Make sure your health insurance covers you for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation, should be seriously considered. If illness occurs while abroad, medical expenses including evacuation may run to tens of thousands of dollars. For a list of travel insurance and air ambulance companies, go to Medical Information for Americans Traveling Abroad on the U.S. State Department website. Bring your insurance card, claim forms, and any other relevant insurance documents. Before departure, determine whether your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures. The Medicare and Medicaid programs do not pay for medical services outside the United States.
Bring adequate supplies of all medications in their original containers, clearly labeled. Carry a signed, dated letter from the primary physician describing all medical conditions and listing all medications, including generic names. If carrying syringes or needles, be sure to carry a physician's letter documenting their medical necessity.Pack all medications in hand luggage. Carry a duplicate supply in the checked luggage. If you wear glasses or contacts, bring an extra pair. If you have significant allergies or chronic medical problems, wear a medical alert bracelet.
You really only need one first aid kit in your travel group,
Disinfectant, antiseptic cream, antibiotic ointment
Gauze bandages and tape
Melatonin, Acetazolamide, or other sleep aid
Malaria pills (if necessary, talk to doctor)
Antibiotics (talk to doctor)
Prescription drugs (talk to doctor)
Diamox for altitude (talk to doctor)
In the HighlandsIf you are traveling to high grounds over 3000 meters, include altitude sickness pills, waterproof items, a thermal blanket, and sunglasses
In the Jungle You will need to pack anti malarial medication, mosquito repellent, sunscreen, and disinfectants
The material for first aid should only be used on minor injuries or ailments that do not require health care. In any case of a major problem, please seek qualified personnel.
may occur in travelers who ascend rapidly to altitudes greater than 2500 meters, including Cusco (3000 meters) and Lake Titicaca (4000 meters). Acetazolamide is the drug of choice to prevent altitude sickness. The usual dosage is 125 or 250 mg twice daily starting 24 hours before ascent and continuing for 48 hours after arrival at altitude. Possible side-effects include increased urinary volume, numbness, tingling, nausea, drowsiness, myopia and temporary impotence. Acetazolamide should not be given to pregnant women or those with a history of sulfa allergy. For those who cannot tolerate acetazolamide, the preferred alternative is dexamethasone 4 mg taken four times daily. Unlike acetazolamide, dexamethasone must be tapered gradually upon arrival at altitude, since there is a risk that altitude sickness will occur as the dosage is reduced.
Travel to high altitudes is generally not recommended for those with a history of heart disease, lung disease, or sickle cell disease.
What Causes Altitude sicness?
The primary cause of altitude illnesses is going too high too quickly. Given time, your body can adapt to the decrease in oxygen at specific altitudes. This is known as acclimatization and generally takes 1 to 3 days at a given altitude.
Prevention of altitude illnesses falls into two categories, proper acclimatization and preventive medications. Below are a few basic guidelines for proper acclimatization. Start below 10,000 feet (3,048 meters) and walk up.
Medication (Require Prescription)
* Diamox (Acetazolamide) allows you to breathe faster so that you metabolize more oxygen, thereby minimizing the symptoms caused by poor oxygenation.
* Dexamethasone (a steroid) is a drug that decreases brain and other swelling, helping to reverse the effects.
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You may be exposed through contaminated food or water. It is rather common in Peru, compared to developed countries.
Hepatitis A and B: Are recommended for all travelers. It should be given at least two weeks before departure. A booster should be given 6-12 months later to confer long-term immunity. Two vaccines are currently available: VAQTA (Merck and Co., Inc.) and HAVRIX (GlaxoSmithKline). Both are well-tolerated. Side-effects, which are generally mild, may include soreness at the injection site, headache, and malaise.
You may be exposed through blood, body fluids or sexual contact with ill people, even if they seem healthy.
Typhoid Also, through contaminated food or water, but happens less frequently. It is recommended for all travelers. It is generally given in an oral form (Vivotif Berna) consisting of four capsules taken on alternate days until completed.
