Vaccination and Travel Information for Peru

PERU

 Information current as at:  February 2009 by The D2 medical centre No1 Fitzwilliam Street Upper Dublin 2 ph 6314500. The experts in travel vaccines Dublin 2.  


Climate: Varies according to area. On the coast winter lasts from June to September. During this period, the mountainous areas are often sunny during the day but cold at night. Heavy rains in the mountains and jungle last from December to April. It never rains in Lima nor most of the coast, except for Tumbes and Piura, which have tropical climates.

Lima: 15-20 ° Celsius in the winter and 20-30 ° Celsius in summer.
Capital City: Lima
Altitude: 90 Metres above sea level
Main Cities: Arequipa, Chiclayo, Cusco, Iquitos, Lambayeque, Trujillo
Population: 27,949,639 (July 2002 est.)
Land Area (sq km): 1,285,220
Currency: 1 nuevo sol = 100 céntimos
Languages: Spanish, Quechua, Aymará
Religions: Roman Catholic
Economy: Cotton, sugar, timber, gold, petroleum, agriculture


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

CHOLERA Immunisation is neither required or 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 strongly recommended.


YELLOW FEVER Yellow fever vaccination is required from travellers over 6 months of age coming from infected areas and is recommended for those who intend to visit jungle areas of the country below 2300 m.

* 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.




There is no risk of malaria in the urban center of Lima, the coastal areas south of Lima, or the highland tourist areas of Cuzco, Machu Picchu, and Lake Titacaca. Malaria occurs in year-round in rural areas below 1,500 meters (4900 feet) elevation in eastern, northeastern, and northwestern Peru, especially along the border with Ecuador. The highest risk of malaria occurs in Piura Department. Malaria risk, P. vivax (69%), P. falciparum (31%), is high in 21 of the 33 sanitary regions, including Ayacucho, Cajamarca, Cerro de Pasco, Chachapoyas, Chanca-Andahuaylas, Cutervo, Cusco, Huancavelica, Jaen, Junín, La Libertad, Lambayeque, Loreto, Madre de Dios, Piura, San Martín, Tumbes and Ucayali. P. falciparum transmission reported in Jaen, Lambayeque, Loreto, Luciano Castillo, Piura, San Martín, Tumbes and Ucayali. Resistance to chloroquine and sulfadoxine–pyrimethamine reported.

AMAZONAS: Significant risk exists in the Amazon region and its tributaries, except there is no risk in the central urban area of Iquitos City. Malaria infection rates may exceed 25% in some areas of the north-eastern lowlands (Loreto Department). Risk areas, in particular, include rural areas of the Departments of Amazonas, Cajamarca (except Hualgayoc Province), La Libertad (except Otuzco, Santiago de Chuco Provinces), Lambayeque, Loreto, Piura (except Talara Province), San Martin and Tumbes, Provinces of Santa (Ancash Dept.); parts of La Convension (Cuzco Dept.), Tayacaja (Huancavelica Dept.), Satipo (Junin Dept.). Chloroquine-resistant P. falciparum is endemic in the regions bordering Brazil.

There are five common medications for malaria prevention available in Ireland . They are: chloroquine, doxycycline, malarone, mefloquine, paludrine. To determine the appropriate antimalarial, it is advised that the traveller discuss this with a D2 Travellers Health Specialist or other Travel Health Professional. None of the medicines are 100% effective against the disease at all times, and each has its own side effects. These need to be discussed with the intending traveller.

 

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 Peru




GENERAL
Medical care is generally good in Lima and usually adequate in other major cities, but it is less so elsewhere. Urban private health care facilities are often better staffed and equipped than public or rural ones. Public hospital facilities in Cusco, the prime tourist destination, are generally inadequate to handle serious medical conditions. One private facility in Cusco is adequate for acute care. Doctors and hospitals often expect immediate cash payment for health services. Comprehensive travel and medical insurance is recommended.

Uninsured travellers who require medical care overseas often face extreme difficulties, whereas travellers who have purchased overseas medical insurance have found it to be life-saving when a medical emergency has occurred.

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.

 

Yellow Fever Map

                                                                                                                                                                              DR JOHN J RYAN MEDICAL DIRECTOR

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