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Peru

Capital City : "Lima"

Official Language: "Spanish, Quechua (locally), Aymara (locally)"
Monetary Unit: "nuevo sol (S/.)"

General information

The information on these pages should be used to research health risks and to inform the pre-travel
consultation. For advice regarding safety and security please check the UK Foreign and
Commonwealth Office (FCO) website.

Travellers should ideally arrange an appointment with their health professional at least four to six
weeks before travel. However, even if time is short, an appointment is still worthwhile. This
appointment provides an opportunity to assess health risks taking into account a number of factors
including destination, medical history, and planned activities. For those with pre-existing health
problems, an earlier appointment is recommended.

All travellers should ensure they have adequate travel health insurance.

A list of useful resources including advice on how to reduce the risk of certain health problems is
available below.

Resources
Food and water hygiene
Insect and tick bite avoidance
Personal safety
Sexually transmitted infections

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Sun protection

Vaccine recommendations

Details of vaccination recommendations and requirements are provided below.

All Travellers
Travellers should be up to date with routine vaccination courses and boosters as recommended in
the UK. These vaccinations include for example measles-mumps-rubella (MMR)
vaccine and diphtheria-tetanus-polio vaccine.

Those who may be at increased risk of an infectious disease due to their work, lifestyle choice,
or certain underlying health problems should be up to date with additional recommended vaccines.
See the individual chapters of the ‘Green Book’ Immunisation against infectious disease for further
details.

Certificate Requirements
There are no certificate requirements under International Health Regulations.

There is a risk of yellow fever transmission in parts of Peru (see ‘Some Travellers’ section
below).

Most Travellers
The vaccines in this section are recommended for most travellers visiting this country. Information
on these vaccines can be found by clicking on the blue arrow. Vaccines are listed alphabetically.

Hepatitis A
Hepatitis A is a viral infection transmitted through contaminated food and water or by direct contact
with an infectious person. Symptoms are often mild or absent in young children, but the disease
becomes more serious with advancing age. Recovery can vary from weeks to months. Following
hepatitis A illness immunity is lifelong.

Those at increased risk include travellers visiting friends and relatives, long-stay travellers, and
those visiting areas of poor sanitation.

Prevention
All travellers should take care with personal, food and water hygiene.

Hepatitis A vaccination

As hepatitis A vaccine is well tolerated and affords long-lasting protection, it is recommended for all
previously unvaccinated travellers.

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Hepatitis A in brief

Tetanus
Tetanus is caused by a toxin released from Clostridium tetani and occurs worldwide. Tetanus
bacteria are present in soil and manure and may be introduced through open wounds such as a
puncture wound, burn or scratch.

Prevention
Travellers should thoroughly clean all wounds and seek appropriate medical attention.

Tetanus vaccination
Travellers should have completed a primary vaccination course according to the UK
schedule.
If travelling to a country where medical facilities may be limited, a booster dose of a tetanus-
containing vaccine is recommended if the last dose was more than ten years ago even if
five doses of vaccine have been given previously.

Country specific information on medical facilities may be found in the ‘health’ section of the FCO
foreign travel advice website.

Tetanus in brief

Some Travellers
The vaccines in this section are recommended for some travellers visiting this country. Information
on when these vaccines should be considered can be found by clicking on the arrow. Vaccines are
listed alphabetically.

Hepatitis B
Hepatitis B is a viral infection; it is transmitted by exposure to infected blood or body fluids. This
mostly occurs during sexual contact or as a result of blood-to-blood contact (for example from
contaminated equipment during medical and dental procedures, tattooing or body piercing
procedures, and sharing of intravenous needles). Mothers with the virus can also transmit the
infection to their baby during childbirth.

Hepatitis B in Peru

2% or more of the population are known or thought to be persistently infected with the hepatitis B
virus (intermediate/high prevalence).

