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Peru is reeling from record case counts of dengue fever. What's driving the outbreak?

Simeon Tegel

Francisca Sosa sits by her father, one of the many Peruvians who've contracted dengue fever in this unprecedented outbreak. Ernesto Benavides/AFP via Getty Images hide caption

Francisca Sosa sits by her father, one of the many Peruvians who've contracted dengue fever in this unprecedented outbreak.

LIMA, Peru – For Lorena Vigo, getting dengue, the virus once known as "breakbone fever," was like no illness she had previously experienced.

On top of the headache, upset stomach and aching joints, she bled from her gums after coming down last month with the mosquito-borne virus in Piura. That's the city of 600,000 residents in northern Peru that is the epicenter of the Andean nation's record-breaking dengue outbreak.

"There were no beds at the hospital," says the 43-year-old, explaining how she was unable to use the public health insurance that she pays into monthly as the health-care system was overwhelmed by the epidemic.

"Everyone I knew got it. At the hospital pharmacy [where her insurance would be accepted], the queue was so long that I didn't even bother to line up. I ended up paying for my own medicines and just treated myself at home."

So far this year, nearly 150,000 Peruvians have come down with the disease , according to the Pan American Health Organization . The current death toll is 248 in what is by far Latin America's most intense dengue outbreak.

Santos Mendoza (66), who suffers from dengue fever, rests on his bed at his house in the "Refugio San Pablo," a camp of straw houses and tents. Ernesto Benavides/AFP via Getty Images hide caption

Santos Mendoza (66), who suffers from dengue fever, rests on his bed at his house in the "Refugio San Pablo," a camp of straw houses and tents.

A rising tide of dengue

The Andean nation is not alone. The disease is on the rise around the globe. The World Health Organization says reported cases jumped from 505,430 in 2000 to 5.2 million in 2019. Most cases are asymptomatic or result in only mild sickness. But a number of patients do go on to develop severe dengue, which can be fatal in up to 13% of untreated patients, according to the Centers for Disease Control.

There is no cure. Treatment of the symptoms revolves around keeping patients hydrated and administering paracetamol, but not some other painkillers, which can actually make the patient worse. Recovery typically takes about a week.

David Salazar, 19, is hospitalized with dengue under a mosquito net at the Support Hospital II in northern Peru. Ernesto Benavides/AFP via Getty Images hide caption

David Salazar, 19, is hospitalized with dengue under a mosquito net at the Support Hospital II in northern Peru.

One vaccine is in development but not yet approved in Peru. Another vaccine has proven problematic, leading to a greater chance of developing severe dengue among those not previously infected.

Peru's unprecedented outbreak has been driven by unusually warm and rainy conditions on Peru's desert coast, first triggered by Yaku, a tropical cyclone not normally seen in this part of the Pacific, and then a localized "coastal" El Niño effect of warmer ocean waters. Both hit in April and May.

That has allowed the Aedes aegypti mosquito, which spreads the four viruses that cause dengue, to breed in large numbers, leaving larvae anywhere there are just a few millimeters of standing clean water.

Relatives of 10-year-old Fer Maria Ancajima, who died from dengue fever, mourn during the wake at her house. Ernesto Benavides/AFP via Getty Images hide caption

Relatives of 10-year-old Fer Maria Ancajima, who died from dengue fever, mourn during the wake at her house.

A report by the Rockefeller Foundation notes that the Aedes mosquito can now "overwinter in more regions," thanks to rising temperatures — which also "enhance dengue virus replication" within the insect, speed up the growth of larvae and cause adult mosquitoes to "bite more frequently."

The unusual weather in Peru is expected to continue, and even intensify and spread to other parts of South America, as the global El Niño weather phenomenon is predicted to gather force later this year.

Poverty is also contributing to the outbreak, with nearly one in 10 Peruvians lacking running water and one in four without sewerage. Many rely on fleets of unregulated water trucks and then store the liquid at home in unsealed containers where mosquitoes can breed, further turbocharging the outbreak.

Harsh words for the government response

Dr. Leslie Soto, an infectious diseases expert and spokesman for the Medical Association of Peru, is one of many who have criticized the government's handling of the epidemic even though it was widely predicted.

"There's been a lack of preparation," he said. "We knew this El Niño was coming. We knew that we needed to get ready yet we didn't. Managing dengue is not the same in a region where it's not prevalent, and where the population doesn't know what precautions to take – like not leaving anything that could be a receptacle for water – as in an area like the Amazon where it is endemic."

He said that the outbreak was exacerbated by a public health-care system widely viewed as shambolic and under-resourced in a country that had the world's highest COVID-19 mortality — 665 deaths per 100,000 population.

"Above all, we need to improve our primary care," he said. "People don't trust it after COVID." In this dengue outbreak, he noted, those who fall ill often bypassed local clinics and went straight to hospitals, which should only be treating the most serious cases. "We don't have the staff, the infrastructure or the medicines," Soto added.

Hospitals in the city of Piura are overwhelmed during the dengue overbreak. Above: A doctor checks on a dengue fever patient under a mosquito net at the Support Hospital II. Treatment addresses symptoms. Ernesto Benavides/AFP via Getty Images hide caption

Hospitals in the city of Piura are overwhelmed during the dengue overbreak. Above: A doctor checks on a dengue fever patient under a mosquito net at the Support Hospital II. Treatment addresses symptoms.

Rosa Gutiérrez, who was forced to resign as health minister on June 16, was widely viewed, both by medical experts and ordinary Peruvians, as out of her depth in handling the outbreak.

To widespread incredulity, she insisted in May that the outbreak would be "resolved" in two weeks, a claim that she was subsequently forced to apologize for . She was also heavily criticized for using dengue statistics that were two weeks out of date during a trip to Piura in an apparent attempt to downplay the severity of the situation, claiming that there were 5,350 cases and one fatality in the region of Piura, of which the city of Piura is the capital. At the time she was speaking, on May 30, the region had more than 42,000 infections and 39 dead.

"But it's not just the health ministry," says Soto. "It's also the education ministry, the housing ministry, infrastructure and regional governments," which are failing. One of the many problems he criticized was the lack of potable water and sanitation services at schools, with pupils often forced to wash their hands in plastic tubs and flush toilets with buckets of water, making the schools dengue hot spots and forcing the Piura regional government to close them for several weeks.

Government measures to address the outbreak have included fumigation, and warning residents to use mosquito nets at night and avoid leaving out anything that could become a receptacle for rainwater, from rubber boots to dishes for potted plants.

A worker fumigates a house to wipe out the Aedes aegypti mosquito, which spreads dengue fever — one of the measures taken to stem the rising case count. Ernesto Benavides/AFP via Getty Images hide caption

A worker fumigates a house to wipe out the Aedes aegypti mosquito, which spreads dengue fever — one of the measures taken to stem the rising case count.

What scientists say about the outbreak

Scientists are reluctant to finger climate change as the culprit for this outbreak. But the combination of this year's Yaku, the coastal El Niño and Peru's unusual weather have created conditions that let the mosquitoes that spread the disease thrive.

Strong global El Niños, like the one predicted to take effect later in 2023, typically hail warmer global averages the following year, warns Gavin Schmidt, director of NASA's Goddard Institute for Space Studies, one of the world's leading climate change research centers. That means that 2024 could potentially be the hottest year on record.

It might even mean that it could be the first year that mean global temperatures exceed preindustrial averages by more than 1.5° Celsius, the limit set by the United Nations as necessary to avoid devastating climate change.

"I don't think we will pass it [1.5° in 2024]," Schmidt told NPR. "But we will get uncomfortably close."

The current dengue outbreak could offer a window into what's going to be an ever more common occurrence as global warming continues.

And there are clear signs that dengue is no longer confined to the Global South. In the past decade or so, cases have been reported for the first time in countries including Canada, Croatia and France.

Simeon Tegel is a British journalist based in Lima, Peru, from where he regularly roams across Latin America. He covers most topics under the sun, from human rights and democracy to cuisine and travel but specializes in environmental stories. A regular contributor to the Washington Post, he has also published stories in The Independent, The Times, The Telegraph, USA Today, Foreign Policy, Vice, the Spectator and, in Spanish, El País. A foodie and an outdoorsman, he is as at home dining in Lima's finest restaurants as he is bivvying out on a glacier 17,000 feet above sea level or bushwacking through the Amazon.

• climate change
• dengue fever

Peru is enduring its worst dengue outbreak ever. Is El Niño making it worse?

Experts say situation offers insight into effects of climate change on mosquito-borne illnesses.

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Peru is battling the worst dengue outbreak in its recorded history, with more than 140,000 registered cases so far this year, and more than 200 people believed to have died from complications related to infections. 

Dengue is prevalent throughout Peru, particularly in lower altitudes, though cases typically drop off as the weather becomes drier.

But not this year. 

The rainy weather that allows mosquito populations to breed — in pools, puddles and any standing water — hasn't let up thanks, in part, to El Niño — the natural, recurring phenomenon that brings warm conditions to the eastern Pacific Ocean and disrupts weather patterns around the world.

Here is what you need to know about dengue and why weather conditions exacerbated by El Niño, and other factors, may lead to even more infections in Peru and elsewhere. 

What is dengue?

Dengue is a virus carried by Aedes mosquitoes, the same species responsible for the transmission of other diseases including yellow fever, Zika and chikungunya. 

While those mosquitos are present on every continent, except Antarctica, they are most prevalent in tropical and subtropical climates.

People who contract the virus might not always exhibit symptoms but those who do can experience high fever, headache, body aches, nausea and/or rash. 

There's no medical treatment, but most people "get over it with a little misery," said infectious diseases specialist and microbiologist Dr. Michael Libman, the director of the Centre for Tropical Medicine at McGill University in Montreal. 

However some infections can become severe resulting in shock, shortness of breath, severe bleeding, organ damage and death.

Children are particularly at risk from severe cases, when dengue can cause a hemorrhagic fever that can be "quite deadly," said Dr. David Fisman, a professor of epidemiology at the University of Toronto's Dalla Lana School of Public Health.

How does El Niño make it worse?

Peru's confirmed case numbers this year are already double those of 2017, when the World Health Organization declared a dengue epidemic in the country as a smaller El Niño effect caused intense rain and flooding. 

Fisman says El Niño can easily exacerbate an outbreak. 

"More mosquitoes, more bites," he said, explaining how an explosion in mosquito populations, due to optimal breeding conditions, also increases the virus "reservoir." As dengue-carrying mosquitoes infect more people, he said, uninfected mosquitoes then pick up the virus from those humans and subsequently spread it further among the human population. 

Further, the effects of El Niño are different around the world and the increased temperatures it fuels can create drought conditions that also boost mosquito populations — by turning flowing water into standing pools where they can breed.

What can we learn from Peru?

There is, of couse, no Earth-like "control planet" free of climate change to compare the changes happening on Earth. But with El Niño — and its opposite, ocean-cooling pattern La Niña — occurring every two to seven years , it can offer some insight into how extreme weather can affect the spread of viruses like dengue, said Fisman. 

"It's sort of like an experimental system that simulates what we anticipate we'll be seeing more and more under climate change scenarios," he said. Climate change is also expected to affect the intensity of El Niño cycles.

But warming planet temperatures, caused by El Niño or climate change — or both — won't just fuel mosquito breeding cycles, they may also expand the range of those mosquitoes, said McGill's Libman. 

That range is expanding northward, which he says is concerning.

The Aedes mosquitoes are found in southern pockets of the contiguous U.S., including Texas and Florida, though the number of locally transmitted cases are quite low. 

Dengue-carrying mosquitoes are "not in Canada yet, but they're not that far either," Libman said. 

Aedes aegypti mosquitoes, which are more likely to spread diseases like dengue to people, are not present in Canada. Aedes albopictus mosquitoes, which can transmit dengue and other arboviruses to a lesser extent , have appeared in a small corner of southwestern Ontario , though there are no indications they carry exotic illnesses. 

Libman says if warming conditions allow either type to thrive in traditionally temperate regions, there is the possibility arboviruses like dengue could adapt, and perhaps be spread more freely by Aedes albopictus mosquitoes. 

• Analysis El Niño is on our doorstep, but not all are created equal. So what does it mean for Canada?
• Flirting with climate danger: UN forecasts 2 in 3 chance of briefly hitting key heat limit soon
• Warmer world is unhealthier place for children, doctors say

He cited the example of the chikungunya virus, which wasn't present in the Western hemisphere until 2013 . Fisman says chikungunya was typically carried by the Aedes aegypti mosquito but adapted to the Aedes albopictus species and "spread like crazy in the Americas where there was no immunity." 

