A Guide to Healthy Travel in South America

By Volker Poelzl

South America presents unique health challenges to travelers from North America and Europe. In addition to unfamiliar diseases, travelers also have to deal with several other health concerns, such as food and water safety, a wide variety of climate conditions, and altitude sickness. While it is easy to become overly concerned about your health when listening to anecdotal accounts, accurate information and not exaggerated precautions will help you stay healthy during your trip. Millions of travelers visit the region yearly without a significant incident. Follow a few precautions laid out below, and you should enjoy your trip.

One of the many fine clinics in South America, here in Buenos Aires.

Prepare Before You Go

Clearly, the more you learn about the health risks of your destination, the more likely you will remain healthy. The first thing you should do is research illnesses and health threats in the South American countries you plan to visit. Most health risks to travelers come from many diseases to which they are unfamiliar. You cannot prevent what you do not know. Consult the excellent resources provided by the CDC for travelers by country for more details. Then, visit and consult your doctor about each disease mentioned before you go. The doctor should inform you about any shots or precautions you need to take. Assume your doctor does not know about specific tropical destinations. In that case, you can be referred to experts in infectious diseases for the necessary shots and preventative measures.

Bring an updated international immunization record that lists health conditions and allergies, which can help you get the proper medical treatment if necessary. If you take prescription medication, bring a supply large enough to last you for your trip. If you wear glasses or contact lenses, bring a spare pair or write down the prescription to get a replacement quickly. Consider bringing your favorite brands of non-prescription medications since you might not be able to find them in South America.

The best way to prepare medically for a trip is to arrive in good health. Seeing a doctor in a foreign country can sometimes be challenging because of the language barrier and the uncertainty of seeking medical help abroad. Again, seeing your doctor or visiting a travel clinic at least one month before your departure is essential to determine what boosters or immunizations you will need, especially if you are traveling with children who may be less resistant.

Common Health Problems in South America

Again, keep in mind that millions of people live and travel to the region, so we are laying out possible issues for preparation and completeness and certainly not discouraging visitors. To begin with, it usually takes time for your body to adapt to the different food bacteria in any region around the world. Initial digestive problems such as diarrhea or constipation are common in South America. These symptoms should go away after a few days. Infections caused by insect bites, minor cuts, and wounds are common in the region. It is best to treat such minor injuries with much more care than you would at home. Should your wound get infected, most are easily treated with antibiotics. Below are listed diseases about which travelers should take precautions in South America, with some far more common than others.

• Traveler’s Diarrhea is common among foreigners who are just getting used to the different bacteria in food. However, travelers’ diarrhea usually subsides by itself after a few days. You should see a doctor if the condition persists longer than a few days or worsens.
  
  
• Malaria is a parasitic disease that affects the liver. It is transmitted by the bite of the infected female anopheles mosquito. For short-term stays in areas with a malaria threat, it is recommended that you take prophylactic drugs. It is best to bring a supply large enough to last for potential exposure. However, remember that malaria is only present in tropical South America and is rare in urban areas. The best malaria protection is to prevent mosquito bites. Use mosquito netting and wear long-sleeve clothing in the evenings and early mornings, in addition to mosquito repellent.
  
  
• Dengue Fever is a viral disease common in tropical areas across South America. It is transmitted by the Aedes aegypti mosquito. Dengue occurs most commonly in urban areas, especially during the rainy season. Since there is no vaccine, avoiding mosquito bites during the day is the only way to lower your risk.
  
  
• Yellow Fever is a viral disease that can cause liver problems. It is transmitted by mosquitoes and occurs mainly in the Amazon region. Since a vaccine is available, you should not take risks and get an immunization. You will be issued an international vaccination certificate, valid for 10 years. Make sure you take it with you. Free yellow fever immunization is available in Brazil at local vaccination posts throughout the Amazon, at vaccination posts along bus routes to the Amazon, and at airports with flights to the Amazon region. Some countries require a yellow fever vaccination when entering from a neighboring country where it is known to occur frequently.
  
  
• Chagas Disease is a severe disease that affects most of South America. It is caused by a parasite transmitted by contact with the feces of a brown, oval-shaped reduviid beetle (also known as the kissing bug). The beetle is found mainly in rural areas. Bed netting can help prevent infection.
  
  
• Rabies is a viral disease transmitted by bites from infected animals. Although rabies cases from dog bites are decreasing in South America, the risk from vampire bat bites is growing. If you plan on staying in remote rural areas, consider getting a pre-exposure rabies vaccination.
  
  
• Hepatitis is a viral disease that affects the liver. Hepatitis A is transmitted by consuming contaminated food and water or by person-to-person contact. Be especially aware of unsanitary conditions, where the transmission of the disease is much more likely. An active vaccine is now available. Hepatitis B is transmitted by bodily fluids, and immunization is also available. Hepatitis C, which is transmitted by blood and through sexual contact, is the most severe type of hepatitis. It is often only diagnosed in the advanced stage when it causes liver cancer and cirrhosis.
  
