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

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.

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

Typhoid

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

Vaccination is recommended for most travellers, particularly travellers visiting friends and relatives, those in contact with an infected person, young children, frequent or long-stay travellers visiting areas where sanitation and food hygiene are likely to be poor, and laboratory personnel who may handle the bacteria for their work.

Prevention

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

Typhoid vaccination
  • Oral and injectable typhoid vaccinations are available.

Typhoid 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

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 is considered a risk and has been reported in domestic animals in this country. Bats may also carry rabies-like viruses.

Prevention
  • 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

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.

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).

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:

  • 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 at risk due to their work such as healthcare or laboratory workers who have direct contact with TB patients or potentially inectious clinical material and vets and abattoir workers who handle animal material, which could be infected with TB.

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

Yellow Fever

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. 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.

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

Resources

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.

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

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 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, 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

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

Zika virus in brief

Important News

12 Dec 2018

Country-specific typhoid risk and vaccine recommendations updated

A review of the risk of typhoid and country-specific recommendations Read more

05 Apr 2018

Worldwide rabies risk reminder

A reminder for travellers of the worldwide risk of rabies Read more

31 Oct 2017

Presenting NaTHNaC malaria maps 2017

What’s in a map? Read more

03 Aug 2017

Zika virus – update and advice for travellers

Following an expert review, three risk ratings for areas of Zika virus transmission have been defined - Advice for travellers visiting these areas has Read more

16 Mar 2017

Yellow fever cases in travellers

European travellers visiting yellow fever risk regions in South America Read more

19 Jan 2016

Diseases transmitted by insects and ticks in the Americas

Depending on the destination, travellers may be at risk of a number of different diseases Read more

21 Jul 2015

Chikungunya virus: Caribbean and the Americas

Ongoing surveillance on Chikungunya virus in Caribbean and the Americas Read more

08 Jul 2015

Yellow fever: Peru

Since the start of 2015, a small number of cases of of jungle (sylvatic) yellow fever have been reported Read more

16 Apr 2015

Yellow fever: Peru

Cases of Yellow fever have been reported from Loreto, Pasco, Piura, Puno and San Martin Read more

All News

Outbreaks

Using information collated from a variety of sources, we regularly review and update information on overseas disease outbreaks and other health issues that may affect the UK traveller.

Please note that not all cases of disease or outbreaks are reported; some diseases may only be reported if they occur outside of the usual recognised risk area or season, or they have been reported in greater than usual numbers.

Further information on the Outbreak Surveillance section.

Yellow fever in Peru

17 Dec 2018 Peru

Fifteen cases of yellow fever (nine laboratory confirmed) were reported up to 11 November 2018. This figure is higher than those reported during the same period of 2017. Of the cases in 2018, the confirmed cases are from the departments of Loreto, San Martin, Ucayali and Madre de Dios.

Human

Vector-Borne

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WHO - Read more

Acute neurological syndrome in Peru

10 Jul 2018 Peru

As of 5 July 2018, a total of 220 cases of Guillain-Barré syndrome have been reported in Peru since the beginning of 2018. Investigations are ongoing.

Human

Miscellaneous

Updates 1

Verified

State - Read more

Yellow fever in Peru

21 Mar 2018 Peru

As of 20 March 2018, a total of 22 yellow fever cases have been reported, eight confirmed, with the remaining 14 under investigation. This figure is higher than the same period in 2017, when there were five cases reported.

Human

Vector-Borne

New Post

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PAHO - Read more

All Outbreaks

Map

Foreign travel advice

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