Prevention

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Travellers should avoid contact with blood or body fluids. This includes:

avoiding unprotected sexual intercourse.

avoiding tattooing, piercing, public shaving, and acupuncture (unless sterile equipment is
used).
not sharing needles or other injection equipment.
following universal precautions if working in a medical/dental/high risk setting.

A sterile medical equipment kit may be helpful when travelling to resource poor areas.

Hepatitis B vaccination

Vaccination could be considered for all travellers, and is recommended for those whose activities or
medical history put them at increased risk including:

those who may have unprotected sex.

those who may be exposed to contaminated needles through injecting drug use.
those who may be exposed to blood or body fluids through their work (e.g. health workers).
those who may be exposed to contaminated needles as a result of having medical or dental
care e.g. those with pre-existing medical conditions and those travelling for medical care
abroad including those intending to receive renal dialysis overseas.
long-stay travellers
those who are participating in contact sports.
families adopting children from this country.

Hepatitis B in brief

Rabies
Rabies is a viral infection which is usually transmitted following contact with the saliva of an
infected animal most often via a bite, scratch or lick to an open wound or mucous membrane (such
as on the eye, nose or mouth). Although many different animals can transmit the virus, most cases
follow a bite or scratch from an infected dog. In some parts of the world, bats are an important
source of infection.

Rabies symptoms can take some time to develop, but when they do, the condition is almost always
fatal.

The risk of exposure is increased by certain activities and length of stay (see below). Children are at
increased risk as they are less likely to avoid contact with animals and to report a bite, scratch or
lick.

Rabies in Peru

Rabies has been reported in domestic and wild animals in this country. Bats may also carry rabies-
like viruses.

Prevention

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Travellers should avoid contact with all animals. Rabies is preventable with prompt post-
exposure treatment.
Following a possible exposure, wounds should be thoroughly cleansed and an urgent local
medical assessment sought, even if the wound appears trivial.
Post-exposure treatment and advice should be in accordance with national guidelines.

Rabies vaccination

Pre-exposure vaccinations are recommended for travellers whose activities put them at increased
risk including:

those at risk due to their work (e.g. laboratory staff working with the virus, those working
with animals or health workers who may be caring for infected patients).
those travelling to areas where access to post-exposure treatment and medical care is
limited.
those planning higher risk activities such as running or cycling.
long-stay travellers (more than one month).

A full course of pre-exposure vaccines simplifies and shortens the course of post-exposure
treatment and removes the need for rabies immunoglobulin which is in short supply world-wide.

Rabies in brief

Tuberculosis (TB)
TB is a bacterial infection transmitted most commonly by inhaling respiratory droplets from an
infectious person. This is usually following prolonged or frequent close contact.

Tuberculosis in Peru
The average annual incidence of TB is greater than or equal to 40 cases per 100,000 population
(further details).

Prevention
Travellers should avoid close contact with individuals known to have infectious pulmonary (lung)
TB.

Those at risk during their work (such as healthcare workers) should take appropriate infection
control precautions.

Tuberculosis (BCG) vaccination

According to current national guidance, BCG vaccine should be recommended for those at
increased risk of developing severe disease and/or of exposure to TB infection e.g. when the
average annual incidence of TB is greater than or equal to 40 cases per 100,000 population. See
Public Health England’s Immunisation against infectious disease, the ‘Green Book’.

For travellers, BCG vaccine is also recommended for:

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unvaccinated, children under 16 years of age, who are going to live for more than 3 months
in this country. A tuberculin skin test is required prior to vaccination for all children from 6
years of age and may be recommended for some younger children.

unvaccinated, tuberculin skin test negative individuals under 35 years of age at risk due to
their work such as healthcare workers, prison staff and vets. Healthcare workers may be
vaccinated over the age of 35 years following a careful risk assessment.

There are specific contraindications associated with the BCG vaccine and health professionals must
be trained to administer this vaccine intradermally (just under the top layer of skin).

Following administration, no further vaccines should be administered in the same limb for 3
months.

The BCG vaccine is given once only, booster doses are not recommended.