"It's not out of the question that the [dengue] virus, at some point or another, there will be changes that allow it to be transmitted even in a place like ours," he said. 

Larviciding for mosquitoes

About the author.

Senior Writer

Nick Logan is a senior writer with CBCNews.ca based in Vancouver. He has worked as a multi-platform reporter and producer for more than a decade, with a particular focus on international news. You can reach out to him at [email protected].

With files from Reuters

Related Stories

• Evidence shows mosquitoes capable of carrying Zika virus may have colony in Ontario
• Slap it, send it: UBC researcher wants you to mail him dead mosquitoes for climate change study

Photography

In photos: Peru extends health emergency amid record dengue outbreak

By Jintak Han | Jun 15, 2023

Peru has extended a health emergency in 18 of its 24 regions, recording more than 140,000 cases and at least 200 deaths in the largest dengue outbreak in the South American nation’s history.

Sebastian Castaneda/Reuters

Although Peru has faced dengue epidemics before — even alongside the coronavirus pandemic — it has been struggling to contain this year’s outbreak since February, when it first declared a 90-day health emergency in 13 regions.

Exacerbated by global climate change and compounded by an incoming El Niño cycle , the warmer climate is providing mosquitoes — carriers of the tropical disease — with ideal conditions for breeding.

San Juan de Lurigancho, the most populous neighborhood of Lima, Peru, on May 19.

Sebastian Castaneda/Bloomberg News

A Health Ministry worker fumigates against mosquitoes carrying the dengue virus in the San Juan de Lurigancho neighborhood on May 19.

A house is fumigated on June 11 to prevent the spread of dengue fever in a neighborhood in Piura, northern Peru.

Ernesto Benavides/AFP/Getty Images

Dengue patients Ana Barco, right, with daughter Angie and son Enzo, look out from their window in Piura on June 2.

Martin Mejia/AP

A doctor checks on dengue patients as they rest under mosquito nets at a hospital in Sullana, in northern Peru, on June 9.

Peru has resorted to drastic measures, such as banning water-filled vases in homes, and mass fumigations to stop the spread of dengue fever.

But the outbreak seems to show no signs of slowing down as field hospitals set up to treat dengue patients remain chronically overcrowded, especially in northern Peru, where hospitals are operating far beyond their capacities.

Dengue patients wait to be seen at a hospital in Piura on June 2.

A child with dengue fever plays with cards as he waits for further medical attention at a hospital in Piura on June 2.

Medicine for the treatment of dengue fever sits on a tray at a hospital in Piura on June 2.

David Salazar, 19, a dengue fever patient, rests under a mosquito net at a hospital in Sullana on June 9.

Two vaccines have been developed against dengue, but obstacles to mass immunizations remain. The older Dengvaxia fell out of favor after it was discovered that it increases the risk of severe dengue in people who have never contracted the virus, while Qdenga is so new that it is not yet approved for use in Peru.

For now, containment focuses more on stopping mosquitoes from spreading the disease, either chemically with pesticides or physically with mosquito nets.

Most people recover from dengue fever within a week when they receive proper treatment. But when left untreated, dengue can kill up to 13 percent of patients, according to the U.S. Centers for Disease Control and Prevention.

The belongings of dengue patient Maria Galan hang on a wall at her house in Piura on June 4.

Relatives mourn for Fer Maria Ancajima, a 10-year-old who died of dengue fever, in Catacaos, Peru.

Relatives of Fer Maria Ancajima carry her coffin during her funeral on June 10.

Ana Barco helps her daughter Angie, who is sick with dengue fever, stay hydrated at their home in Piura on June 2.

A house is fumigated in Piura on June 11.

A Health Ministry worker carrying a fogger exits a structure in Lima, Peru, on May 19.

More from The Post

Peru battles record dengue outbreak, in a warning for a warming world

El Niño is looming. Here’s what that means for weather and the world.

The latest from The Washington Post

Photo editing and production by Jintak Han

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Travel Advisory November 15, 2023

Peru - level 2: exercise increased caution.

Last Update: Reissued with updates to crime information.

Exercise increased caution due to  crime, civil unrest, and the possibility of kidnapping . Some areas have increased risk. Read the entire Travel Advisory.

Do not travel to:

• The Colombian-Peruvian border area in the Loreto Region due to  crime .
• The Valley of the Apurímac, Ene, and Mantaro Rivers (VRAEM), including areas within the Departments of Ayacucho, Cusco, Huancavelica, and Junin, due to  crime  and  terrorism .

Country Summary : Crime, including petty theft, carjackings, muggings, assaults, and other violent crime, is common in Peru and can occur during daylight hours despite the presence of many witnesses. Kidnapping is rare, but does occur. The risk of crime increases at night. Organized criminal groups have been known to use roadblocks to rob victims in areas outside of the capital city of Lima.

Demonstrations occur regularly throughout the country. Public demonstrations can take place for a variety of political and economic issues. Demonstrations can cause the shutdown of local roads, trains, and major highways, often without prior notice or estimated reopening timelines. Road closures may significantly reduce access to public transportation and airports and may disrupt travel both within and between cities.

U.S. travelers participating in Ayahuasca and Kambo ceremonies should be aware that numerous persons, including U.S. citizens, have reported that while under the influence of these substances, they have witnessed or been victims of sexual assault, rape, theft, serious health problems and injuries, and even death.

Currently, U.S. government personnel cannot travel freely throughout Peru for security reasons . Read the  country information page  for additional information on travel to Peru.

If you decide to travel to Peru:

• Be aware of your surroundings.
• Monitor local media for breaking events and adjust your plans as needed.
• Enroll in the  Smart Traveler Enrollment Program  ( STEP ) to receive Alerts and make it easier to locate you in an emergency.
• Follow the Department of State on  Facebook  and  Twitter .
• Follow the U.S. Embassy on  Facebook  and  Twitter .
• Review the U.S. Embassy  webpage .
• Review the  Country Security Report  for Peru.
• Prepare a contingency plan for emergency situations. Review the  Traveler’s Checklist .
• Visit the CDC page for the latest  Travel Health Information  related to your travel.

Colombian-Peruvian border area in the Loreto Region – Level 4: Do Not Travel

Drug trafficking and other criminal activity, combined with poor infrastructure, limits the capability and effectiveness of Peruvian law enforcement in this area.

The U.S. government has limited ability to provide emergency services to U.S. citizens as U.S. government personnel are restricted from traveling within 20 kilometers of the border with Colombia in the Loreto region, except on the Amazon River itself, without permission. This includes travel on the Putumayo River, which forms most of the Peru-Colombia border.

U.S. government personnel must receive advance permission for any travel to the Peruvian-Colombian border.

Valley of the Apurímac, Ene, and Mantaro Rivers (VRAEM) includes areas within the Departments of Ayacucho, Cusco, Huancavelica, and Junin – Level 4: Do Not Travel

Remnants of the Shining Path terrorist group are active in the VRAEM. The group may attack with little or no warning, targeting Peruvian government installations and personnel.

Drug trafficking and other criminal activity, combined with poor infrastructure, limit the capability and effectiveness of Peruvian law enforcement in this area.

U.S. government personnel are restricted from traveling in the VRAEM except for certain areas during daylight hours. U.S. government personnel must receive advance permission for any travel to the VRAEM. The U.S. government has limited ability to provide emergency services to U.S. citizens due to these travel restrictions.

Visit our website for  Travel to High-Risk Areas .

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Must have six months validity at time of entry.

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Free, issued at the port of entry.

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$30,000 USD. More than $10,000 USD must be declared upon entry.

Same as entry.

Embassies and Consulates

U.S. Embassy Lima Avenida La Encalada cdra. 17 s/n Surco, Lima 33 Peru Telephone: + (51)(1) 618-2000 Emergency After-Hours Telephone: + (51)(1) 618-2000 Fax: + (51) (1) 618-2724 Email: [email protected]

U.S. Consular Agency - Cusco Av. El Sol 449, Suite #201 Cusco, Peru Telephone: + (51)(84) 231-474 Emergency After-Hours Telephone:  + (51)(1) 618-2000 Fax: + (51)(84) 245-102

Email: [email protected]

Destination Description

See the Department of State’s Fact Sheet on Peru for information on U.S.-Peru relations.

Entry, Exit and Visa Requirements

COVID-19 Requirements

• There are no COVID-related entry requirements for U.S. citizens.

Requirements for Entry :

• A passport with six months validity is required to enter Peru. Migraciones (Immigration) authorities may also require evidence of return/onward travel.
• Be sure your date and place of entry is officially documented by Migraciones, whether you arrive at a port, airport, or land border.
• Your length of approved stay will be determined by border officials at the time of entry, and can range from 30 to 183 days. Extensions for tourists are usually not approved, and overstays result in fines.
• The Embassy is unable to assist if you are denied entry. Peruvian immigration requires airlines to return travelers who are denied entry to their point of origin.

Requirements for Exit :

• If you do not have an entry record, you will not be allowed to exit the country until immigration authorities confirm the time and place of your entry into the country. This can be a difficult process, costing considerable time and money to resolve.
• Make sure Migraciones (Immigration) records your entry, and then save the record for your exit. An entry record is required even at remote border crossings, where often the proper officials are not present.
• Immediately report lost/stolen passports to local police and keep the report. You must apply for a new passport at the Embassy and obtain a replacement entry record from Migraciones using your police report prior to exiting Peru.

Travel with Minors : Regardless of nationality, all children who are traveling with both birth parents are required to have a valid passport and the necessary visa or citizenship of the country where they are traveling. Peruvian immigration procedures are complex for minors traveling without one or both parents/legal guardians.

For entry/exit from Peru, U.S. citizen minors under the age of 18, traveling alone (or with only one parent), generally do not require additional documentation if entering as a tourist for less than 183 days. However, if the stay lasts more than 183 days, then a Permiso Notarial de Viaje is required (see below).

U.S. citizen minors who are dual national Peruvians, traveling alone (or with only one parent), require a Permiso Notarial de Viaje. Furthermore, step-parents or guardians accompanying a dual U.S.-Peruvian citizen minor must provide a Permiso Notarial de Viaje from the non-traveling minor’s parents (as listed on the birth certificate). Finally, if an accompanying parent has sole custody, legal documentation is required (such as a foreign court-approved custody document stating sole custody, a death certificate, a Peruvian court-approved document for travel, or a birth certificate listing only one parent).

A Permiso Notarial de Viaje is a written, notarized authorization from the non-traveling parent(s). Peruvian immigration will not accept a document notarized by the U.S. Embassy or a document notarized by a U.S. notary in lieu of a Permiso Notarial de Viaje. Please be aware that these authorizations are valid for 30 days and one trip only.

How to get a Permiso Notarial de Viaje:

• In the United States, at the nearest Peruvian Consulate. There are multiple locations .
• In Peru, at most Peruvian notaries. An apostilled U.S. birth certificate is required for issuance.

The U.S. Embassy is unable to assist travelers who are prevented from traveling for lack of a Permiso Notarial de Viaje.

HIV Restrictions : The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to, or foreign residents of, Peru.

Find information on dual nationality , prevention of international child abduction , and customs regulations on our websites.

Safety and Security

Terrorism:   Terrorist groups and those inspired by such organizations are intent on attacking U.S. citizens abroad. Terrorists are increasingly using less sophisticated methods of attack – including knives, firearms, and vehicles – to more effectively target crowds. Frequently, their aim is unprotected or vulnerable targets, such as: 

• High-profile public events (sporting contests, political rallies, demonstrations, holiday events, celebratory gatherings, etc.) 
• Hotels, clubs, and restaurants frequented by tourists 
• Places of worship 
• Schools 
• Parks 
• Shopping malls and markets 
• Public transportation systems (including subways, buses, trains, and scheduled commercial flights)  

U.S. Embassy Lima enforces a Restricted Travel Policy for Embassy personnel, which is based on its assessment of conditions and developments throughout the country. See the Overseas Security and Advisory Council’s Country Security Report for Peru. See the latest Travel Advisory for Peru .

The VRAEM (Valley of the Apurímac, Ene, and Mantaro Rivers) is particularly remote and a known safe haven for narcotraffickers and the last operational remnants of the Shining Path terrorist group.

For more information, see our  Terrorism  page.  

Crime : Crime is a widespread problem in Peru.

