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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
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.
Vaccinations
Routine vaccinations are essential due to a persistent rise of vaccine-preventable diseases (especially markedly high rates of diphtheria, pertussis, and measles) globally. Prior to travel, travelers should be up-to-date with the age-appropriate routine vaccinations recommended by their home country, which may include: COVID-19; H. influenzae type B (Hib); hepatitis A; hepatitis B; influenza; measles, mumps, rubella; meningococcal; pneumococcal; polio; rotavirus; tetanus, diphtheria, pertussis (Tdap preferred; consider an early pertussis booster for high-risk travelers); varicella.
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 certificate proving yellow fever vaccination 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.
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 chikungunya, mpox, rabies, or typhoid fever.
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)
(2021) 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.
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), dengue, leishmaniasis, mayaro virus, West Nile 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, avian influenza, helminths, leptospirosis, marine hazards, plague, sexually transmitted infections, snakebites, tuberculosis.
Safety and Security
See also: Library article for Safety and Security
Key Safety Risks
- Road conditions and traffic collisions
- Public transportation
- Maritime safety
- Petty crime
- Heightened crime risk for women
- Food and beverage spiking
- Theft of vehicles
- Scams
- Cybersecurity
- Natural disasters
Key Security Threats
- Risk of violent protests
- Cross-border threats in areas bordering Colombia
- Explosions in public places
- Landmines
- Violent crime
- Kidnapping, which may target foreign nationals
- Random acts of armed violence
- Piracy
Emergency Phone Number
The national emergency number is 911.