Yellow fiber: Highly recommended if traveling to jungle areas . You could be requested to show a vaccination certificate upon arrival to Puerto Maldonado or Iquitos
Yellow fever vaccine is recommended for all travelers going to the following areas less than 2300 m in elevation. You should receive the yellow fever shot 10 days prior your arrival to Peru,
Yellow fever Areas: Especially if going to any area in Puerto Maldonado, Manu,Tambopata,Iquitoss, San Martín, Loreto, Amazonas, Ucayali.
The vaccine should be considered only for those at increased risk due to prolonged travel, heavy exposure to mosquitoes.
Malaria: Currently, there is no available vaccine for this illness, but you should consider receiving prophylaxis, in addition to standard measures of precaution such as using insect repellent, using bednets while you sleep and wearing long-sleeved pants and shirts. This preventative measures will also help in avoiding getting dengue fever (there is no prophylaxis or vaccination for dengue fever, also known as breakbone fever).
Malaria in Peru: prophylaxis is recommended for all areas below 2000 m (6561 ft), including the cities of Iquitos and Puerto Maldonado,
Mefloquine is taken once weekly in a dosage of 250 mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after departure.
Mefloquine may cause mild neuropsychiatric symptoms, including nausea, vomiting, dizziness, insomnia,
Mefloquine should not be given to anyone with a history of seizures, psychiatric illness, cardiac conduction disorders, or allergy to quinine or quinidine
Rabies: Rabies vaccine is recommended for travelers spending a lot of time outdoors, for travelers at high risk for animal bites.
it is recommended for all travelers who have not received a tetanus-diphtheria immunization within the last 10 years.
Measles-mumps-rubella vaccine:is recommended - MMR vaccine should not be given to pregnant or severely immunocompromised individual
For more information, please read: http://wwwnc.cdc.gov/travel/destinati...
Do not drink tap water unless it has been boiled, filtered, or chemically disinfected. Do not drink unbottled beverages or drinks with ice. Do not eat fruits or vegetables unless they have been peeled or cooked. Avoid cooked foods that are no longer piping hot. Cooked foods that have been left at room temperature are particularly hazardous. Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Avoid food and beverages obtained from street vendors. Do not eat raw or undercooked meat or fish, including ceviche. Some types of fish may contain poisonous biotoxins even when cooked. Barracuda in particular should never be eaten. Other fish that may contain toxins include red snapper, grouper, amberjack, and sea bass.
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 accompanied by nausea, vomiting, cramps, fever or blood in the stool. Antibiotics which have been shown to be effective include ciprofloxacin (Cipro), levofloxacin (Levaquin), rifaximin (Xifaxan), or azithromycin (Zithromax). Either loperamide (Imodium) or diphenoxylate (Lomotil) should be taken in addition to the antibiotic to reduce diarrhea and prevent dehydration.
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
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.
Wear long sleeves, long pants, hats and shoes (rather than sandals). Apply insect repellents containing 25-50% DEET (N,N-diethyl-3-methylbenzamide) or 20% picaridin (Bayrepel) to exposed skin (but not to the eyes, mouth, or open wounds). DEET may also be applied to clothing. Products with a lower concentration of either repellent need to be repplied more frequently. Products with a higher concentration of DEET carry an increased risk of neurologic toxicity, especially in children, without any additional benefit. Do not use either DEET or picaridin on children less than two years of age. For additional protection, apply permethrin-containing compounds to clothing, shoes, and bed nets. Permethrin-treated clothing appears to have little toxicity. Don't sleep with the window open unless there is a screen. If sleeping outdoors or in an accomodation that allows entry of mosquitoes, use a bed net, preferably impregnated with insect repellent, with edges tucked in under the mattress. The mesh size should be less than 1.5 mm. If the sleeping area is not otherwise protected, use a mosquito coil, which fills the room with insecticide through the night.