• Sexual assaults and rapes can occur, even in tourist areas. Travel in groups, do not leave food or drinks unattended, and use caution if a stranger offers you food or drink.
• Intoxicated travelers, including U.S. citizens, also have been sexually assaulted, injured, or robbed while under the influence of drugs and alcohol.
• Pick-pocketing, robbery, and hotel room theft are the most common crimes. Armed robberies have occurred throughout the city, including popular tourist destinations. Armed assailants usually target victims for their smartphones, wallets, or purses. If confronted by someone with a weapon, it is best not to resist.
• Incapacitating drugs, such as rohypnol and scopolamine, have been used to facilitate robberies and sexual assaults. Seek medical attention if you begin to feel ill.
• On routes to and from the airport in Lima, robberies have occurred where the assailant uses a tool to break a window while the vehicle is stopped in traffic.  Keep your belongings in the trunk or out of sight. Authorized taxi booths are present at the airport in Lima that will charge a flat rate according to the destination.
• Use hotel safes, if available. Avoid wearing obviously expensive jewelry or clothing, and carry only the cash or credit cards that you need.
• Stay alert in crowds and on public transportation. Be aware that thieves might create distractions to target you.
• Avoid isolated areas when on foot, especially after dark.
• Be alert for robberies in which criminals enter a taxi and force victims to withdraw money from ATMs.
• Use an app-based taxi service, order a taxi by phone, or use a service affiliated with a major hotel, as it is usually safer than hailing an unknown taxi on the street.
• Use ATMs in well-protected indoor areas such as banks or shopping malls. Avoid withdrawing large amounts of cash at one time.
• Do not let your credit card out of your sight in order to avoid credit card “skimming.” You should expect the vendor to use a credit card reader in your presence. The vendor will ask for your passport or ID number on the receipt.
• To avoid carjacking or theft from your car while you are stopped at intersections, drive with your doors locked and windows rolled up. Do not leave valuables in plain view.

There is little government presence in many remote areas of the Andes and Amazon basin. Illicit activities, such as illegal mining, logging, and coca production, are common.

Drug trafficking and other criminal activity, combined with poor infrastructure, limit the capability and effectiveness of Peruvian law enforcement in these areas.

The U.S. government has limited ability to provide emergency services to U.S. citizens along the Colombian border and in the VRAEM, as U.S. government personnel are restricted from traveling in these regions.

Demonstrations  occur frequently. They may take place in response to political or economic issues, on politically significant holidays, and during international events. 

• Demonstrations can be unpredictable; avoid areas around protests and demonstrations.
• Past demonstrations have turned violent.
• Check local media for updates and traffic advisories. 

International Financial Scams:  See the  Department of State  and the  FBI pages for information.

Financial scams are prevalent in Peru. Scams are often initiated through Internet postings/profiles or by unsolicited emails and letters. Scammers almost always pose as U.S. citizens who have no one else to turn to for help. Common scams include:

• Money transfers 
• Grandparent/Relative targeting 

Victims of Crime :  U.S. citizen victims of sexual assault are encouraged to contact the U.S. Embassy for assistance. Report crimes to the local police and contact the U.S. Embassy in Lima. Remember that local authorities are responsible for investigating and prosecuting crime.

• U.S. Embassy: +51-1-618-2000 (phone is answered 24 hours a day, seven days a week)
• Local police: 105 (National Police)
• Tourist Police: 0800-22221
• IPeru: 01-574-8000 (a tourist information service that has English-speaking personnel)

See our webpage on help for U.S. victims of crime overseas .

• Help you find appropriate medical care.
• Assist you with reporting a crime to the police.
• Contact relatives or friends with your written consent.
• Provide general information regarding the victim’s role during the local investigation and following its conclusion.
• Provide a list of local attorneys.
• Provide information on victims’ compensation programs in the United States .
• Provide information on assistance programs for victims of crime in Peru .
• Provide an emergency loan for repatriation to the United States and/or limited medical support in cases of destitution.
• Help you find accommodation and arrange flights home.
• Replace a stolen or lost passport.

Domestic Violence :  U.S. citizen victims of domestic violence are encouraged to contact the Embassy for assistance. Telephone (answered 24 hours): +51-1-618-2000

Tourism : The tourism industry, including adventure activities (e.g. paragliding, sandboarding, etc.), is unevenly regulated, and safety inspections for equipment and facilities do not commonly occur. Hazardous areas/activities are not always identified with appropriate signage, and staff may not be trained or certified either by the host government or by recognized authorities in the field. U.S. citizens are encouraged to pay attention to waiver and liability policies of tour companies, as they may vary or not exist. In the event of an injury, appropriate medical treatment is typically available only in/near major cities. First responders are generally unable to access areas outside of major cities and to provide urgent medical treatment. U.S. citizens are encouraged to purchase medical evacuation insurance . 

Local Laws & Special Circumstances

Criminal Penalties : You are subject to local laws. If you violate local laws, even unknowingly, you may be expelled, arrested, or imprisoned. Individuals establishing a business or practicing a profession that requires additional permits or licensing should seek information from the competent local authorities prior to practicing or operating a business.

Ayahuasca/Kambo/Hallucinogens:  Traditional hallucinogens, often referred to as ayahuasca or kambo, are often marketed to travelers as “ceremonies” or “spiritual cleansing,” and typically contain dimethyltryptamine (DMT), a strong hallucinogen that is illegal in the United States and many other countries.

• Intoxicated travelers, including U.S. citizens, have been sexually assaulted, injured, or robbed while under the influence of these substances.
• Health risks associated with ayahuasca are not well understood, and, on occasion, U.S. citizens have suffered serious illness or death after taking these drugs.
• These incidents often occur in remote areas and far away from modern medical facilities, making the risks even greater.
• Penalties for possessing, using, or trafficking in illegal drugs in Peru are severe.
• Offenders can expect long pre-trial detention and lengthy prison sentences under harsh conditions with significant expense for themselves and/or their families.
• Never agree to carry a suitcase or package through customs for anyone.
• Peru uses strict screening procedures for detecting narcotics smuggling at its international airports.

Customs Currency Regulations :

• $30,000 USD or its equivalent in cash or negotiable items is the maximum allowed for entry or exit.
• Any amount in excess of $10,000 USD must be declared and the legal source proven.

Artifacts :

• Peruvian law forbids the export of pre-Columbian objects and other artifacts protected by cultural patrimony statutes.
• U.S. customs officials are required to seize pre-Columbian objects and certain colonial religious artwork brought into the United States.

Animal Products/Plants :

• Avoid products made of wild plants and animals, as many are of illegal origin and may involve protected or endangered species, whose sale and export are illegal.
• Peruvian authorities will seize any protected species that is sold or transported, either live or transformed into food, medicinal beverages, leather, handcrafts, garments, etc.
• Some products, including live animals, require special permits when leaving Peru.
• Knowingly importing into the United States wildlife or plants that were taken from the wild or sold in violation of the laws of Peru (or any other country) is a violation of the Lacey Act (16 USC § 3371).

Furthermore, some laws are also prosecutable in the United States, regardless of local law. For examples, see our website on crimes against minors abroad and the Department of Justice website.

Arrest Notification : If you are arrested or detained, ask police or prison officials to notify the U.S. Embassy immediately. See our webpage for further information.

Special Circumstances : Many popular destinations in Peru are remote. These areas have few facilities that are able to provide advanced or emergency medical care.

• Local rescue capabilities are severely limited. Many mountain areas are too high for helicopters to reach safely. Accidents or injuries while hiking or climbing are common; crisis responders may take hours or even days to reach you if they are traveling over great distances and/or rough terrain.
• When using tourist company services, travelers are encouraged to use qualified and licensed operators. Many do not meet international safety standards. Inquire about safety standards prior to engaging in adventure activities. The Ministerio de Comercio Exterior y Turismo (Tourism Ministry) website provides information on tourism companies.
• Always check with local authorities before traveling about local geographic, climatic, health, and security conditions that may impact your safety.
• Be aware that you may not have access to phone or internet for days at a time. Check in with family prior to going to remote areas and leave detailed written plans and timetables. Use of a personal GPS beacon is encouraged.

Seismic Activity :  Earthquakes are common throughout Peru. On May 26, 2019, a magnitude 8.0 earthquake struck the Loreto region of Peru. One fatality in the Cajamarca region and 11 injuries as well as isolated power outages and some infrastructure damage were reported.

• Visit Peru’s National Emergency Operations Center (COEN) for more information.
• In the event of a natural disaster, monitor local media and government agencies, including IPeru , the Commission to Promote Peru for Exports and Tourism (PROMPERU) , and Peru’s National Meteorology and Hydrology Service (SENAMHI) for updates.
• WhatsApp: IPeru +51-944-492-314
• Twitter: @Promperu @COENPeru @SENAMHIPeru @Sismos_Peru_IGP
• Visit the U.S. Centers for Disease Control and Prevention website for information on emergency preparedness and response.

Legal Issues in Peru :

• The legal system in Peru may require victims or their families to hire lawyers to advance their cases through the legal system, even for victims of serious crimes.
• U.S. citizens have reported unethical practices by lawyers and others, resulting in costly losses and little hope of remedy through the local judicial system.
• Peruvian laws are subject to change with little notice . The Peruvian government publishes little information in English. The U.S. Embassy cannot give detailed advice about Peruvian law.

Counterfeit and Pirated Goods : Although counterfeit and pirated goods are prevalent in many countries, they may still be illegal according to local laws. You may also pay fines or have to give them up if you bring them back to the United States. See the U.S. Department of Justice website for more information.

Faith-Based Travelers : See the following webpages for details:

• Faith-Based Travel Information
• International Religious Freedom Report – see country reports
• Human Rights Report – see country reports

LGBTQI+ Travelers : There are no legal restrictions on same-sex sexual relations or the organization of LGBTI events in Peru.

See our LGBTQI+ Travel Information page and section 6 of our Human Rights report for further details.

Travelers with Disabilities:  Peruvian law prohibits discrimination against persons with physical and mental disabilities, and the law is enforced.  Social acceptance of persons with disabilities in public is as prevalent as in the United States. The most common types of accessibility may include ramps, special cashiers for those with disabilities, and elevators. Expect accessibility to be limited in public transportation, and common in lodging, communication/information, and general infrastructure. There is a significant difference between Lima (and other large cities) and the rest of the country.

• Rental, repair, and replacement services are available for aids/equipment/devices.
• The Ministry of Foreign Affairs has a list of translators .

Students : See our Students Abroad page and FBI travel tips .

Women Travelers : See our travel tips for Women Travelers .

COVID-19 Testing:

• PCR and/or antigen tests are available for U.S. citizens in Peru, and test results are reliably available within one calendar day.
• Peru is able to test for COVID-19 in country. Private hospitals and laboratories as well as the Peruvian Ministry of Health (MINSA) are administering tests.
• U.S. citizens are responsible for their own COVID-19 testing costs.

COVID-19 Vaccines:

The COVID-19 vaccine is available for U.S. citizens to receive in Peru. Visit the FDA's website to  learn more about FDA-approved vaccines  in the United States.  

• Pfizer-BioNTech, Moderna, AstraZeneca, and Sinopharm vaccines are available in Peru.
• For more information about the Peruvian Ministry of Health’s (MINSA) national vaccine strategy, see (in Spanish)  MINSA's website .

Medical Care :

• Specialized medical care can cost tens of thousands of dollars, and you are expected to pay in full at the time of discharge.
• Pharmacies are widely available. However, some medications might not be offered, and brand names will differ from products in the United States.
• Exercise caution if you explore herbal and folk remedies.

For emergency services in Peru, dial 113 .

Ambulance services are not present throughout the country or are unreliable in most areas except Lima and other major cities. Training and availability of emergency responders may be below U.S. standards. Injured or seriously ill travelers may prefer to take a taxi or private vehicle to the nearest major hospital rather than wait for an ambulance.

We do not pay medical bills . Be aware that U.S. Medicare/Medicaid does not apply overseas. Most hospitals and doctors overseas do not accept U.S. health insurance.

Medical Insurance : Make sure your health insurance plan provides coverage overseas. Most care providers overseas only accept cash payments. See our webpage for more information on insurance overseas. Visit the U.S. Centers for Disease Control and Prevention for more information on type of insurance you should consider before you travel overseas.

We strongly recommend supplemental insurance to cover medical evacuation.

Always carry your prescription medication in original packaging, along with your doctor’s prescription. Check with the Government of Peru to ensure the medication is legal in Peru.

Vaccinations : Be up-to-date on all vaccinations recommended by the U.S. Centers for Disease Control and Prevention.

Further health information :

• World Health Organization
• U.S. Centers for Disease Control and Prevention (CDC)

Air Quality : Visit  AirNow Department of State  for information on air quality at U.S. Embassies and Consulates.

The U.S. Embassy maintains a list of doctors and hospitals . We do not endorse or recommend any specific medical provider or clinic.

