|
Yellow Fever
A vaccine certificate is needed for some jungle regions, such as
Puerto Maldonado.
All travelers should visit either their personal physician or a
travel health clinic
4-8 weeks before departure. This is to insure
that they are up to date with all necessary vaccinations and
that there is no health risk in traveling.
Malaria
Prophylaxis
with Lariam, Malarone, or doxycycline is recommended for all
areas except Lima and its vicinity, the coastal areas south of
Lima, the highland tourist areas (Cusco, Machu Picchu, and Lake
Titicaca), and the departments of Arequipa, Moquegua, Puno, and
Tacna.
Vaccinations
Hepatitis A
Recommended for all travelers
Typhoid
Recommended for all travelers
Yellow fever
Recommended for all travelers, except those visiting only Lima
and the coastal areas. Required for travelers arriving from a
yellow-fever-infected area in Africa or the Americas.
Hepatitis B
For travelers who may have intimate contact with local
residents, especially if visiting for more than 6 months
Rabies
For travelers who may have direct contact with animals and may
not have access to medical care
Routine immunizations
All travelers should be up-to-date on tetanus-diphtheria,
measles-mumps-rubella, polio, and varicella immunizations
Medications
Travelers' diarrhea
is the most common travel-related ailment. The cornerstone of
prevention is
food and water
precautions,
as outlined below. All travelers should bring along an
antibiotic and an antidiarrheal drug to be started promptly if
significant diarrhea occurs, defined as three or more loose
stools in an 8-hour period or five or more loose stools in a
24-hour period, especially if associated with nausea, vomiting,
cramps, fever or blood in the stool. A quinolone antibiotic is
usually prescribed: either
ciprofloxacin (Cipro)
500 mg twice daily or
levofloxacin (Levaquin)
500 mg once daily for a total of three days. Quinolones are
generally well-tolerated, but occasionally cause sun sensitivity
and should not be given to children, pregnant women, or anyone
with a history of quinolone allergy. Alternative regimens
include a three day course of
rifaximin (Xifaxan)
200 mg three times daily or
azithromycin (Zithromax)
500 mg once daily. Rifaximin should not be used by those with
fever or bloody stools and is not approved for pregnant women or
those under age 12. Azithromycin should be avoided in those
allergic to erythromycin or related antibiotics. An
antidiarrheal drug such as loperamide (Imodium) or diphenoxylate
(Lomotil) should be taken as needed to slow the frequency of
stools, but not enough to stop the bowel movements completely.
Diphenoxylate (Lomotil) and loperamide (Imodium) should not be
given to children under age two.
Most cases of
travelers' diarrhea are mild and do not require either
antibiotics or antidiarrheal drugs.
Adequate fluid intake
is essential.
If
diarrhea is severe or bloody, or if fever occurs with shaking
chills, or if abdominal pain becomes marked, or if diarrhea
persists for more than 72 hours, medical attention should be
sought.
Though
effective, antibiotics are not recommended prophylactically
(i.e. to prevent diarrhea before it occurs) because of the risk
of adverse effects, though this approach may be warranted in
special situations, such as immunocompromised travelers.
"HOME"
|