To prevent sandfly bites, follow the same precautions as for mosquito bites, except that netting must be finer-mesh (at least 18 holes to the linear inch) since sandflies are smaller.
Note: the DEET concentratoin tells you how long the DEET lasts. For example, 100% DEET will last about 10 hours; 10% DEET about 90 minutes, 25% DEET 2.5 hours, etc. Also, the majority of the DEET product, when sprayed onto the skin, either evaporates or is absorbed into the body,which is why such high concentrations are required.
The history of Peru inspires a childlike fascination, it is ideal for children aged seven or eight upwards. Earlier than that, the cultural significance and civilisation is lost.
You will explore the dazzling Inca ruins of Machu Picchu and Cusco, visit the remnants of the ancient Nazca and Paracas cultures, soak up the sights and sounds of artisans markets, ride in reed boats on Lake Titicaca, and experience the people and wildlife living in the tropical rain forests.
the recommendations for infants and young children are the same as those for adults, except that certain vaccines and medications should not be administered to this age group.
The recommendations for malaria prophylaxis are the same for young children as for adults, except that (1) dosages are lower; and (2) doxycycline should be avoided.
DEET-containing insect repellents are not advised for children under age two, so it's particularly important to keep children in this age group well-covered to protect them from mosquito bites.
Food and water precautions, which are recommended for all travelers, must be strictly followed at all times, because diarrhea is especially dangerous in this age group and because the vaccines for hepatitis A and typhoid fever are not approved for children less than two years of age.
Travel with Pregnancy
In general, pregnant women should avoid traveling to countries which do not have modern facilities for the management of premature labor and other complications of pregnancy.
For pregnant women in good health, the second trimester is probably the safest time to go abroad and the third trimester the least safe, since it's far better not to have to deliver in a foreign country.
Before departure, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency obstetric care if necessary
Travel to altitudes greater than 4000 meters (13,100 feet) should be avoided during pregnancy. During the third trimester and during high-risk pregnancies, travel should be limited to altitudes less than 2500 meters (8200 feet).
Pregnant women should not travel to areas where yellow fever and malaria occurs, Malaria may cause life-threatening illness in both the mother and the unborn child.
Strict attention to food and water precautions is especially important for the pregnant traveler because some infections, such as listeriosis, have grave consequences for the developing fetus. Additionally, many of the medications used to treat travelers' diarrhea may not be given during pregnancy. Quinolone antibiotics, such as ciprofloxacin (Cipro) and levofloxacin (Levaquin), should not be given because of concern they might interfere with fetal joint development.
Herei we have some good links to get more info about Peru
For a public ambulance in Peru, call 141. For a private ambulance, which usually offers better service, look in the local telephone directory or call one of the following:
In general, private clinics offer better care than the public hospitals. There are several high-quality medical clinics in Lima that are open 24/7 for medical emergencies. They also function as hospitals and offer subspecialty consultations. Many travelers go to one of the following:
Most pharmacies in Lima and Cusco are well-supplied. Many travelers go to one of the following:
Pharmax (Av. La Encalada 1541, Nonterrico, across the street from the U.S. Embassy; tel. 434-1460; 24-hour delivery service)
Pharmax (Av. Salaverry 3100, San Isidro; tel. 264-2282; 24-hour delivery service)
Farmacia Deza (Av. Conquistadores 1140, San Isidro; tel. 440-3798; 24-hour delivery service)
Las Colonias (Santa Elena Norte 102-104 Street, Monterrico, 21st block of Primavera Av. by the Museo de Oro; English-speaking owner)
Many of the major supermarkets, including Wong and Santa Isabel, include good pharmacies.
Screening for HIV and hepatitis remains inadequate. In September 2007, four people were found to have become infected with HIV from blood transfusions at public hospitals. At around the same time, thirty people who went to a social security dialysis center were found to have become infected with hepatitis C (see ProMED-mail, September 14, 2007). Transfusions in Peru should be avoided if at all possible.