Health Facilities in General:

• Adequate health facilities are available in Lima and other major cities, but health care in rural areas may be below U.S. standards.
• Public medical clinics lack basic resources and supplies.
• Hospitals and doctors often require payment “up front” prior to service or admission. Credit card payment is usually available. Some hospitals and medical professionals require cash payment.
• Private and public hospitals usually require advance payment or proof of adequate insurance before admitting a patient.
• Travelers should make efforts to obtain complete information on billing, pricing, and proposed medical procedures before agreeing to any medical care.
• Medical staff may speak little or no English.
• Generally, in public hospitals only minimal staff is available overnight in non-emergency wards.
• Patients bear all costs for transfer to or between hospitals if they do not have insurance.
• Psychological and psychiatric services are limited, even in the larger cities, with hospital-based care only available through government institutions.

Medical Tourism and Elective Surgery :

• U.S. citizens have suffered serious complications or died during or after having cosmetic or other elective surgery.
• Medical tourism is a rapidly growing industry. People seeking health care overseas should understand that medical systems operate differently from those in the United States and are not subject to the same rules and regulations. Anyone interested in traveling for medical purposes should consult with their local physician before traveling and visit the U.S. Centers for Disease Control and Prevention website for information on Medical Tourism, the risks of medical tourism, and what you can do to prepare before traveling to Peru.
• We strongly recommend supplemental insurance to cover medical evacuation in the event of unforeseen medical complications.
• Your legal options in case of malpractice are very limited in Peru.
• Although Peru has many elective/cosmetic surgery facilities that are on par with those found in the United States, the quality of care varies widely. If you plan to undergo surgery in Peru, make sure that emergency medical facilities are available and professionals are accredited and qualified.

Pharmaceuticals:

• Exercise caution when purchasing medication overseas. Pharmaceuticals, both over the counter and requiring prescription in the United States, are often readily available for purchase with little controls. Counterfeit medication is common and may prove to be ineffective, the wrong strength, or contain dangerous ingredients. Medication should be purchased in consultation with a medical professional and from reputable establishments.
• U.S. Customs and Border Protection and the Food and Drug Administration are responsible for rules governing the transport of medication back to the United States. Medication purchased abroad must meet their requirements to be legally brought back into the United States. Medication should be for personal use and must be approved for usage in the United States. Please visit the  U.S. Customs and Border Protection  and the  Food and Drug Administration  websites for more information.   

Please review Peru's rules on medication .  

Non-Traditional Medicine:

• U.S. citizens have suffered serious complications or died while seeking medical care from non-traditional “healers” and practitioners in Peru. Ensure you have access to licensed emergency medical facilities in such cases.

Assisted Reproductive Technology and Surrogacy :

• If you are considering traveling to Peru to have a child through use of assisted reproductive technology, please see our ART and Surrogacy Abroad page .
• Surrogacy is illegal for foreigners in Peru, subject to complex local regulation.
• If you decide to pursue parenthood in Peru via assisted reproductive technology (ART) with a gestational mother, be prepared for long and unexpected delays in documenting your child’s citizenship. Be aware that individuals who attempt to circumvent local law risk criminal prosecution.

Water Quality:

• In many areas, tap water is not potable. Bottled water and beverages are generally safe, although you should be aware that many restaurants and hotels serve tap water unless bottled water is specifically requested. Be aware that ice for drinks may be made using tap water. 
• Many cities in Peru, such as Puno, Cusco, Arequipa, Ayacucho, and Huaraz, are at high altitude. Be aware of the symptoms of altitude sickness, and take precautions before you travel. Visit the U.S. Centers for Disease Control and Prevention website for more information about  Travel to High Altitudes .

Adventure Travel:

• Visit the U.S. Centers for Disease Control and Prevention website for more information about  Adventure Travel . 

General Health :

The following diseases are prevalent:

• Travelers’ Diarrhea
• Guillain-Barré Syndrome
• Hepatitis A and B
• Leishmaniasis
• Tuberculosis
• Yellow fever

Use the U.S. Centers for Disease Control and Prevention recommended mosquito repellents and sleep under insecticide-impregnated mosquito nets. Chemoprophylaxis is recommended for all travelers even for short stays.  

HIV/AIDS: For more information visit MINSA’s website (in Spanish): https://www.dge.gob.pe/vih/ .

Visit the U.S. Centers for Disease Control and Prevention website for more information about  Resources for Travelers  regarding specific issues in Peru.

Air Quality:

• Air pollution is a significant problem in several major cities in Peru. Consider the impact seasonal smog and heavy particulate pollution may have on you and consult your doctor before traveling if necessary.  
• Infants, children, and teen.
• People over 65 years of age.
• People with lung disease such as asthma and chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema.
• People with heart disease or diabetes.
• People who work or are active outdoors. 

Travel and Transportation

Road Conditions and Safety :  Driving conditions in Peru are very different from those found in the United States, and can be considerably more dangerous. Visitors are strongly encouraged to familiarize themselves with local law and driving customs before attempting to operate vehicles.

• Roads are often poorly maintained and may lack crash barriers, guard rails, signs, and streetlights.
• Fog is common on coastal and mountain highways, making conditions more treacherous.
• Slow-moving buses and trucks frequently stop in the middle of the road unexpectedly.
• Road travel at night is particularly hazardous. Due to safety concerns, U.S. Embassy personnel are prohibited from traveling on mountainous roads at night.
• Traveling in a group is preferable to solo travel. Spare tires, parts, and fuel are needed when traveling in remote areas, where distances between service areas are long.

Traffic Laws:  Traffic laws are often ignored and rarely enforced, creating dangerous conditions for drivers and pedestrians.

• Seat belts are mandatory for driver and front-seat passengers in a private vehicle.
• It is against the law to talk on a cellular phone while driving, and violators may be fined.
• When driving in urban areas, taxis and buses often block lanes impeding traffic.
• Directional signals are often not used, and vehicles frequently turn from the middle through traffic lanes.
• While driving outside major cities and on the Pan-American Highway, you must drive with your lights on.
• Traffic officers must wear uniforms and identification cards that include their last name on their chest.
• Traffic officers are not allowed to retain your personal identification or vehicle documents.
• Under no circumstances should you offer or agree to pay money to traffic officers.
• If you are involved in an accident, you MUST contact local police and remain at the scene without moving your vehicle until the authorities arrive. This rule is strictly enforced, and moving a vehicle or leaving the scene of an accident may constitute an admission of guilt under Peruvian law.
• If your car is a rental, call the agency or representative of the insurance company provided by the rental agency.
• Always carry your driver's license, a copy of your passport, and the rental agreement when you drive a rental car.
• International driver's licenses are valid for one year, while driver's licenses from other countries are generally valid for 30 days.

Public Transportation : Many buses are overcrowded, poorly maintained, and lack safety features such as seat belts.

• Bus accidents resulting in multiple deaths and injuries are common due to routes along narrow, winding roads without a shoulder and steep drop-offs.
• Accidents are frequently attributed to excessive speed, poor bus maintenance, poor road conditions, and driver fatigue.
• Individuals should use private taxi companies or car-share applications when traveling as opposed to hailing taxis on the side of the road for safety.

See our Road Safety page for more information. Visit the website of Peru’s  national tourist office  and national authority responsible for road safety. 

Aviation Safety Oversight : The U.S. Federal Aviation Administration (FAA) has assessed the government of Peru’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Peru’s air carrier operations. Further information may be found on the FAA’s safety assessment page .

Maritime Travel : Mariners planning travel to Peru should check for U.S. maritime advisories and alerts . Information may also be posted to the U.S. Coast Guard homeport website , and the NGA broadcast warnings .

For additional travel information

• Enroll in the  Smart Traveler Enrollment Program (STEP)  to receive security messages and make it easier to locate you in an emergency.
• Call us in Washington, D.C. at 1-888-407-4747 (toll-free in the United States and Canada) or 1-202-501-4444 (from all other countries) from 8:00 a.m. to 8:00 p.m., Eastern Standard Time, Monday through Friday (except U.S. federal holidays).
• See the  State Department’s travel website  for the  Worldwide Caution  and  Travel Advisories .
• Follow us on  Twitter  and  Facebook .
• See  traveling safely abroad  for useful travel tips.

Peru was cited in the State Department’s 2022 Annual Report to Congress on International Child Abduction for demonstrating a pattern of non-compliance with respect to international parental child abduction. Review information about International Parental Child Abduction in  Peru . For additional IPCA-related information, please see the  International Child Abduction Prevention and Return Act ( ICAPRA )  report.

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The Foreign, Commonwealth & Development Office ( FCDO ) provides advice about risks of travel to help British nationals make informed decisions. Find out more about FCDO travel advice .

Areas where  FCDO  advises against all but essential travel  

Your travel insurance could be invalidated if you travel against advice from the Foreign, Commonwealth & Development Office (FCDO).

Within 20km south of the Peru-Colombia border 

FCDO  advises against all but essential travel to areas within 20km south of the Putumayo River and border between Peru and Colombia (Loreto region) except for: 

• the Amazon River
• the area of the triple border with Brazil and Colombia from and including the towns of Caballococha in Peru up to the actual triple border at Santa Rosa de Yavari town

The Valley of the Apurímac, Ene, and Mantaro Rivers ( VRAEM )

FCDO advises against all but essential travel to the Valley of the Apurímac, Ene, and Mantaro Rivers, also known as the VRAEM region.

Most visits to Peru are incident free. FCDO advises against all but essential travel to the two areas above for safety and security reasons.

Find out more about  why  FCDO  advises against travel . 

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• Copy URL https://www.pbs.org/newshour/health/what-you-need-to-know-about-the-latest-outbreak-of-dengue-fever

What you need to know about the latest outbreak of dengue fever

Roughly 4.7 million people have been infected with dengue fever so far in 2024, an explosion of cases centered in Latin America and the Caribbean that experts warn could grow.

“We’re seeing a worrisome trend of expansion and increasing circulation of the virus at the global scale,” said Dr. Gonzalo Vazquez-Prokopec, a professor at Emory University who researches the intersection of ecology, epidemiology and global health.

Heavy precipitation from El Nino and the ongoing effects of human-driven climate change have fostered conditions in which mosquitoes that carry the disease can thrive. Populations in more regions of the world are being exposed to dengue as summers grow longer and hotter summers, especially in urban areas that are home to Aedes aegypti , the type of mosquito that transmits the virus, Vazquez-Prokopec said.

In late March, Puerto Rico issued a public health emergency after about 600 people were confirmed to have dengue fever, leading to hundreds of hospitalizations.

READ MORE : Puerto Rico has declared an epidemic following a sharp rise in dengue cases

People living in and traveling to these areas can take precautions to prevent exposure and further transmission. While vaccines exist to prevent the worst outcomes of dengue fever, there is no cure if someone gets sick.

How many cases have been identified in this outbreak?

So far in the first four months of 2024 alone, more than 4.6 million people in the Americas are estimated to have been infected with dengue fever, said Thais Dos Santos of Pan-American Health Organization (PAHO) . That amounts to more cases than were recorded during all of 2023, she said.

How is dengue fever transmitted?

The dengue virus is carried in the gut of female mosquitoes. When the insect bites an infected person and then feeds on someone else, it can spread the infection to that person.

People cannot directly spread dengue to each other.

Places with unreliable access to clean drinking water are particularly vulnerable in part because people may need to collect and store water in vessels, which become the perfect environment for mosquitoes to breed.

What are the symptoms of dengue fever?

Roughly two-thirds of people who are infected with dengue show no signs for disease, Dos Santos said.

But for those who do, symptoms typically develop within two weeks. People most commonly complain of sudden high fever and headache. The illness can be painful, and a person’s condition can deteriorate rapidly, Dos Santos said. Symptoms include muscle and joint pain, fatigue, nausea and vomiting.

Who is at risk of severe dengue infections?

There are four known serotypes, or strains, of the dengue virus. Infection with one strain typically leaves the person who was sick with lifelong immunity, but only from that strain, said Dr. Anna Durbin, who directs the Center for Immunization Research at Johns Hopkins University.

If the person gets infected again with a different strain, that can launch a process called antibody-dependent enhancement, where the immune system’s collection of antibodies “acts as a chaperone,” Durbin said, escorting the virus throughout the body. The person can become extremely ill and may require hospitalization.

Because first-time infections often result in undetected cases with no symptoms or mild ones, many people do not realize they have been exposed. It is upon the second bite and introduction of a different strain that people can get really sick, Vazquez-Prokopec said.

“If there's an outbreak going on, the best thing to prevent severe dengue is to go to the doctor as soon as you feel symptoms,” he said.

What treatment is available for dengue fever?

While there is no cure for dengue fever, people experiencing symptoms of infection can work with their health care provider to manage them. This may include taking medication to relieve pain, increasing fluid intake to prevent dehydration and getting plenty of rest.

