Vaccination and Travel Information for Ecuador

ECUADOR

 Information current as at:  February 2009 by The D2 Medical centre No 1 Fitzwilliam Street Upper Dublin 2. The experts in travel vaccines Dublin 2.


Climate: Ecuador has four distinct geographical regions, each with a unique climate and environment. However, it is generally cooler than most people would expect in the equator, due to cold sea currents and the altitude in the Highlands.
The Coast's climate (e.g. Guayaquil) is warm with temperatures averaging 25 ° C to 31° C during the year. The rainy season (December to May) is warm and very humid. The dry season is less humid.
The climate on the Highlands varies according to the altitude; during the year, a subtropical climate prevails on the Andean valleys, at higher altitudes it is tempered spring like, at nights it is cold. In Quito the temperature ranges from 7 ° C at night, to 26 C° at noon.
The Amazon Region normally has a warm, humid and rainy climate. The average temperature varies from 23 - 26 ° C.
The Galapagos islands enjoy warm and dry weather, with an average yearly temperature of 28 degrees C.
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Quito ( temperature of 15-23 ° Celsius through the year, at an altitude of 2818 metres).
Capital City: Quito
Altitude: 2800 metres
Main Cities: Cuenca, Guayaquil
Population: 13,447,494 (July 2002 est.)
Land Area (sq km): 283,560
Currency: 1 US dollar = 100 cents
Languages: Spanish, Quechua
Religions: Roman Catholic
Economy: Oil, agriculture, silver, gold, bananas, shrimp, coffee, cocoa, fish

The D2 Medical advises all travellers to be 'up-to-date' for:

CHOLERA Immunisation is neither required nor recommended.
DIPHTHERIA We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.

HEPATITIS 'A' Immunisation is strongly recommended but not compulsory.


HEPATITIS 'B' Immunisation is strongly recommended for travellers who will be in the area for 1 month or more.
Transmission of Hepatitis B is through sex or contact with contaminated blood, needles and syringes.

POLIO Adults who are travelling to areas where poliomyelitis cases are occurring, or where the contracting the disease is possible, and who have received a primary series with either IPV or OPV should receive another dose of IPV before departure. For adults, available data do not indicate the need for more than a single lifetime booster dose with IPV.



RABIES Immunisation is recommended for travellers who will be in rural or remote areas for 1 month or more at a time.


TUBERCULOSIS (TB) Immunisation is not compulsory, and is not routinely recommended for adults.
Children should be immunised at any age.
A skin test is available if immune status is in doubt, and this is recommended pre- and post- travel for those going to ‘at risk’ regions.


TETANUS We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.

TYPHOID FEVER Immunisation is recommended for travellers who will be in rural or remote areas for 1 month or more at a time.


YELLOW FEVER A yellow fever vaccination certificate is required from travellers over 1 year of age coming from infected areas.


* World Health Organization:
The following countries and areas are regarded as Yellow Fever infected areas:

Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan (south of 15°N), Togo, Uganda, United Republic of Tanzania, Zambia.
America: Belize, Bolivia, Brazil, Colombia, Costa Rica, Ecuador, French Guiana, Guyana, Panama, Peru, Suriname, Trinidad and Tobago, Venezuela




Malaria risk, P. falciparum (57%), P. vivax (43%), exists throughout the year below 1500 metres, with some risk in Cotopaxi, Loja and Los Rios. Higher transmission risk is found in El Oro, Esmeraldas and Manabi. The risk is elevated in the northern lowlands on both sides of the Andes. Travellers visiting only Quito, the central highland tourist areas (including Cotopaxi volcano), Cuenca, Guayaquil city, or the Galapagos Islands are not at risk and do not require prophylaxis. In malarious areas, the risk is likely to be increased from February until August.
The coastal provinces of Esmeraldas, Guayas (including Guayaquil), and Manabi account for two-thirds of all officially reported malaria, followed by Los Rios, Pinchincha, and Napo Provinces. Other provinces with malaria include El Oro, Morona-Santiago, Pastaza, Sucumbios, and Zamora-Chinchipe. Countrywide, 65%–70% of malaria is vivax, 30% to 35% is falciparum, but falciparum causes up to 70% of malaria in Manabi Province. A high proportion of P. falciparum cases in Esmeraldas Province are reportedly resistant to chloroquine.

 

Warnings:

  • All travellers are advised to ask their health professional about the side-effects of the various medications, as problems may occur with balance/fine skills, heart disease, blood pressure pills, epilepsy, mental illness and pregnancy.
  • Not all medications are suitable for everybody, neither are any of the recommended medications 100%effective. Other mosquito preventative measures are recommended in association with any recommended medication (see below).

 

Self Treatment Regimes:

  • Travellers who develop fever should seek immediate medical help. If Malaria is confirmed then self-treatment regimes are available. Travellers may wish to discuss these with their health professional BEFORE they travel. They are best used in association with a firm diagnosis of malaria (which may be done either by a laboratory of with the aid of a ‘rapid diagnostic kit’).

 

General Advice on Mosquito Prevention.
Malaria is transmitted by mosquito bite, so recommend all travellers to the country to:

  • cover exposed skin after dusk when they are at most risk for getting bitten
  • use insect repellent with DEET in it.
  • return before dusk from country areas where malarial mosquitoes are the most active
  • sleep in screened room or use a bed net, remembering to tuck in the edges & spray inside.
  • sleep in air conditioned rooms or rooms with fans. Vapour pads and smoke coils also help. Insect buzzers are useless.

Malaria map of Ecuador




GENERAL
Medical care is available, but it varies in quality. Ambulances, with or without trained emergency staff, are in short supply. Medical care is adequate in major cities but varies in quality elsewhere. Medical facilities are limited. Doctors and hospitals often expect immediate cash payment for health services.

HEALTH, ACCIDENTS AND INSURANCE
Accidents and injuries are the leading cause of death among travellers under the age of 55. Most are caused by motor vehicle and motorcycle crashes; and to a lesser degree, drowning, aircraft crashes, murders, and burns.

Heart attacks cause most fatalities in older travellers, but infections cause only 1% of fatalities in overseas travellers. Generally, infections are the most common cause of travel-related illness.

Travellers are advised to obtain, before departure, travel health insurance with specific overseas coverage. The policy should include a medical evacuation benefit. Check for any exclusions that are part of the policy, and keep in mind that many insurance policies have terrorism exclusion clauses. The D2 Medical  recommends that the policy also provide 24-hour access to an assistance centre that can help arrange and monitor delivery of medical care, and determine if air ambulance services are required.
region, with little extreme exercise.

                                                                                                                                                       DR JOHN J RYAN MEDICAL DIRECTOR

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