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).
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.
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.
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)(2018) Malaria risk due to P. vivax (84%) and P. falciparum (16%) exists throughout the year in rural areas in inter- Andean valleys below 2300 m 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.
- 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.
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
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 drug trafficking, the presence of armed groups, and other ongoing security concerns, Canada (GAC) advises reconsidering travel (or avoiding nonessential travel) to areas bordering Colombia and Ecuador and to Kimbiri, Pichari, and Vilcabamba districts (the city of Cusco and Machu Picchu are not affected; Cusco Region); Huallaga and Tocache provinces (San Martín Region); the Upper Huallaga and Ene river valleys in Huánuco and San Martín regions; Padre Abad province (Ucayali Region); Huacaybamba, Huamalíes, Leoncio Prado, and Marañón provinces (Huánuco Region); Concepción and Satipo provinces (Junín Region); Tayacaja province (Huancavelica Region); Abancay, Andahuaylas, and Chincheros districts (Apurímac Region); Huanta and La Mar provinces (Ayacucho Region); the valley of Apurímac, Ene, and Mantaro rivers. U.S. (DOS) and Australia (DFAT) have more limited warnings. U.K. (FCO) has no current warning.
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.
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.
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.
Landmines and other unexploded ordnance may exist in areas bordering Ecuador.
Piracy (involving private, leisure vessels) occurs along the Amazon River.
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.
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.
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. 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.
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 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.
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
HIV testing is not required to obtain a tourist, work, or residence visa.