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 US 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 classified as upper middle income. Located in South America along the Pacific Ocean (north of Chile and south of Colombia), the climate is extremely diverse with classifications that range from dry (arid) to humid equatorial (no dry season), with cooler temperatures in some high-altitude areas.
Vaccinations
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 COVID-19, 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 US Centers for Disease Control (CDC):
WHO—International Travel and Health (current online update, Country List)
(2020) Malaria risk due to P. vivax (80%) and P. falciparum (20%) exists throughout the year in rural areas in inter-Andean valleys below 2500 m. Twelve departments in the country reported indigenous malaria cases; 90% of cases are concentrated in the department of Loreto and 16% of the total cases are due to P. falciparum from Loreto.- 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 Region: 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 2-24).- Drug resistance3 : Chloroquine.
- Malaria species: P. vivax 85%, P. falciparum 15%.
- Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4
3 Refers to P. falciparum malaria unless otherwise noted.
4 Primaquine and tafenoquine can cause hemolytic anemia in people with G6PD deficiency. Patients must be screened for G6PD deficiency before starting primaquine or tafenoquine. See Tafenoquine Approved for Malaria Prophylaxis and Treatment for more information.
Other Concerns
Travelers' Diarrhea
See also: Library article for Travelers' Diarrhea
High risk exists throughout the country, with moderate risk in deluxe accommodations. Community sanitation and food safety measures are generally inadequate. Some itineraries (e.g., remote destinations, austere accommodations) and activities (e.g., ecotourism, eating street or local-market food) further increase risk.
Travelers should observe food and beverage precautions, which 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, mayaro virus, Zika may pose a risk. Personal protective measures are important.
Other Disease and Health Risks
Additional concerns include air pollution, altitude illness, anthrax disease, hantavirus, helminths, leptospirosis, marine hazards, melioidosis, plague, schistosomiasis, sexually transmitted infections, snakebites, tuberculosis.
Consular Advice
The material below includes information from the US Department of State (DOS), the UK Foreign, Commonwealth & Development 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 crime, terrorism, and civil unrest, US (DOS) advises avoiding areas bordering Colombia in Loreto Region, the valley of the Apurímac, Ene, and Mantaro rivers (including areas within Ayacucho, Cusco, Huancavelica, and Junín regions), Puno Region (including the Peruvian side of Lake Titicaca), and Apurímac Region. Canada (GAC) and Australia (DFAT) have more limited warnings. UK (FCO) has no current warning.
States of emergency for crime prevention have been declared in some parts of Peru. Specific regions and highways may have an increased security presence. Travelers should avoid crowds, carry photo identification (ID) at all times, follow the advice of local authorities, and monitor the situation through local media.
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 assault) exists throughout the country, especially in Lima (including tourist areas of Miraflores and Barranco and on routes to and from the airport), Cusco, Arequipa, Huaraz (Ancash Region), and other cities; on river cruises in the Amazon jungle; along the Inca Trail.
High risk of petty crime exists throughout the country, especially in Lima, Cusco and other major cities, particularly on intercity buses, in bus stations, and in hotels, restaurants, and airports.
Express kidnappings to force cash withdrawals at ATMs may 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.
Risk exists of robberies and/or assaults occurring after consuming intentionally drugged food or drink; tourists are frequently targeted.
Civil Unrest
Protests and demonstrations frequently occur throughout the country (including in Cusco, Arequipa, Puerto Maldonado, Iquitos, Puno, and Machu Picchu Ruins) 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 Ecuador, Colombia, and Brazil. Landmines and other unexploded ordnance may exist in areas bordering Ecuador.
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 less than 10 in most high-income countries.
Speed laws are poorly enforced.
Seat belt laws are poorly enforced.
Drunk driving laws are poorly enforced.
Structural standards for vehicles may not meet international standards.
Airline Safety
The US 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.
