseen attacks are possible.

Crime

High risk of violent crime (armed robbery and sexual assault) and petty crime exists throughout the country, especially in Quito (particularly in El Panecillo, Parque La Carolina, and the districts of La Mariscal, Guápulo, South Quito, and Old Town Quito), Guayaquil (particularly in Malecón 2000 boardwalk), and other cities and on volcano hiking trails, including Cerro Mandango near Vilcabamba, Loja Province.

Kidnappings by criminal groups occur in northern and northeastern areas bordering Colombia and Peru, including the Cuyabeno Wildlife Reserve. Targets may include foreigners (especially Westerners), including foreigners working for oil companies.

Express kidnappings to force cash withdrawals at ATMs occur throughout the country, especially in Quito and Guayaquil.

Scams involving ATMs, credit cards, and the use of distraction techniques to commit robbery (including squirting substances on victims) have been reported.

Civil Unrest

Protests and demonstrations frequently occur throughout the country and have the potential to turn violent without warning. Bystanders are at risk of harm from violence or from the response by authorities. Disruption to transportation, free movement, or the ability to carry out daily activities may occur.

Unsafe Areas

A dangerous security environment exists in areas bordering Colombia, including Cuyabeno Wildlife Reserve.

Piracy (involving commercial vessels) occurs in coastal waters.

Water Safety

Passenger boats may be unsafe on the Galápagos Islands. Decline water transportation in vessels that appear overloaded or lack personal flotation devices or life jackets.

Rent water sports equipment from reputable operators. Scuba dive only with personnel certified by PADI or NAUI, and use equipment only from PADI- or NAUI-certified dive operators.

Outdoor Safety

Basic safety standards for adventure activities (including bungee jumping, canopy tours, and recreational off-roading) may not be in place. Travelers should only use reputable adventure-sport operators for activities and equipment rentals.

Transportation Safety

High risk of traffic-related injury or death exists. The road-traffic death rate is 12 to 24 per 100,000 population. The rate is less than 10 in most high-income countries. Seek local advice before traveling on roads outside urban areas after dark. Driving at night is not advised.

Traffic flows on the right-hand side of the road. Travelers (including drivers and pedestrians) accustomed to traffic moving on the opposite side should be vigilant when navigating traffic.

Avoid public buses (especially in Guayaquil) due to safety and security concerns, including risk of armed robbery.

Many taxis are unsafe. Use taxis from official ranks or dispatched via smart phone app or radio from a reputable company and ascertain the license or identification number of the dispatched vehicle.

Airline Safety

U.S. Federal Aviation Administration has determined that the civil aviation authority of this country oversees its air carriers in accordance with minimum international safety standards.

Natural Disasters

The rainy season is from May through November in areas east of the Andes mountains and December through May in coastal areas. Floods, mudslides, and landslides may occur.

Seismic and volcanic activity frequently occur.

Consular Information

Selected Embassies or Consulates in Ecuador

  • United States: [+593] 2-398-5000; ec.usembassy.gov
  • Canada: [+593] 2-2455-499; www.ecuador.gc.ca
  • United Kingdom: [+593] 2-3972-200; www.gov.uk/world/organisations/british-embassy-in-ecuador
  • Australia: [+593] 4-601-7529

Ecuador's Embassies or Consulates in Selected Countries

  • In the U.S.: www.ecuador.org
  • In Canada: www.embassyecuador.ca
  • In the U.K.: reinounido.embajada.gob.ec
  • In Australia: australia.embajada.gob.ec

Visa/HIV Testing

HIV testing is not required to obtain a tourist, work, or residence visa.