What can be done to prevent dengue fever?

Use mosquito repellant and wear long-sleeved shirts and long pants in areas where dengue is spreading, Vazquez-Prokopec said. Mosquitoes that transmit dengue are day biters, so mosquito nets over beds are a less effective prevention measure (although these fine-mesh nets are recommended to slow the spread of other mosquito-borne illnesses, such as malaria ).

“Make sure you don't accumulate standing water in or around your house,” Dos Santos said.

In addition to removing standing water when possible, Vazquez-Prokopec said it is important that communities spray for mosquitoes and households use mosquito-repellent coils to deter the insects from feeding on residents.

He added that when traveling to an area where dengue fever is endemic, it’s a good idea to wear mosquito repellant for the next three or four days after returning home to prevent introduction of the disease to your community.

One prevention method that has gained attention is the introduction of male mosquitoes infected with the bacteria Wolbachia . When those mosquitoes mate with female mosquitoes, the resulting eggs do not hatch, thus stopping the possible spread of any diseases the insects may carry.

“We cannot give up on vector control,” Vazquez-Prokopec said.

Why is this recent outbreak so widespread?

Dengue cases declined between 2016 and 2018 but began an uptick before the COVID pandemic, Durbin said. COVID lockdowns prevented people (and the virus) from circulating, meaning fewer people were getting bitten or had a chance to develop immunity.

But a recent surge of global travel, coinciding with an El Nino year, has translated to a dramatic increase in confirmed and suspected dengue infections, Durbin said.

“In the past two years, it's exploded,” she said.

More than 5 million people have developed dengue fever since early 2023, according to estimates released by the World Health Organization in January, and the Americas “reported the largest proportion of the global burden.” Confirmed and suspected cases in the Western Hemisphere have more than quadrupled over the last five years.

Will the continental U.S. experience a significant outbreak?

For now, most people in the continental U.S. do not need to be concerned about dengue fever, Dos Santos said. During warm weather, a lot of people spend time inside screened-in houses with air conditioning, she said. When they are thirsty, they turn a faucet for water and generally do not need to store rainwater. But that type of infrastructure is not guaranteed in parts of the world that struggle more regularly with dengue fever, she said.

Laura Santhanam is the Health Reporter and Coordinating Producer for Polling for the PBS NewsHour, where she has also worked as the Data Producer. Follow @LauraSanthanam

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COVID-19: travel health notice for all travellers

Peru travel advice

Latest updates: Entry and exit requirements – updated information on entry restrictions at land and river borders with Ecuador

Last updated: June 4, 2024 08:03 ET

On this page

Safety and security, entry and exit requirements, laws and culture, natural disasters and climate, peru - exercise a high degree of caution.

Exercise a high degree of caution in Peru due to high levels of crime, as well as social conflicts and strikes that may occur across the country.

Regional advisory - Avoid non-essential travel

• Huallaga and Tocache provinces in the department of San Martín
• the Upper Huallaga and Ene river valleys in the departments of Huánuco and San Martín
• Padre Abad province in the department of Ucayali
• Huacaybamba, Humalíes, Leoncio Prado and Marañón provinces in the department of Huánuco
• Concepción and Satipo provinces in the department of Junín
• Tayacaja province in the department of Huancavelica
• the districts of Abancay, Andahuaylas and Chincheros in the department of Apurímac
• Huanta and La Mar provinces, in the department of Ayacucho
• Valley of Apurimac, Ene and Mantaro rivers (VRAEM)

Border area with Colombia - Avoid non-essential travel

Avoid non-essential travel to areas within 20 km of the border with Colombia due to drug trafficking and occasional incursions by armed guerrilla forces from Colombia into Peru.

Border area with Ecuador - Avoid non-essential travel

Avoid non-essential travel to areas within 20 km of the border with Ecuador, especially in the Cordillera del Cóndor region, due to the safety threat posed by landmines.

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State of emergency in regions bordering Ecuador

On January 10, 2024, the Peruvian government declared a state of emergency in the northern regions bordering Ecuador following the Government of Ecuador’s declaration of a nationwide state of “internal armed conflict” on January 9, 2024. The state of emergency is in effect in the following regions:

If you are in these regions, you should carry identification with you at all times.

Demonstrations and strikes

Demonstrations and strikes take place regularly throughout the country. Strikes can complicate travel and disrupt public transport and services, including your ability to travel to or leave isolated tourist destinations such as Machu Picchu. They could also lead to border closures with Bolivia. Protestors may also block rivers essential for transportation in some remote regions, including the Manu region of Madre de Dios and Iquitos region. This may result in the temporary detainment of tourists.

Even peaceful demonstrations can turn violent at any time. Police have used tear gas and other methods to disperse crowds in the past. Authorities often declare a state of emergency in response to demonstrations. 

Peruvian law prohibits political activities by foreigners. You may face detention or deportation if you take part in a demonstration.

• Avoid areas where demonstrations and large gatherings are taking place
• Follow the instructions of local authorities
• Consult local media to be aware of strikes and demonstrations that may affect your stay or travel plans

Mass gatherings (large-scale events)

State of Emergency 

The Peruvian government periodically declares a state of emergency in certain areas to allow the military to assist police forces to respond to security incidents and natural disasters. When a state of emergency is in effect, security forces have increased rights to:

• restrict freedom of movement
• monitor correspondence
• conduct search and seizures
• detain persons of interest

Border area with Colombia

Criminal activity related to narcotics trafficking and occasional incursions by armed guerrilla forces from Colombia at Cordillera del Cóndor, Peru, pose a threat to personal security.

Border area with Ecuador

Cross the Peru–Ecuador border at official crossing points only due to the presence of landmines along the border.

Basic services in the Tumbes district have become increasingly difficult to access due to an increased number of migrants entering Peru from the North land border with Ecuador. The increased population has limited the provision of these services.

Valle de los Ríos Apurímac, Ene y Mantaro (VRAEM)

Drug trafficking.

Cocaine production and trafficking occurs inVRAEM. Travel is particularly dangerous in areas where there is coca cultivation and processing.

Domestic terrorism

Incidents of domestic terrorism have occurred in VRAEM, particularly the region where the Apurímac, Ayacucho, Cuzco and Junín departments meet.

Crime rates are high throughout the country.

• Maintain a high level of vigilance and personal security awareness, especially at night
• Avoid walking in deserted or under-populated areas
• Travel in groups whenever possible

Petty crime

Petty crime, such as pickpocketing and purse snatching, occurs, particularly in Lima, in other cities and even in crowded, public areas. Theft occurs frequently in hotels, restaurants, bus stations and airports, on intercity buses and microbuses and while hailing taxis.

• Avoid wearing expensive watches and jewellery, or showing signs of affluence
• Ensure that your belongings, including your passport and other travel documents, are secure at all times
• Never leave bags unattended

Pickpockets and bag snatchers may work in pairs or groups and employ a variety of ruses to divert their victim’s attention. A common scam involves spraying a substance on victims and then robbing them while pretending to help clean the stain, or distracting the victim by asking questions while another person perpetrates the theft. In some cases, thieves on motorcycles will snatch purses, backpacks or cellular phones. 

Violent crime

Violent crime occurs. Incidents have included:

• kidnappings

Armed robbery

Armed robberies are on the rise. While most victims are not physically injured, criminals will not hesitate to use force when opposed.

• If you are robbed, hand over your cash, electronic devices and valuables without resistance
• Be particularly vigilant after visiting a bank, an ATM or a change bureau, as thieves may follow and rob victims.
• Use ATMs inside banks and during regular hours of service, when guards are on duty

Assaults have occurred along the Inca Trail and in the Huaraz region of the Cordillera Blanca mountains. Hiking in these regions should be done in groups.

Express kidnappings involving tourists have occurred. Victims are usually abducted for a few hours and forced to withdraw money from ATMs for their release. Most express kidnappings take place at night, but incidents also occur during daylight hours. Incidents often involve criminals posing as taxi drivers, or taxi drivers working for organized gangs. Virtual kidnappings occur throughout the country. Criminals use stolen cellphones to contact family members claiming to have kidnapped the owner of the phone and then ask for ransom money.

• Be suspicious of strangers approaching you on the street
• Never leave your cellphone unattended
• Be cautious when using cellphones and smart devices in public as they are often targeted by thieves, especially while people are using them
• Ensure your phone is password protected

Organized crime

Organized crime is reportedly increasing in parts of Lima Province and in some districts of the Department of Piura. In some parts of the country, military and security forces have been deployed to assist police in combatting organized crime.

Incidents of domestic terrorism occur, particularly in remote jungle areas such as:

• parts of the Huancavelica and Ucayali departments
•  the Upper Huallaga river valley in the Huánuco and San Martín departments.

Incidents have included:

• temporary ambushes of small villages
• bombings or threats of violence against local security forces or community figures

Overland travel in these regions is unsafe.

Counterfeit currency

Counterfeit currency in both sol and U.S. dollars is a growing and serious problem. Counterfeit bills are widely distributed, including by banks, casinos and local stores.

Avoid moneychangers on the street, as they may carry counterfeit currency or work with pickpockets.

Credit card fraud

Credit card and ATM fraud occurs. Be cautious when using debit or credit cards:

• pay careful attention when your cards are being handled by others
• use ATMs located in well-lit public areas or inside a bank or business
• avoid using card readers with an irregular or unusual feature
• cover the keypad with one hand when entering your PIN
• check for any unauthorized transactions on your account statements

Criminals posing as taxi drivers often rob tourists along the route to and from Lima’s Jorge Chávez International Airport.

• Use a secure taxi service when arriving at and leaving the airport
• Exercise caution en route to and from your hotel

Thieves also pose as police officers to gain the confidence and cooperation of their potential victims.

• If you are stopped by local authorities, ask to see official identification and record the officer’s name, badge number and district.
• For traffic violations, request that the officer issue you a fine in writing, which is payable at a later date.
• You should also note the location of the arrest.

Legitimate police officers have also extorted money in exchange for dismissing minor offences or traffic violations. They have also stolen money and valuables during searches.

• If you are searched, even at the airport, ensure you have all your belongings before leaving
• If you are planning to participate in volunteer activities in Peru, ensure that the company organizing your trip is legitimate
• Make sure your accommodations and return arrangements are secure before travelling

Useful links

• Lima Airport Partners
• Overseas fraud
• Volunteering abroad

Spiked food and drinks

Snacks, beverages, gum and cigarettes may contain drugs that could put you at risk of sexual assault and robbery.

• Be wary of accepting these items from new acquaintances
• Never leave food or drinks unattended or in the care of strangers

Women’s safety

Women travelling alone may be subject to some forms of harassment and verbal abuse. Incidents of sexual assault, including rape, occur throughout the country, particularly in tourist destinations. In some cases, tour guides have been implicated.

• Do not travel alone, especially after dark.
• Remain particularly vigilant at bus terminals and in taxis.
• Be careful when dealing with strangers or recent acquaintances, especially regarding the acceptance of rides or other invitations.

Women reporting sexual assault should contact police immediately. Medical examinations at identified clinics are part of the investigation process. Women who have delayed reporting may experience more scrutiny by local authorities.

Advice for women travellers

Adventure tourism

Each year, several hikers and climbers are victims of serious, sometimes fatal, accidents in the Andes, including at the Huayna Picchu peak near Machu Picchu and the Cordillera Blanca region in Huaraz, where Peru’s highest peaks are located.

The Inca Trail is usually closed each year in February for maintenance. Other trails, such as those found in Ollantaytambo, may be poorly marked. Hikers have become lost. Be aware that steep or slippery areas are neither fenced nor marked.

In November 2023, the Cusipata District in Quispicanchi Province closed two access routes to Vinicunca, the “Rainbow Mountain.” The closure follows violent disputes between the municipalities surrounding the access routes. Access to Vinicunca from Quispicanchi Province will be closed indefinitely, but access remains open via the Pitumarca District in Canchis Province.

Remote areas of Peru, where popular jungle excursions operate, may not have cellphone coverage or internet access.

