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).
Ecuador is a developing nation classified as upper middle income. Located in western South America along the Pacific Ocean (north of Peru and south of Colombia), the climate is classified as humid equatorial (long dry season) along the southern coast and humid equatorial (no dry season) along the northern coast, with cooler temperatures inland in some high-altitude areas.
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 Brazil, Democratic Republic of the Congo, and Uganda. This also applies to airport transit stops (no exit through immigration checkpoint) longer than 12 hours in these countries.
- Official Status: listed by WHO as a country where YF transmission risk is present.
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.
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)(2019) Malaria risk due to P. vivax (67%) and P. falciparum (33%) exists throughout the year below 1500 m, with moderate risk in coastal provinces. Risk is low in Quito and in provinces that are part of the Inter-Andean or Sierra region. 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. Risk of P. falciparum malaria 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 2-12).
- Drug resistance3 : Chloroquine.
- Malaria species: P. vivax 72%, P. falciparum 28%.
- Recommended chemoprophylaxis: Areas with malaria in Carchi, Esmeraldas, Morona Santiago, Orellana, and Pastaza Provinces: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine.4 Other areas with rare cases of malaria: None (practice mosquito avoidance).
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.
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
Other Disease and Health Risks
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 civil unrest and other ongoing security concerns, U.S. (DOS) advises avoiding travel to Azuay, Bolívar, Carchi, Chimborazo, Cotopaxi, Esmeraldas (northern areas), Guayas (including Guayaquil), Imbabura, Loja, Los Ríos, Manabí, Pichincha (including Quito), Sucumbíos, and Tungurahua provinces and advises avoiding travel within and between cities and provinces. U.K. (FCO), Canada (GAC), and Australia (DFAT) have more limited warnings.
No intrinsic risk of attack by terrorist groups exists, but unforeseen attacks are possible.
High risk of violent crime (armed robbery and sexual assault) and high risk of petty crime exist throughout the country, especially in Quito (particularly in El Panecillo, El Ejido, and La Carolina parks and the districts of La Mariscal, La Floresta, La Marin, Guápulo, South Quito, and Old Town Quito); in Guayaquil (in the districts of Urdesa, Kennedy, Alborada, and Malecón Simón Bolívar [including Cerro Santa Ana]; near the bus terminal, the downtown and market areas, and the Sagrado Corazón de Jesús [statue of Jesus Christ] on Cerro del Carmen); in other cities (Cuenca, Manta, and Riobamba); on volcano hiking trails (including Cerro Mandango near Vilcabamba, Loja Province, the Pichincha volcano, and the volcano outside the limits of the Quito TelefériQo or its pathway); in Montañita (Santa Elena Province); on beaches in the province of Esmeraldas; in jungle lodges in the Lower Rio Napo and Cuyabeno Wildlife Reserve.
Theft of valuables from unattended accommodations is common.
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.
Risk exists of robberies and/or assaults occurring after consuming intentionally drugged food or drink; tourists are frequently targeted.
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.
A dangerous security environment exists in areas bordering Colombia, including Cuyabeno Wildlife Reserve.
Piracy (involving commercial vessels) occurs in coastal waters.
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.
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.
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.
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.
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.
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
HIV testing is not required to obtain a tourist, work, or residence visa.