Tuberculosis in brief

Typhoid
Typhoid is a bacterial infection transmitted through contaminated food and water. Previous typhoid
illness may only partially protect against re-infection.

Travellers who will have access to safe food and water are likely to be at low risk. Those at
increased risk include travellers visiting friends and relatives, frequent or long-stay travellers to
areas where sanitation and food hygiene are likely to be poor.

Typhoid in Peru
Typhoid fever is known or presumed to occur in this country.

Prevention
All travellers should take care with personal, food and water hygiene.

Typhoid vaccination
Both oral and injectable typhoid vaccinations are available, and vaccination is recommended for
laboratory personnel who may handle the bacteria for their work.

Vaccination could be considered for those whose activities put them at increased risk (see above).

Typhoid in brief

Yellow Fever

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Yellow fever is a viral infection transmitted by mosquitoes which predominantly feed between dawn
and dusk, but may also bite at night, especially in the jungle environment. Symptoms may be
absent or mild, but in severe cases it can cause internal bleeding, organ failure and death.

Yellow fever in Peru

There is a risk of yellow fever transmission in parts of this country, see below.

Prevention

Travellers should avoid mosquito bites at all times.

Yellow fever vaccination

Vaccination is recommended for those aged 9 months of age and older travelling to the
following areas at altitudes below 2,300m: the Regions of Amazonas, Cuzco (for Cuzco city,
Machu Pichu and the Inca trail see below), Huánuco, Junín, Loreto, Madre de Dios, Pasco,
Puno (for Puno city see below), San Martin, Ucayali and designated areas of the following
Regions far-north-eastern Ancash; far-north of Apurimac; northern and north-eastern
Ayacucho; northern and eastern Cajamarca; far northern Huancavelica; eastern La Libertad,
and eastern Piura.
Vaccination is generally not recommended for travellers whose itineraries are limited to
areas west of the Andes: regions of Labayeque and Tumbes and designated areas of south,
west and central Cajamarca and western Piura, but could be considered for a small subset
of travellers to such areas who are at increased risk because of:
– Prolonged travel
– Heavy exposure to mosquito bites
– Inability to avoid insect bites
Vaccination is not recommended for travellers whose itineraries are limited to the following
areas: all areas above 2,300m altitude, areas west of the Andes not listed above, the cities
of Cuzco, Puno and the capital city of Lima, Machu Picchu, and the Inca Trail.
See yellow fever vaccine recommendation map provided by the World Health Organization
2018.

The yellow fever vaccine is not suitable for all travellers, there are specific undesirable effects
associated with it. This vaccine is only available at registered yellow fever vaccination centres.
Health professionals should carefully assess the risks and benefits of the vaccine, and seek
specialist advice if necessary.

Yellow fever in brief

Malaria

Malaria is a serious illness caused by infection of red blood cells with a parasite called Plasmodium.

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The disease is transmitted by mosquitoes which predominantly feed between dusk and dawn.

Symptoms usually begin with a fever (high temperature) of 38°C (100°F) or more. Other symptoms
may include feeling cold and shivery, headache, nausea, vomiting and aching muscles. Symptoms
may appear between eight days and one year after the infected mosquito bite.

Prompt diagnosis and treatment is required as people with malaria can deteriorate quickly. Those at
higher risk of malaria, or of severe complications from malaria, include pregnant women, infants
and young children, the elderly, travellers who do not have a functioning spleen and those visiting
friends and relatives.

Prevention
Travellers should follow an ABCD guide to preventing malaria:

Awareness of the risk – Risk depends on the specific location, season of travel, length of stay,
activities and type of accommodation.

Bite prevention – Travellers should take mosquito bite avoidance measures.

Chemoprophylaxis – Travellers should take antimalarials (malaria prevention tablets) if appropriate

for the area (see below). No antimalarials are 100% effective but taking them in combination with
mosquito bite avoidance measures will give substantial protection against malaria.

