You must discuss your own particular needs and contraindications to vaccines or tablets with your doctor or practice nurse. Advice can change so check again for future visits.
Ensure you are fully insured for medical emergencies including repatriation. The 'T7' leaflet (from Post Offices) gives details of health care agreements between countries. The completed form must be submitted about 6 weeks before you plan to leave.
Immunisations
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Confirm primary courses and boosters are up to date as recommended for life in Britain - including vaccines given to special groups because of risk exposure or complications (e.g. hepatitis B for health care workers, influenza and pneumococcal vaccines for the elderly).
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Courses or boosters usually advised: diphtheria; tetanus; hepatitis A; yellow fever (mainly for Western and Amazonian areas and Iguacu Falls).
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Vaccines sometimes advised: typhoid; hepatitis B; rabies; tuberculosis.
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Yellow fever certificate is required if over 9 months old and entering from an area with risk of yellow fever transmission, unless they are in possession of a waiver stating that immunisation is contraindicated on medical grounds.
Notes on the diseases mentioned above
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Tetanus is contracted through dirty cuts and scratches. This is a serious infection of the nervous system.
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Typhoid and hepatitis A are spread through contaminated food and water. Typhoid causes septicaemia and hepatitis A causes liver inflammation and jaundice. In risk areas you should be immunised if good hygiene is impossible.
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Tuberculosis is most commonly transmitted via droplet infection. Those going to countries where it is common, especially those mixing closely with the local population and those at occupational risk, e.g. health care workers, should ensure that they have previously been immunised. Check with your doctor or nurse.
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Diphtheria is also spread by droplet infection through close personal contact. Vaccination is advised if close contact with locals in risk areas is likely.
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Yellow fever is spread by mosquito bites. It is a serious often fatal illness. Vaccination is recommended for those who travel into risk areas. View yellow fever risk areas.
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Hepatitis B is spread through infected blood, contaminated needles and sexual intercourse, It affects the liver, causes jaundice and occasionally liver failure. Those visiting high risk areas for long periods or at social or occupational risk should be immunised.
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Rabies is spread through bites or licks on broken skin from an infected animal. It is always fatal. Vaccination is advised for those going to risk areas that will be remote from a reliable source of vaccine. Even when pre-exposure vaccines have been received urgent medical advice should be sought after any animal bite.
Malaria
Malaria is a serious and sometimes fatal disease transmitted by mosquitoes. You cannot be vaccinated against malaria.
Malaria precautions
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A risk of serious malaria is present throughout the year in forested areas below 900m within the nine states of Amazonia (Acre, Amapa, Amazonas, Maranhhao (west), Mato Grosso (north), Para (except Belem City on the coast), Rondonia, Roraima and Tocantins). Transmission is high in rain forest areas and occurs less commonly in urban areas in Amazonia such as Porto Velho, Boa Vista, Macapa, Manaus, Maraba, Rio Branco and Santarem.
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There is usually only minimal risk in the tourist resort of Iguaçu Falls but those exploring outside the resort itself into rural or jungle areas, especially into Paraguay, should consider antimalarial tablets.
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There is a risk for those going on cruises up the Amazon, especially as boats enter populated parts of the rain forest where infected mosquitoes may be taken on board. Most cruises up the Amazon river end up/or start at the city of Manaus where there is a risk of malaria.
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Risk is minimal in all states outside Amazonia including the populated eastern coast from Fortazela south to Rio de Janeiro and Sao Paulo (go to Malaria Map).
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Malaria precautions are essential. Avoid mosquito bites by covering up with clothing such as long sleeves and long trousers especially after sunset, using insect repellents on exposed skin and, when necessary, sleeping under a mosquito net.
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Check with your doctor or nurse about suitable antimalarial tablets.
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Atovaquone/proguanil OR doxycycline OR mefloquine is usually recommended for those visiting risk areas.
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If you have been travelling in a malarious area and develop a fever seek medical attention promptly. Remember malaria can develop even up to one year after exposure.
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If travelling to high risk malarious areas, remote from medical facilities, carrying emergency malaria standby treatment may be considered.
Advice for travellers
Outbreaks of dengue fever are common in South America and often occur after the rainy seasons where mosquitoes breed more actively. It causes a feverish illness with headache and muscle pains like a bad, prolonged, attack of influenza. There may also be a rash. Mosquito bites should be avoided whenever possible.
This map is only intended as a guide since mosquitoes do not respect boundaries and the risk areas shown may not be exact. Substantial malaria risk is shaded in dark red - becoming a lighter red where the risk is minimal.
The above advice is appropriate for the majority of travelers to this country. If you are at all unsure as to what measures are suitable for you, (eg if you are pregnant, or are suffering from a condition requiring special medication), it is recommended that you talk to your health advisor. This page is produced by the Scottish Centre for infection and Environmental Health.