If you intend to hike, trek or climb:

• never do so alone, and always hire an experienced guide from a reputable company
• only use licensed companies recommended by the Ministry of Tourism for adventure tours and sports
• exercise extreme caution while climbing, as local authorities have limited rescue capabilities
• buy travel insurance that includes helicopter rescue and medical evacuation
• ensure that your physical condition is good enough to meet the challenges of your activity
• make sure that you’re properly equipped and well-informed about weather and other conditions that may pose a hazard
• inform a family member or friend of your itinerary, including when you expect to be back to camp
• know the symptoms of acute altitude sickness, which can be fatal
• obtain detailed information on trekking routes or ski slopes before setting out and do not venture off marked trails or slopes
• always leave the contact information of the tour operator with your family and friends
• always hire an experienced guide from a reputable company if you travel in remote areas
• iPerú ‎ - Peruvian government’s Tourist Information and Assistance‎
• APOTUR  - The Peruvian Association of Incoming and Domestic Tour Operators (in Spanish)
• APAVIT   - Peruvian Association of Travel and Tourist Agencies (in Spanish)
• APTAE - Peruvian association of adventure, eco, and specialized tourism (in Spanish)
• Qualified Tourism Service Companies  - Ministry of foreign trade and tourism (in Spanish)

Water activities

There have been several recent white-water rafting accidents and drownings involving tourists, particularly on the Urubamba River near Cuzco. Companies offering white-water rafting, their guides and their equipment may not be held to the same standards as similar companies in Canada. Rescue services may not be consistent with international standards.

Coastal waters can be dangerous. Strong currents exist in the Pacific Ocean and in rivers. Life guards are not always present or properly trained at beaches.

Swimming in jungle lakes and rivers can be dangerous due to the presence of parasites and wildlife.

Seek advice and consult residents and local authorities about conditions before swimming, surfing or participating in other aquatic activities.

Water safety abroad

Ayahuasca ceremonies

Spiritual cleansing and ayahuasca ceremonies, offered by shamans and other individuals, involve consuming substances that can cause medical complications and severely impair cognitive and physical abilities. Exposure to these substances has led to serious illness, injury, assault and even the death of several tourists.

Ceremonies often take place in remote areas with no access to medical or mental health facilities or resources and limited communication with local authorities. Most of the time, the facilities lack basic first aid or emergency plans for those suffering from physical or psychological illness from these ceremonies. Ayahuasca ceremonies are not regulated and there is no way to assess the safety of any of the services, the operators or the shamans.

Road safety

Road conditions and road safety are poor throughout the country. Drivers are extremely aggressive, and they do not respect traffic laws. Mountainous roads can be particularly dangerous, especially at night. Poor signage also poses a hazard. Accidents causing fatalities are common.

Regular police spot checks can cause traffic delays.

When renting a vehicle, always purchase insurance. Most drivers in Peru have only the minimum required car insurance, which may not adequately cover accidents.

Vehicles are a target for robbery. Criminals have thrown objects in front of oncoming traffic in the hope that cars will stop. If this occurs and you need to stop, do so only in a safe location, such as a gas station.

• While travelling by car, keep your doors locked and windows shut at all times
• Keep your personal belongings in the trunk of the vehicle, as criminals have been known to shatter windows to “smash and grab” and to attempt entry when they see travel bags or merchandise
• Avoid travelling by road outside of major cities after dark, when there is a higher risk of robbery

State of the roads in Peru in real time  – Government of Peru (in Spanish)

Thefts on boats by river pirates occur along rivers in the Amazon jungle.

Mariners should take appropriate precautions.

Live piracy report  - International Maritime Bureau

Public transportation

Buses and minibuses operate between most major cities. Demonstrations and strikes can lead to disruptions to traffic and public transportation.

Many of the buses and combis in Lima are old, poorly maintained and overcrowded. Drivers of these vehicles tend to dominate the roads and disregard other drivers or pedestrians.

Intercity bus travel can be dangerous due to the risk of bus accidents, which are usually caused by excessive speed, poor vehicle maintenance and driver fatigue. Armed gangs have been known to stop buses to rob travellers, especially at night. Incidents of assaults on buses have also been reported.

The Government of Peru publishes a list of the bus companies with the highest rates of involvement in fatal or serious injury traffic accidents.

• Only use reputable transportation companies
• Contact your travel agency for a list of recommended intercity bus companies

Ministry of Transportation  - Government of Peru (in Spanish)

Trains operate between Arequipa-Cusco-Puno and between Cusco-Ollantaytambo-Machu Picchu . Demonstrations, strikes and derailments can disrupt travel by train, including trains to or from Machu Picchu.

• Train services – Peru rail
• Train to Machu Picchu - Inca rail

Licensed taxis are not metered. Taxi drivers sometimes do not provide change or will continue to drive until they can obtain change.

• Do not hail taxis on the street
• Reserve a taxi by calling a reputable taxi company or use taxi services associated with major hotels
• Agree to a fare prior to departure and do not pay until you have reached your destination
• Try to carry the exact fare

We do not make assessments on the compliance of foreign domestic airlines with international safety standards.

Information about foreign domestic airlines

entry_restrictions_at_land_and_river_borders_with_ecuador

Entry restrictions at land and river borders with Ecuador

On January 11, 2024, the Government of Ecuador announced new entry restrictions in response to the ongoing state of internal armed conflict.

All foreigners entering Ecuador at crossing points with the land or river borders must present a criminal record check from their country of origin or residence. The original criminal record check and the Spanish translation must be apostilled and cover the past five years. Minors travelling with their family members will generally be exempt.

If you cannot provide a criminal record check, the Ecuadorian Migration System will check to verify that you don’t have previous convictions.

• Requirements to enter and exit Ecuador – Ministry of Interior (in Spanish)
• Entry requirements to Ecuador through land borders – Ministry of tourism (in Spanish)
• Migration information – Ecuador Immigration Agency (in Spanish)
• Changes to authentication services in Canada
• Authentication of documents

Every country or territory decides who can enter or exit through its borders. The Government of Canada cannot intervene on your behalf if you do not meet your destination’s entry or exit requirements.

We have obtained the information on this page from the Peruvian authorities. It can, however, change at any time.

Verify this information with the  Foreign Representatives in Canada .

Entry requirements vary depending on the type of passport you use for travel.

Before you travel, check with your transportation company about passport requirements. Its rules on passport validity may be more stringent than the country’s entry rules.

Regular Canadian passport

Your passport must be valid for at least 6 months beyond the date you expect to leave Peru.

Passport for official travel

Different entry rules may apply.

Official travel

Passport with “X” gender identifier

While the Government of Canada issues passports with an “X” gender identifier, it cannot guarantee your entry or transit through other countries. You might face entry restrictions in countries that do not recognize the “X” gender identifier. Before you leave, check with the closest foreign representative for your destination.

Other travel documents

Different entry rules may apply when travelling with a temporary passport or an emergency travel document. Before you leave, check with the closest foreign representative for your destination.

• Foreign Representatives in Canada
• Canadian passports

Tourist visa: not required for a stay of less than 90 days per 365 day period Business visa: required  Student visa: required

If you entered Peru with a business visa, you must obtain a certificate from the Peruvian Ministry of the Economy to prove that all Peruvian taxes on income earned during the trip have been paid prior to leaving the country. The certification is required even if no money was paid or earned and must be presented to the central Peruvian immigration office in Lima before departure.

Entering the country

You must register your entry into Peru at the port of entry or checkpoint.

• Only cross the border at official checkpoints
• Ensure the immigration office at your port of entry is open at the time you intend to cross the border

Other entry requirements

Customs officials may ask you to show them:

• a return or onward ticket
• proof that you have a place to stay
• proof that you have sufficient funds for the duration of your stay

Length of stay

As a Canadian tourist, you may stay in Peru for up to 90 days in a 365-day period.

Overstaying is a criminal offence. There is a fine for each day of overstay. This fee must be paid upon exiting the country.

Dual citizenship

Peruvian–Canadians entering Peru using their Canadian passport are subject to visit restrictions, including length of stay and associated fines. Dual nationals must use the same nationality to enter and exit the country.

• Children and travel

Travellers under 18 exiting Peru after a stay of 183 days are automatically protected by Peru’s law on minors and will require the authorization of both parents/guardians to exit the country.

Children who have resident status in Peru must have written permission from the non-accompanying parents to leave the country.

Children born of Canadian parents in Peru require a Peruvian passport to leave the country for the first time. Contact Peruvian immigration officials for more information.

Travelling with children

Yellow fever

Learn about potential entry requirements related to yellow fever (vaccines section).

Relevant Travel Health Notices

• Global Measles Notice - 13 March, 2024
• Zika virus: Advice for travellers - 31 August, 2023
• COVID-19 and International Travel - 13 March, 2024
• Dengue: Advice for travellers - 6 May, 2024

This section contains information on possible health risks and restrictions regularly found or ongoing in the destination. Follow this advice to lower your risk of becoming ill while travelling. Not all risks are listed below.

Consult a health care professional or visit a travel health clinic preferably 6 weeks before you travel to get personalized health advice and recommendations.

Routine vaccines

Be sure that your  routine vaccinations , as per your province or territory , are up-to-date before travelling, regardless of your destination.

Some of these vaccinations include measles-mumps-rubella (MMR), diphtheria, tetanus, pertussis, polio, varicella (chickenpox), influenza and others.

Pre-travel vaccines and medications

You may be at risk for preventable diseases while travelling in this destination. Talk to a travel health professional about which medications or vaccines may be right for you, based on your destination and itinerary. 

Yellow fever   is a disease caused by a flavivirus from the bite of an infected mosquito.

Travellers get vaccinated either because it is required to enter a country or because it is recommended for their protection.

• There is a risk of yellow fever in this country.

Country Entry Requirement*

• Proof of vaccination is not required to enter this country.

Recommendation

• Vaccination is recommended depending on your itinerary.
• Contact a designated Yellow Fever Vaccination Centre well in advance of your trip to arrange for vaccination.
• Discuss travel plans, activities, and destinations with a health care professional.
• Protect yourself from mosquito bites.

About Yellow Fever Yellow Fever Vaccination Centres in Canada * It is important to note that   country entry requirements   may not reflect your risk of yellow fever at your destination. It is recommended that you contact the nearest   diplomatic or consular office   of the destination(s) you will be visiting to verify any additional entry requirements.

There is a risk of hepatitis A in this destination. It is a disease of the liver. People can get hepatitis A if they ingest contaminated food or water, eat foods prepared by an infectious person, or if they have close physical contact (such as oral-anal sex) with an infectious person, although casual contact among people does not spread the virus.

Practise  safe food and water precautions and wash your hands often. Vaccination is recommended for all travellers to areas where hepatitis A is present.

Measles is a highly contagious viral disease. It can spread quickly from person to person by direct contact and through droplets in the air.

Anyone who is not protected against measles is at risk of being infected with it when travelling internationally.

Regardless of where you are going, talk to a health care professional before travelling to make sure you are fully protected against measles.

  Hepatitis B is a risk in every destination. It is a viral liver disease that is easily transmitted from one person to another through exposure to blood and body fluids containing the hepatitis B virus.  Travellers who may be exposed to blood or other bodily fluids (e.g., through sexual contact, medical treatment, sharing needles, tattooing, acupuncture or occupational exposure) are at higher risk of getting hepatitis B.

Hepatitis B vaccination is recommended for all travellers. Prevent hepatitis B infection by practicing safe sex, only using new and sterile drug equipment, and only getting tattoos and piercings in settings that follow public health regulations and standards.

Coronavirus disease (COVID-19) is an infectious viral disease. It can spread from person to person by direct contact and through droplets in the air.

It is recommended that all eligible travellers complete a COVID-19 vaccine series along with any additional recommended doses in Canada before travelling. Evidence shows that vaccines are very effective at preventing severe illness, hospitalization and death from COVID-19. While vaccination provides better protection against serious illness, you may still be at risk of infection from the virus that causes COVID-19. Anyone who has not completed a vaccine series is at increased risk of being infected with the virus that causes COVID-19 and is at greater risk for severe disease when travelling internationally.

Before travelling, verify your destination’s COVID-19 vaccination entry/exit requirements. Regardless of where you are going, talk to a health care professional before travelling to make sure you are adequately protected against COVID-19.

 The best way to protect yourself from seasonal influenza (flu) is to get vaccinated every year. Get the flu shot at least 2 weeks before travelling.  

 The flu occurs worldwide. 

•  In the Northern Hemisphere, the flu season usually runs from November to   April.
•  In the Southern Hemisphere, the flu season usually runs between April and   October.
•  In the tropics, there is flu activity year round. 

The flu vaccine available in one hemisphere may only offer partial protection against the flu in the other hemisphere.

The flu virus spreads from person to person when they cough or sneeze or by touching objects and surfaces that have been contaminated with the virus. Clean your hands often and wear a mask if you have a fever or respiratory symptoms.

Malaria  is a serious and sometimes fatal disease that is caused by parasites spread through the bites of mosquitoes.   There is a risk of malaria in certain areas and/or during a certain time of year in this destination. 