Diagnosis – Travellers who develop a fever of 38°C [100°F] or higher more than one week after
being in a malaria risk area, or who develop any symptoms suggestive of malaria within a year of
return should seek immediate medical care. Emergency standby treatment may be considered for
those going to remote areas with limited access to medical attention.

Risk Areas
There is a low risk of malaria in the Amazon basin of Peru along the border with Brazil,
particularly in Loreto province and in the other rural areas of Peru below 2,000m including
that part of the Amazon Basin which borders Bolivia: awareness of risk and bite
avoidance recommended.
There is no risk in the city of Lima and the coastal region south of Chiclayo: bite avoidance
recommended.

Special risk groups

In low risk areas, antimalarials may be considered in exceptional circumstances for travellers who
are at higher risk of malaria (such as long term travellers visiting friends and relatives), or of severe
complications from malaria (such as the elderly [over 70 years], the immunosuppressed, those with
complex co-morbidities, pregnant women, infants and young children).

Travellers with an absent or poorly functioning spleen should be dissuaded from travel to any area
with risk of malaria, but where travel is essential awareness, rigorous bite avoidance and
antimalarials should be advised.

In these circumstances, you may wish to seek specialist advice, although atovaquone/proguanil OR
doxycycline OR mefloquine would be suitable options except in rural areas of Peru below 2,000m
including that part of the Amazon Basin which borders Bolivia where chloroquine plus proguanil
would be a suitable option.

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The final decision whether or not to advise antimalarials rests with the travel health advisor and the
traveller after individual risk assessment.

Antimalarial Recommendations Map

Open map in a new window

Resources
Malaria in brief
Malaria factsheet
Insect and tick bite avoidance
Children’s antimalarial dose table
Guidelines for malaria prevention in travellers from the United Kingdom

Other risks

There are some risks that are relevant to all travellers regardless of destination. These may for
example include road traffic and other accidents, diseases transmitted by insects or ticks, diseases
transmitted by contaminated food and water, sexually transmitted infections, or health issues
related to the heat or cold. Some additional risks (which may be present in all or part of this
country) are mentioned below and are presented alphabetically.

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Altitude
There is a risk of altitude illness when travelling to destinations of 2,500 metres (8,200 feet) or
higher. Important risk factors are the altitude gained, rate of ascent and sleeping altitude. Rapid
ascent without a period of acclimatisation puts a traveller at higher risk.

There are three syndromes; acute mountain sickness (AMS), high-altitude cerebral oedema (HACE)
and high-altitude pulmonary oedema (HAPE). HACE and HAPE require immediate descent and
medical treatment.

Altitude illness in Peru

There is a point of elevation in this country higher than 2,500 metres. Some example places of
interest: Machu Picchu 2,430m, Cusco 3,399m; Inca trail max ~4,200m; Pisac 2,972m; Cerro de
Pasco 4,330m; La Rinconada 5,100m; Puno 3,827m

Prevention

Travellers should spend a few days at an altitude below 3,000m.

Where possible travellers should avoid travel from altitudes less than 1,200m to altitudes
greater than 3,500m in a single day.
Ascent above 3,000m should be gradual. Travellers should avoid increasing sleeping
elevation by more than 500m per day and ensure a rest day (at the same altitude) every
three or four days.
Acetazolamide can be used to assist with acclimatisation, but should not replace gradual
ascent.
Travellers who develop symptoms of AMS (headache, fatigue, loss of appetite, nausea and
sleep disturbance) should avoid further ascent. In the absence of improvement or with
progression of symptoms the first response should be to descend.
Development of HACE or HAPE symptoms requires immediate descent and emergency
medical treatment.

Altitude illness in brief

Biting insects or ticks

Insect or tick bites can cause irritation and infections of the skin at the site of a bite. They can also
spread certain diseases.

Diseases in South America

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There is a risk of insect or tick-borne diseases in some areas of South America. This includes
diseases such as American Trypanosomiasis (Chagas Disease), chikungunya, leishmaniasis and
West Nile virus.