  
• Tuberculosis is a bacterial infection that most frequently affects the lungs. It is transmitted through the air by coughing or through unpasteurized milk or milk products. Tuberculosis is on the rise worldwide, and treatment-resistant strains have recently emerged. If you suspect you might have been exposed, you should get a tuberculin skin test to determine if you have been infected.
  
  
• Typhoid Fever is a severe bacterial disease transmitted through contaminated food and water. Although typhoid vaccination is not completely effective, you should add it to your immunization list, especially if you intend to travel in rural and remote areas.
  
  
• AIDS is caused by the HIV virus and is transmitted through blood and sexual intercourse. It is estimated that nearly two million people in South America are currently infected with HIV. The highest number of HIV infections is among men who have sex with other men, but heterosexual women are also increasingly affected. Female sex workers also have a higher risk of contracting the virus. Since prostitution and sex tourism are present in South America, foreign travelers should take special precautions.

While this list of common diseases may seem discouraging, keep in mind that most visitors to South America have few health problems. If you take precautions and know the most common health risks, you will likely not have any severe issues.

Sanitary Factors

Sanitary conditions vary drastically from country to country. Nevertheless, it is a good idea to be concerned about water and food safety throughout South America. Numerous diseases and germs are food-borne, and it is vital to adopt sanitary practices in the tropics, where germs are more abundant. Wash your hands often and always before you eat. Hygiene standards at restaurants vary quite a bit, and a more expensive restaurant is not automatically a guarantee for food safety. Pick a busy restaurant with a high turnover of food since that is the best assurance that the food is safe. You should be especially careful with street vendors and roadside food stalls. If you eat raw fruits or vegetables, make sure they are peeled or washed in purified water. Be cautious with seafood, especially shellfish, and lightly cooked meat dishes. Food should be cooked thoroughly and served hot. Avoid unpasteurized dairy products.

The most common health problem I have had in South America is food poisoning. At one time in La Paz, Bolivia, I was in bed for a week, and I was ready to call a doctor when my condition finally improved. It is mostly in rural areas, where sanitation is not always pristine, and the chances of catching a food-borne disease are greater. If you drink unfiltered water in rural areas, you should be tested for intestinal parasites after you return home. Consider bringing water purification tablets or a portable water filter if you travel to places without purified water. Tap water in cities and towns is usually treated, but you should avoid drinking unfiltered tap water. Avoid ice cubes unless you know they are made from purified water.

Environmental Factors

Several environmental factors can also impact travelers’ health. Are you sensitive to intense sunlight, humidity, or specific allergens? Does a rapid change in altitude affect you? You should consider these factors when planning a trip to South America.

If you arrive in tropical South America from a temperate climate zone, be prepared to make adjustments to the heat. Seasons are reversed in the southern hemisphere, intensifying the heat and sun effect if you travel during the northern winter. Give your body time to adjust to the different climate, and drink plenty of bottled water. Use sunglasses, sunscreen, and a hat to protect yourself from the effects of the tropical sun. Using a sunscreen lotion with a sun protection factor of 30+ is best.

Many low-lying areas of tropical South America are very humid, and this can also take some time to get used to. To help your body gradually adjust to the humidity, stay in a hotel with air conditioning unless you have a very tough constitution.

A sudden change in altitude from the lowlands up to the Andean high plateau often causes altitude sickness due to the lower oxygen levels in high-altitude air. Although prescription drugs for altitude sickness are available, slowly traveling up the Andes works equally well if you have extra time. Try to choose a destination halfway up the mountains and spend a few days there before ascending to your final destination. Coca tea, widely available and legal in Peru and Bolivia, is said to reduce the effects of altitude sickness.

Lima, Peru’s capital, is at sea level, and the Amazon basin has an average elevation of 300 feet. But other destinations in the Andes are significantly higher in the sky and require adjustment accordingly:

• Cuzco (Peru): 11,152 feet.
• Arequipa (Peru): 7,550 ft.
• Puno (Peru, Lake Titicaca): 12,549 ft.
• Copacabana (Lake Titicaca, Bolivia): 12,500 ft.
• La Paz (Bolivia): 13,250 ft.
• Cochabamba (Bolivia): 8,432 ft.
• Quito (Ecuador): 9,350 ft.

Getting Medical Care in South America

If you develop a minor health problem, keep in mind that across South America, you can buy many prescription medications over the counter, and pharmacists often give health advice. If you decide to see a doctor, it is worth finding out about the local public health system. Most South American countries have a fundamental public health system where locals and foreigners can see a doctor or nurse at a very low cost. If you prefer a private doctor or hospital, your consulate should be able to make recommendations, or you could ask at a pharmacy, your hotel, or the tourist information center. Learning a few phrases in the local language about your health condition beforehand is a good idea so you can tell the doctor about your problem. Payment is usually expected during the consultation, even if doctor’s visits are included in your home or travel health insurance. Secure an invoice or proof of payment listing the health condition and treatment so you can be reimbursed after your return home.

For health resources worldwide as well as South America, please visit our Health, Safety, and Insurance for Travelers and Expatriates Abroad section.

Photo credit: Hospital in Buenos Aires by Robert Cutts.

Volker Poelzl is a Living Abroad Contributing Editor for TransitionsAbroad.com. He has extensively traveled in South America, both by air and on the ground.