Antimalarial medication may be recommended depending on your itinerary and the time of year you are travelling. Consult a health care professional or visit a travel health clinic before travelling to discuss your options. It is recommended to do this 6 weeks before travel, however, it is still a good idea any time before leaving.    Protect yourself from mosquito bites at all times:  • Cover your skin and use an approved insect repellent on uncovered skin.  • Exclude mosquitoes from your living area with screening and/or closed, well-sealed doors and windows. • Use insecticide-treated bed nets if mosquitoes cannot be excluded from your living area.  • Wear permethrin-treated clothing.    If you develop symptoms similar to malaria when you are travelling or up to a year after you return home, see a health care professional immediately. Tell them where you have been travelling or living. 

In this destination, rabies is carried by dogs and some wildlife, including bats. Rabies is a deadly disease that spreads to humans primarily through bites or scratches from an infected animal. While travelling, take precautions , including keeping your distance from animals (including free-roaming dogs), and closely supervising children.

If you are bitten or scratched by an animal while travelling, immediately wash the wound with soap and clean water and see a health care professional. Rabies treatment is often available in this destination. 

Before travel, discuss rabies vaccination with a health care professional. It may be recommended for travellers who are at high risk of exposure (e.g., occupational risk such as veterinarians and wildlife workers, children, adventure travellers and spelunkers, and others in close contact with animals). 

Safe food and water precautions

Many illnesses can be caused by eating food or drinking beverages contaminated by bacteria, parasites, toxins, or viruses, or by swimming or bathing in contaminated water.

• Learn more about food and water precautions to take to avoid getting sick by visiting our eat and drink safely abroad page. Remember: Boil it, cook it, peel it, or leave it!
• Avoid getting water into your eyes, mouth or nose when swimming or participating in activities in freshwater (streams, canals, lakes), particularly after flooding or heavy rain. Water may look clean but could still be polluted or contaminated.
• Avoid inhaling or swallowing water while bathing, showering, or swimming in pools or hot tubs. 

Travellers' diarrhea is the most common illness affecting travellers. It is spread from eating or drinking contaminated food or water.

Risk of developing travellers' diarrhea increases when travelling in regions with poor standards of hygiene and sanitation. Practise safe food and water precautions.

The most important treatment for travellers' diarrhea is rehydration (drinking lots of fluids). Carry oral rehydration salts when travelling.

Typhoid   is a bacterial infection spread by contaminated food or water. Risk is higher among children, travellers going to rural areas, travellers visiting friends and relatives or those travelling for a long period of time.

Travellers visiting regions with a risk of typhoid, especially those exposed to places with poor sanitation, should speak to a health care professional about vaccination.  

Insect bite prevention

Many diseases are spread by the bites of infected insects such as mosquitoes, ticks, fleas or flies. When travelling to areas where infected insects may be present:

• Use insect repellent (bug spray) on exposed skin
• Cover up with light-coloured, loose clothes made of tightly woven materials such as nylon or polyester
• Minimize exposure to insects
• Use mosquito netting when sleeping outdoors or in buildings that are not fully enclosed

To learn more about how you can reduce your risk of infection and disease caused by bites, both at home and abroad, visit our insect bite prevention page.

Find out what types of insects are present where you’re travelling, when they’re most active, and the symptoms of the diseases they spread.

There is a risk of chikungunya in this country.  The risk may vary between regions of a country.  Chikungunya is a virus spread through the bite of an infected mosquito. Chikungunya can cause a viral disease that typically causes fever and pain in the joints. In some cases, the joint pain can be severe and last for months or years.

Protect yourself from mosquito bites at all times. There is no vaccine available for chikungunya.

Cutaneous and mucosal   leishmaniasis   causes skin sores and ulcers. It is caused by a parasite spread through the bite of a female sandfly.

Risk is generally low for most travellers. Protect yourself from sandfly bites, which typically occur after sunset in rural and forested areas and in some urban centres. There is no vaccine or medication to protect against leishmaniasis.

• In this country,   dengue  is a risk to travellers. It is a viral disease spread to humans by mosquito bites.
• Dengue can cause flu-like symptoms. In some cases, it can lead to severe dengue, which can be fatal.
• The level of risk of dengue changes seasonally, and varies from year to year. The level of risk also varies between regions in a country and can depend on the elevation in the region.
• Mosquitoes carrying dengue typically bite during the daytime, particularly around sunrise and sunset.
• Protect yourself from mosquito bites . There is no vaccine or medication that protects against dengue.

Zika virus is a risk in this country. 

Zika virus is primarily spread through the bite of an infected mosquito. It can also be sexually transmitted. Zika virus can cause serious birth defects.

During your trip:

• Prevent mosquito bites at all times.
• Use condoms correctly or avoid sexual contact, particularly if you are pregnant.

If you are pregnant or planning a pregnancy, you should discuss the potential risks of travelling to this destination with your health care provider. You may choose to avoid or postpone travel. 

For more information, see Zika virus: Pregnant or planning a pregnancy.

American trypanosomiasis (Chagas disease)   is a risk in this country. It is caused by a parasite spread by infected triatomine bugs. The infection can be inactive for decades, but humans can eventually develop complications causing disability and even death.

Risk is generally low for most travellers. Protect yourself from triatomine bugs, which are active at night, by using mosquito nets if staying in poorly-constructed housing. There is no vaccine available for Chagas disease.

Animal precautions

Some infections, such as rabies and influenza, can be shared between humans and animals. Certain types of activities may increase your chance of contact with animals, such as travelling in rural or forested areas, camping, hiking, and visiting wet markets (places where live animals are slaughtered and sold) or caves.

Travellers are cautioned to avoid contact with animals, including dogs, livestock (pigs, cows), monkeys, snakes, rodents, birds, and bats, and to avoid eating undercooked wild game.

Closely supervise children, as they are more likely to come in contact with animals.

There is a risk of   plague   in this country. Plague is a bacterial disease that can cause serious illness, and if left untreated, death.

The occurrence of cases in areas where the plague bacteria are known to circulate can be influenced by weather and environmental conditions. In some countries, this results in seasonal outbreaks. Travellers to areas where plague routinely occurs may be at risk if they are camping, hunting, or in contact with rodents.

Plague is spread by:

• bites from fleas infected with the plague
• direct contact with body fluids or tissues from an animal or person who is sick with or has died from plague

Overall risk to travellers is low.   Protect yourself   by   reducing contact with fleas  and potentially infected rodents and other wildlife.

Person-to-person infections

Stay home if you’re sick and practise proper cough and sneeze etiquette , which includes coughing or sneezing into a tissue or the bend of your arm, not your hand. Reduce your risk of colds, the flu and other illnesses by:

•   washing your hands often
• avoiding or limiting the amount of time spent in closed spaces, crowded places, or at large-scale events (concerts, sporting events, rallies)
• avoiding close physical contact with people who may be showing symptoms of illness 

Sexually transmitted infections (STIs) , HIV , and mpox are spread through blood and bodily fluids; use condoms, practise safe sex, and limit your number of sexual partners. Check with your local public health authority pre-travel to determine your eligibility for mpox vaccine.  

Tuberculosis is an infection caused by bacteria and usually affects the lungs.

For most travellers the risk of tuberculosis is low.

Travellers who may be at high risk while travelling in regions with risk of tuberculosis should discuss pre- and post-travel options with a health care professional.

High-risk travellers include those visiting or working in prisons, refugee camps, homeless shelters, or hospitals, or travellers visiting friends and relatives.

Medical services and facilities

Quality of care varies throughout the country.

Private hospitals and clinics in urban centres are well-staffed and -equipped to handle any emergency or medical issue. Public hospitals and rural facilities, even in some tourist destinations and major cities, may not meet Canadian standards or may be inadequate to treat serious conditions.

Cases of serious injury or illness in remote areas may require evacuation to the nearest adequate medical facility in the country. Clinic, hospital and evacuation expenses can be costly and the service provider often expects immediate cash payment or confirmation of payment from an insurance company.

Make sure you get travel insurance that includes coverage for medical evacuation and hospital stays.

Travel health and safety

Keep in Mind...

The decision to travel is the sole responsibility of the traveller. The traveller is also responsible for his or her own personal safety.

Be prepared. Do not expect medical services to be the same as in Canada. Pack a   travel health kit , especially if you will be travelling away from major city centres.

You must abide by local laws.

Learn about what you should do and how we can help if you are arrested or detained abroad .

Penalties for possession, use or trafficking of illegal drugs are severe. Convicted offenders can expect lengthy jail sentences, regardless of the amount of narcotics seized at arrest.

If you are arrested in Peru, you should expect lengthy delays to resolve your case, pre-trial detention in harsh conditions and significant related expenses.

• Pack your own luggage and monitor it closely at all times
• Never transport other people’s packages, bags or suitcases

Drugs, alcohol and travel

Identification

You must carry photo identification at all times. Keep a photocopy of your passport in a safe place, in case it's lost or confiscated. Failure to show identification could result in detention.

Peruvian authorities may impose fines and other penalties for any action considered to be disrespectful at historical and archaeological sites such as Machu Picchu, Ollantaytambo and Saqsayhuaman. Visitors to Machu Picchu must adhere to strict regulations regarding entry restrictions and behaviour within the site. Check with your travel guide or agent for the latest information.

Peruvian law strictly prohibits the export of antiques and artefacts (huacos) from pre-colonial civilizations. Purchase reproductions of colonial or pre-colonial art from reputable dealers only and insist on obtaining documentation from Peru's National Institute of Culture to prove that the object is a reproduction and may be exported.

The export of coca tea bags and products is prohibited.

It is illegal to remove certain fauna and flora items from Peru. Items made from or displaying animals, insects or plants may be seized. If you are convicted of possession of such items, you could face heavy fines or jail sentences.

National Forest and Wildlife Service (SERFOR) - Ministry of Agriculture and Irrigation of Peru (in Spanish)

Photography

It is forbidden to photograph military installations.

2SLGBTQI+ travellers

Peruvian law does not prohibit sexual acts between individuals of the same sex. However, homosexuality is not widely accepted in Peruvian society.

Travel and your sexual orientation, gender identity, gender expression and sex characteristics

Dual citizenship is legally recognized in Peru.

If you are a Canadian citizen, but also a citizen of Peru, our ability to offer you consular services may be limited while you're there. You may also be subject to different entry/exit requirements .

Travellers with dual citizenship

International Child Abduction

The Hague Convention on the Civil Aspects of International Child Abduction is an international treaty. It can help parents with the return of children who have been removed to or retained in certain countries in violation of custody rights. The convention applies between Canada and Peru.

If your child was wrongfully taken to, or is being held in Peru, and if the applicable conditions are met, you may apply for the return of your child to the Peruvian court.

If you are in this situation:

• act as quickly as you can
• contact the Central Authority for your province or territory of residence for information on starting an application under The Hague Convention
• consult a lawyer in Canada and in Peru to explore all the legal options for the return of your child
• report the situation to the nearest Canadian government office abroad or to the Vulnerable Children's Consular Unit at Global Affairs Canada by calling the Emergency Watch and Response Centre

If your child was removed from a country other than Canada, consult a lawyer to determine if The Hague Convention applies.

Be aware that Canadian consular officials cannot interfere in private legal matters or in another country's judicial affairs.

• List of Canadian Central Authorities for the Hague Convention
• International Child Abductions: A guide for affected parents
• The Hague Convention – Hague Conference on Private International Law
• Canadian embassies and consulates by destination
• Request emergency assistance

You must carry an international driving permit. A foreign driver's licence can be used only in Lima and only for 30 days after arrival.

Carry identification and vehicle registration at all times.

International Driving Permit

The currency is the Peruvian sol (PEN). The U.S. dollar is widely accepted.

Credit cards are not commonly accepted outside major cities. Many establishments will request to see a passport to confirm the identity of the person using the credit card. 

ATMs are not easily accessible in small towns. They often have limits to the amount and number of daily withdrawals.

El Niño

The complex weather phenomenon called El Niño happens at irregular intervals of 2 to 7 years. El Niño generally generates heavy rainfalls, occurring at the same time as the rainy season, from November to May.

• Keep informed of regional weather forecasts before and during your travels, and plan accordingly.
• Ensure you have adequate insurance to cover the consequences of such events, including the disruption of travel plans. 

Seismic activity

Earthquakes.

Peru is in an active seismic zone and is prone to earthquakes.

Dangerous landslides can also occur, even after minor earthquakes.

Latest earthquakes  - Government of Peru (in Spanish)

Tsunamis can occur following seismic activity. Tsunami evacuation routes are posted along the Costa Verde in Lima and several locations on the coast.