Prevention

All travellers should avoid insect and tick bites day and night.
There are no vaccinations (or medications) to prevent these diseases.

Further information about specific insect or tick-borne diseases for this country can be found, if
appropriate on this page, in other sections of the country information pages and the insect and tick
bite avoidance factsheet.

Dengue
Dengue is a viral infection transmitted by mosquitoes which predominantly feed between dawn and
dusk. It causes a flu-like illness, which can occasionally develop into a more serious life-threatening
form of the disease. Severe dengue is rare in travellers.

The mosquitoes that transmit dengue are most abundant in towns, cities and surrounding areas. All
travellers to dengue areas are at risk.

Dengue in Peru

There is a risk of dengue in this country.

Prevention

All travellers should avoid mosquito bites particularly between dawn and dusk.
There is currently no medication or vaccination available for travellers to prevent dengue.

Dengue in brief

Zika Virus
Zika virus (ZIKV) is a viral infection transmitted by mosquitoes which predominantly feed between
dawn and dusk. A small number of cases of sexual transmission of ZIKV have also been reported.
Most people infected with ZIKV have no symptoms. When symptoms do occur they are usually mild
and short-lived. Serious complications and deaths are not common. However, there is now scientific
consensus that Zika virus is a cause of congenital Zika syndrome (microcephaly and other
congenital anomalies) and Guillain-Barré syndrome.

Zika virus in Peru

This country is considered to have a high risk of ZIKV transmission. Pregnant women are
advised to postpone non-essential travel until after pregnancy. Details of specific affected
areas within this country are not available but the mosquitoes that transmit ZIKV are unlikely to be
found above 2,000m altitude.

The map below shows areas which are above 2,000m and can be used by travellers and health
professionals as a general guide to indicate potentially lower risk areas for mosquito-acquired ZIKV
infection. Travellers whose itineraries are limited to areas above 2,000m are at a lower risk of

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acquiring ZIKV from a mosquito; however there may still be a risk of sexual transmission.

Map provided by the Travelers’ Health Branch, Centers for Disease Control and Prevention

The categories shown on this map are intended as a general guideline and should not be
considered to indicate absolute risk. Elevation may vary within an area to a larger extent than this
map can depict. The presence of mosquitoes may change seasonally, with increasing temperatures
or rainfall, and may change over time. Travellers to destinations that cross or are near an elevation
border may wish to consider the destination as an area of lower elevation. Travellers to high
elevations are still at risk of getting Zika from sex.

Prevention

All travellers should avoid mosquito bites particularly between dawn and dusk.
There is no vaccination or medication to prevent ZIKV infection.
It is recommended that pregnant women planning to travel to areas with a high risk of ZIKV
transmission should postpone non-essential travel until after pregnancy.
Women should avoid becoming pregnant while travelling in, and for 8 weeks after leaving
an area with active ZIKV transmission or 8 weeks after last possible ZIKV exposure
Couples should follow guidance on prevention of sexual transmission of Zika and avoid
conception while travelling and for up to 6 months on return.
If a woman develops symptoms compatible with ZIKV infection, it is recommended she
avoids becoming pregnant for a further 8 weeks following recovery.
Pregnant women who visited this country while pregnant, or who become pregnant within 8
weeks of leaving this country or within 8 weeks after last possible ZIKV exposure,

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should contact their GP, obstetrician or midwife for further advice, even if they have not
been unwell. Further information about when to perform fetal ultrasound scanning, and, if
necessary, referral to the local fetal medicine service is available.

Preventing sexual transmission

Most cases of ZIKV are acquired via mosquito bites but cases of sexual transmission of ZIKV
are occasionally reported.
See further information for pregnant women, their partners and couples planning pregnancy

See detailed guidance on factors to consider when assessing the risk of ZIKV.

Zika virus in brief

Latest News: Peru

Outbreaks: Peru

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