Health Care in Lima

A yellow fever vaccination certificate is required of travellers over six months of age arriving from infected areas. Travellers arriving from non-endemic zones should note that vaccination is strongly recommended for travel to areas within the Amazon Basin, even if an outbreak has not been reported and they would normally not require a vaccination certificate to enter the country.

Immunisation against typhoid is advised, as the incidence of typhoid is very high. Falciparum malaria exists in all areas below 1500m and in the areas of Jaen, Lambayeque, Loreto, Luciano Castillo, Piura, San Martin, Tumbes and Ucayali. All health centres, which are controlled by the Ministry of Health, will provide free information and medication to anyone entering a high risk area.

Food and drink
Drink only bottled water. Pasteurised milk is widely available. Avoid dairy products that are likely to have been made from unboiled milk. Avoid street food vendors and the cheaper restaurants. Only eat well-cooked meat and fish, preferably served hot. Pork, salad and mayonnaise may carry increased risk. Vegetables should be cooked and fruit peeled. Always check the expiry date of processed food.

Other risks
Hepatitis A occurs, and hepatitis B and D are a risk in the Amazon Basin. Dengue fever outbreaks are common in the Amazon Basin. In April 2005, there were reported cases of Dengue fever in the northern outskirts of Lima, isolated parts of the jungle provinces of Loreto, San Martin and Ucayali and in the northern coastal area between Tumbes and La Libertad. The incidence of typhoid fever is very high.

Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. For more information, consult the Health appendix.
Altitude sickness can be a problem if visiting the highlands. Visitors should take time to acclimatise and avoid doing too much strenuous exercise on the day or arrival.

Insect bites may be a problem in the jungle and the highlands. Insect repellent and long layers for the evening are recommended. Malaria is prevalent in northern parts of Peru and in Iquitos (Amazon) particularly, where there is risk of flooding during the Peruvian summer months of November to April.

Healthcare

Following WHO guidelines issued in 1973, a cholera vaccination certificate is no longer a condition of entry to Peru. However, autochthonous cases of cholera were reported in 1996. Up-to-date advice should be sought before deciding whether these precautions should include vaccination as medical opinion is divided over its effectiveness; see the Health appendix for more information.

International travellers are strongly advised to take out full health insurance and should be prepared to pay up front for medical services.