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General map of Peru

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

Peru is a developing nation but is in the upper half of the world's economies. Located between Ecuador and Bolivia on the Pacific Ocean, its climate varies from tropical in the east to dry desert in the west, and temperate to frigid in the Andes. The dusty, dry climate in non-jungle areas may affect persons with allergies, bronchitis, or sinusitis.

Immunizations

Yellow Fever

See also: Library article for Yellow Fever

Vaccination is usually recommended if you’ll be traveling in areas where there is risk of yellow fever transmission.

  • Requirement: no requirement for any traveler.
  • 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 (84%), P. falciparum (16%) – exists throughout the year in rural areas in inter-Andean valleys at altitudes below 2300 m and in and in the high and low Amazonian jungle regions. The 45 highest-risk districts where the largest number of cases are concentrated are in the regions of Amazonas, Junin, San Martin and principally Loreto. Ninety-eight percent of P. falciparum cases are reported from Loreto, which is situated in the Amazon and contains 14 of the highest-risk districts in the country. P. falciparum resistance to chloroquine and sulfadoxinepyrimethanine (Fansidar) has been reported in Peru since 2000.
  • Recommended prevention in risk areas: B in P. vivax risk areas – Risk of P. vivax malaria only. Mosquito bite prevention plus chloroquine chemoprophylaxisa
  • Recommended prevention in Loreto Department: 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: All departments < 2,000 m (6,562 ft), including the cities of Iquitos and Puerto Maldonado and only the remote eastern regions of La Libertad and Lambayeque. None in the following areas: Lima Province; the cities of Arequipa, Ica, Moquegua, Nazca, Puno, and Tacna; the highland tourist areas (Cusco, Machu Picchu, and Lake Titicaca); and along the Pacific Coast (see Map 3-37).
  • Estimated relative risk of malaria for US travelers: Moderate.
  • Drug resistance4: Chloroquine
  • Malaria species: P. vivax 85%, P. falciparum 15%.
  • Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, or mefloquine.
    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.

Other Food-Borne Illnesses

Precautions to prevent brucellosis may be needed.

Insect- and Arthropod-Borne Diseases

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

Other Disease and Health Risks

Additional concerns include air pollution, altitude illness, hantavirus, leptospirosis, marine hazards, plague and 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, the presence of armed groups, and other ongoing security concerns, Australia (DFAT) advises avoiding travel to areas bordering Colombia and advises reconsidering travel (or avoiding nonessential travel) to areas bordering Ecuador (Loreto, Amazonas, and Cajamarca regions). U.S. (DOS) and Canada (GAC) have more limited warnings. U.K. (FCO) has no current warning.

Terrorism Risk

Risk of attack by domestic terrorist groups exists in rural or remote areas of Apurímac, Ayacucho, Cusco, Huánuco (including the upper Huallaga river valley), Junín, and San Martín regions. Targets may include domestic and international organizations and businesses.

Crime

High risk of violent crime (armed robbery, sexual assault, carjacking, and murder) and petty crime exists throughout the country, especially in Lima, Cusco (particularly in San Blas neighborhood), Arequipa, and other cities.

Kidnappings by criminal groups may occur in Ayacucho, Cusco, Huánaco, and Junín departments. Targets may include foreigners (especially Westerners).

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

Scams involving counterfeit currency, credit cards, extortion, and false identity (such as criminals posing as police officers or taxi drivers) have been reported.

Civil Unrest

Protests and demonstrations frequently occur throughout the country, especially in the southern cities of Puno (Puno Region) and Arequipa (Arequipa Region), 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 (including train service to Machu Picchu), free movement, or the ability to carry out daily activities may occur.

Unsafe Areas

Landmines and other unexploded ordnance may exist in areas bordering Ecuador.

Piracy (involving private, leisure vessels) occurs along the Amazon River.

Water Safety

Basic safety standards for recreational water activities (including scuba diving and rafting) are often not in place. 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 recreational off-roading in Ica and Huacachina, Ica Region and all activities in Cusco Region) are often not 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 < 10 in most high-income countries. Speed laws are poorly enforced. Driving at night is not advised. Seek local advice before traveling on roads outside urban areas after dark.

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

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.

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 November through May in areas east of the Andes mountains. Floods, mudslides, and landslides may occur.

Seismic and volcanic activity frequently occur, especially in southern areas.

Consular Information

Selected Embassies or Consulates in Peru

  • United States: [+51] 1-618-2000; pe.usembassy.gov
  • Canada: [+51] 1-319-3200; www.peru.gc.ca
  • United Kingdom: [+51] 1-617-3000; www.gov.uk/world/organisations/british-embassy-peru
  • Australia: [+51] 1-630-0500; peru.embassy.gov.au

Peru's Embassies or Consulates in Selected Countries

  • In the U.S.: www.embassyofperu.org
  • In Canada: www.embassyofperu.ca
  • In the U.K.: www.peruembassy-uk.com
  • In Australia: www.embaperu.org.au

Visa/HIV Testing

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