Directorate of Hydrography and Navigation  (in Spanish)

There are active and potentially active volcanoes in southern Peru. Debris from erupting volcanoes may clog rivers and cause them to overflow, resulting in potential flash floods and mudslides. Transportation and services may be affected. Ash clouds may cause disruptions to domestic and international flights. If you live or are travelling near active volcanoes:

• monitor levels of volcanic activity through the local media
• pay careful attention to all warnings issued and follow the advice of local authorities
• Be prepared to modify your travel arrangements or even evacuate the area on short notice

Geophysical Institute of Peru  (in Spanish)

Higher tides are experienced several times throughout the year and may cause flooding and damage along the coast.

Rainy season

The rainy season extends from November to May in the Peruvian Andes.

Seasonal flooding, mudslides and landslides can hamper overland travel and reduce the provision of essential services such as utilities, emergency and medical care, food, fuel and water supplies. Roads may become impassable and bridges damaged.

Keep informed of regional weather forecasts and plan accordingly.

• Emergency monitoring  – National Institute of Civil Defence (in Spanish)
• Nationwide weather warnings  – National Meteorology and Hydrology Service of Peru (in Spanish)
• Tornadoes, cyclones, hurricanes, typhoons and monsoons

Local services

• Police: 105
• Tourist police: +51 980 122 335 (Whatsapp number)
• Medical assistance: 116
• Firefighters: 116

Consular assistance

For emergency consular assistance, call the embassy of Canada to Peru, in Lima, and follow the instructions. At any time, you may also contact the Emergency Watch and Response Centre in Ottawa.

The decision to travel is your choice and you are responsible for your personal safety abroad. We take the safety and security of Canadians abroad very seriously and provide credible and timely information in our Travel Advice to enable you to make well-informed decisions regarding your travel abroad.

The content on this page is provided for information only. While we make every effort to give you correct information, it is provided on an "as is" basis without warranty of any kind, expressed or implied. The Government of Canada does not assume responsibility and will not be liable for any damages in connection to the information provided.

If you need consular assistance while abroad, we will make every effort to help you. However, there may be constraints that will limit the ability of the Government of Canada to provide services.

Learn more about consular services .

Risk Levels

  take normal security precautions.

Take similar precautions to those you would take in Canada.

  Exercise a high degree of caution

There are certain safety and security concerns or the situation could change quickly. Be very cautious at all times, monitor local media and follow the instructions of local authorities.

IMPORTANT: The two levels below are official Government of Canada Travel Advisories and are issued when the safety and security of Canadians travelling or living in the country or region may be at risk.

  Avoid non-essential travel

Your safety and security could be at risk. You should think about your need to travel to this country, territory or region based on family or business requirements, knowledge of or familiarity with the region, and other factors. If you are already there, think about whether you really need to be there. If you do not need to be there, you should think about leaving.

  Avoid all travel

You should not travel to this country, territory or region. Your personal safety and security are at great risk. If you are already there, you should think about leaving if it is safe to do so.

Should You Avoid Travel to Places With Dengue Outbreaks?

If you have a trip planned to a tropical country this summer, recent headlines might be giving you some anxiety.  

Dengue, a potentially fatal mosquito-borne viral infection, is exploding in the Caribbean and Central and South America. According to the Pan-American Health Organization, over 5 million cases of the disease have been reported in the region so far this year.  

Last year, climate change and an El Niño weather pattern combined to create the warmest year on record. One result was higher-than-normal numbers of dengue-carrying mosquitoes surviving the winter and spreading to new latitudes and higher elevations. This has caused unprecedented spikes in cases, especially in places not used to having such high levels of the virus. States of emergency have been declared in Puerto Rico, Peru and parts of Brazil.  

“The incidence of dengue is quite high right now, and a lot of that is because it’s going into new populations where people didn’t have any previous immunity,” says Dr. Indi Trehan, an associate professor in emergency medicine and infectious diseases at UW School of Medicine’s Department of Pediatrics, whose research and clinical work has focused on the diagnosis and management of tropical diseases. “As a traveler, there are more places you have to worry about now than you would’ve had to five, 10 years ago.” 

So does that mean you should cancel your visit to San Juan or ditch your beach vacation in São Paulo? Here is what you need to know.   

How do I know if I should call off my trip?

If a country is in the middle of an outbreak of dengue or any other infectious disease, it’s important to do some research about what is going on there. Check the U.S. Department of State  for travel advisories and the Centers for Disease Control and Prevention’s website to read about the risks of traveling to the country you plan to visit. If the area has limited healthcare resources, it might not be wise to go if you won’t have access to medical attention in the event you do get sick. That’s not to mention possibly burdening an already overtaxed healthcare system.

In the end, you need to make your own personal risk assessment. If you are immunocompromised or have a chronic disease, your risk tolerance will likely be very different, especially if you won’t have access to the medical care you’d need if a complication with your condition arises. And if you’re pregnant, it might be worth it to avoid places with mosquitoes carrying tropical diseases altogether — if dengue is endemic, it’s possible Zika and malaria are too, which can cause serious complications for pregnancy. 

Is there a vaccine for dengue? 

Unfortunately, there isn’t a vaccine or preventive medication for dengue that’s currently available for travelers. Dengue vaccines exist but only for people who live in an endemic area. That’s because, typically, the first time you get dengue, it’s very mild — many people don’t experience any symptoms at all.  

But if you get it again, the risk increases. 

“The second time you get it, especially if it’s a different strain, then you can have very severe illness,” says Trehan.  

Think unbearable joint pain (the disease is also called “breakbone fever”), high fever, vomiting and, in its worst form, hemorrhagic fever that can lead to organ failure.  

So the bad news is that you currently can’t take a vaccine, but if you’ve never had dengue before, it’s much less likely to be severe.  

“Dengue is the most common of the major tropical illnesses that people get when they travel to South America,” says Trehan. “So it’s pretty wise for American travelers to be aware of the dangers and lower their risk.”

How else can I protect myself?

If you decide to go, there are specific precautions to take in a tropical region to avoid mosquito-borne diseases. (The same species of mosquito that carries dengue also transmits Zika, yellow fever and Japanese encephalitis.) 

Don’t forget protection 

The best thing you can do? Be diligent about your personal protective equipment. This includes bed nets, keeping your arms and legs covered day and night, and wearing insect repellent with at least 30% DEET on exposed skin.  

“If you’re also wearing sunscreen, apply it first and make sure it has dried completely before applying repellant,” says Dr. Nandita Mani , an infectious disease specialist and associate medical director of infection prevention and control at UW Medical Center. “And be aware that mosquitoes carrying dengue bite throughout the day but have peak activity in the early morning, late afternoon, and evening.” 

You’re not safe at night either, though: The mosquitoes that carry malaria are nocturnal. 

Visit a travel clinic to see what other vaccines you can get 

While a dengue vaccine doesn’t exist for travelers, many others do that you should consider, depending on where you’re going, what kind of trip it is (a tour of major cities versus a jungle trek), and how long you’ll be there. 

Vaccines are available in the U.S. for typhoid, yellow fever, Japanese encephalitis, rabies and cholera, as well as prophylaxis pills to prevent malaria. Many of these diseases, like dengue, are spreading to new places at faster rates thanks to climate change. Remember also that no vaccine or preventive medication will be perfect at protecting you, and most have specific requirements for how they need to be administered to make them as effective as possible. 

The best place to go to find out which vaccines are prudent to get is a travel clinic like the Travel Medicine Clinic at UW Medical Center – Northwest or the Infectious Disease & Travel Medicine Clinic at Harborview .

Finally, don’t forget about staying up to date on your basic shots for flu, COVID-19, tetanus, hepatitis and other routine vaccines. 

“Respiratory infections, especially in the tropical regions, are more of a year-round thing rather than just a winter problem,” says Trehan. “For example, we see COVID spikes every summer.”’ 

Measles, too, is increasing globally, including in many places in Europe.  

“This is a highly contagious infectious disease, and it’s important to make sure that you’re up-to-date with vaccination,” says Mani. If you’re traveling with a baby who hasn’t gotten their measles vaccine yet, Mani recommends getting an early dose — they can get one as young as six months old.  

Tell your doctor where you’ve been  

If you do start feeling sick after visiting a country with dengue or any other infectious disease, head straight to the emergency room. They’re more likely to have the resources needed to test you quickly for travel-related diseases.  

“If you’re concerned at all, see a doctor,” says Mani. “You should seek medical attention if you return with unexplained fever, vomiting, new rash, diarrhea, severe headache, joint pains, jaundice or pain behind the eyes.” 

And when you get there, tell them where you’ve been traveling.  

“When you come back and you feel sick, the first thing you should say is, ‘I was in the middle of a safari in Kenya,’” says Trehan. “Don’t make it a mystery, let your healthcare providers know where you’ve been and what you did and what kind of exposures you may have had, including food, water and bug bites.” 

That information will, of course, make it much easier for them to diagnose an infectious disease like dengue and start treating you faster.  

Don’t forget about other risks 

Despite how scary a disease like dengue can be, Trehan points out that the things most likely to pose a risk to your health while traveling are much more commonplace.  

“The No. 1 risk is road traffic accidents,” says Trehan. “So be really cautious about what kind of vehicle you’re getting into. The second biggest risk is colds, flu, diarrhea, the sort of stuff you could get at home.” 

Then there are the health problems you already have.  

“Maybe you’re forgetting to take your meds on time, or you’re sleep deprived, or you’re drinking a little more, or you’re not eating as well and out of your normal exercise and sleep routines, so your own health problems can get worse,” he says.  

But in most cases, Trehan doesn’t think you should stay home. 

“Life’s short. I think you got to go travel,” he says. “Enjoy the world, enjoy the experience of seeing things and seeing people in new places, but just be prepared.” 

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• Signs and Symptoms
• How It Spreads
• Areas with Risk
• Dengue in the United States
• Dengue Print Resources
• Dengue Vaccine
• Clinical Features
• Clinical Testing and Diagnosis
• Dengue Clinical Care
• Dengue Course

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About Dengue

• Dengue viruses are spread to people through mosquito bites.
• A person can be infected with dengue multiple times in their life.
• Each year, up to 400 million people are infected by a dengue virus.

Dengue is a viral disease caused by any of the four related viruses: dengue virus 1, 2, 3, and 4.

There are four different but closely-related dengue virus types: dengue-1, dengue-2, dengue-3, and dengue-4.

The most common dengue symptom is fever with:

• Aches and pains (eye pain, typically behind the eyes, muscle, joint, or bone pain)
• Nausea, vomiting
• Any warning sign

When to expect symptoms

• Symptoms of dengue usually begin within 2 weeks after being bitten by an infected mosquito.
• Symptoms typically last 2–7 days. Most people will recover after about a week.

Areas with Risk of Dengue

Dengue transmission is common in tropical and subtropical areas of the world.

How it spreads

Dengue viruses are mainly spread to people by the bite of an infected Aedes mosquito.

The best way to prevent dengue is to avoid mosquito bites.

In the United States, there is a dengue vaccine recommended for use in children 9 through 16 with laboratory confirmation of a previous dengue infection, living in areas where dengue is common.

• There is no specific medicine to treat dengue.
• Rest as much as possible.
• Take acetaminophen to control fever and relieve pain.
• Drink plenty of fluids to stay hydrated.
• See a healthcare provide r if you develop a fever or have symptoms of dengue. Tell him or her about your travel.

The vaccine is not approved for use in U.S. travelers who are visiting but not living in an area where dengue is common.

Learn about dengue viruses, how dengue spreads, how to prevent dengue, and the areas with risk of dengue.

For Everyone

Health care providers.

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Oropouche Fever in the Americas

Oropouche fever is a disease caused by Oropouche virus. It is spread through the bites of infected midges (small flies) and mosquitoes.

Symptoms of Oropouche fever are similar to dengue and include headache, fever, muscle aches, stiff joints, nausea, vomiting, chills, or sensitivity to light. Severe cases may result in neuroinvasive disease such as  meningitis .

Symptoms typically start 4–8 days after being bitten and last 3–6 days. Most people recover without long-term effects. Treatment is supportive; no specific medications or vaccines are available.

• There are outbreaks of Oropouche fever in parts of Brazil, Bolivia, Colombia, Peru, and  Cuba  (see map).
• Oropouche fever is spread by the bite of infected midges (small flies) and mosquitoes.
• Illness can occur in people of any age and is often mistaken for dengue.
• Travelers to affected areas should take steps to avoid bug bites .
• Travelers should seek medical care if they develop high fever, headache, muscle aches, stiff joints, nausea, vomiting, chills, or sensitivity to light during or after travel.

Traveler Information

• Health Information for Travelers to Bolivia
• Health Information for Travelers to Brazil
• Health Information for Travelers to Colombia
• Health Information for Travelers to Cuba
• Health Information for Travelers to Peru
• Epidemiological Update – Oropouche in the Region of the Americas
• Information Note from the Cuban Ministry of Public Health

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