Ecuador
South America · Physician brief
Yellow fever entry rule for arrivals from endemic countries
Ecuador requires proof of yellow fever vaccination for travellers (roughly ages 1–60) who spent more than 10 days in certain endemic South American countries — including Bolivia, Brazil, Colombia, and Peru — before arriving. Travellers coming directly from Switzerland are not affected. The vaccine must be given at least 10 days before entry. Carry the certificate if your itinerary chains several Andean/Amazon countries.
Ecuadorian immigration / WHO IHR ↗ · Updated 2026
Altitude — Quito and the Andean highlands
Quito sits at about 2,850 m and other Andean destinations (Cotopaxi, Quilotoa, the Avenue of the Volcanoes) are higher. Acute mountain sickness can occur on rapid ascent. Allow time to acclimatise and discuss acetazolamide with your travel medicine specialist for fast climbs or high treks. This is a non-infectious risk, not prevented by any vaccine.
EKRM / HealthyTravel ↗ · Updated 2026
Galápagos — distinct low-risk destination
The Galápagos Islands have no yellow fever and no malaria, and arboviral risk is very low. Yellow fever vaccination is not recommended for travel limited to the islands. Sun protection, seasickness prevention, and standard food and water precautions are the practical concerns. Note Ecuador may ask for a YF certificate based on your prior itinerary, not the islands themselves.
CDC Travelers' Health ↗ · Updated 2026
Vaccines
Disease-specific guidance
Malaria
ModerateMalaria occurs below 1,500 m in the coastal and Amazon lowlands; there is no transmission in Quito, Guayaquil, the Galápagos, or above 2,300 m. Risk is highest in the eastern Amazon and northern coastal provinces (e.g. Esmeraldas, Morona-Santiago, Orellana, Pastaza, Sucumbíos). Most cases are P. vivax with some P. falciparum; parasites are chloroquine-resistant. Prophylaxis is reserved for higher-risk provinces; elsewhere insect precautions alone.
- Risk
- <1,500 m coastal & Amazon lowlands
- Higher-risk
- Esmeraldas, Morona-Santiago, Orellana, Pastaza, Sucumbíos
- No risk
- Quito, Guayaquil, Galápagos, >2,300 m
- Species
- ~85% P. vivax, ~15% P. falciparum (chloroquine-resistant)
- Prophylaxis
- Atovaquone-proguanil, doxycycline, or mefloquine (high-risk areas)
Yellow fever
ModerateYellow fever risk in Ecuador is in the Amazon (Oriente) lowlands east of the Andes below 2,300 m. Vaccination is recommended for the eastern provinces and not for Quito, Guayaquil, the western lowlands, or the Galápagos. An entry-certificate rule applies to travellers who spent over 10 days in certain endemic South American countries before arrival.
- Vaccine
- Single dose, lifelong protection
- Timing
- ≥10 days before travel
- Recommended
- Amazon provinces <2,300 m east of Andes
- Risk provinces
- Morona-Santiago, Napo, Orellana, Pastaza, Sucumbíos, Zamora-Chinchipe, Tungurahua
- Not needed
- Quito, Guayaquil, Galápagos, >2,300 m
- Entry rule
- Certificate if >10 days in endemic SA country before arrival
Dengue
HighDengue is endemic in the coastal and Amazon lowlands with year-round transmission and rainy-season peaks; major coastal cities such as Guayaquil are affected. Risk is negligible in the high Andes (Quito) and very low in the Galápagos. Daytime mosquito-bite prevention is the main protection below ~1,800 m.
- Distribution
- Coastal & Amazon lowlands; Guayaquil
- Vector
- Aedes aegypti — daytime biter
- Low/none
- Quito and high Andes; Galápagos very low
Chikungunya
LowChikungunya circulates in the lowlands sharing the same daytime Aedes vector as dengue, so dengue prevention also protects against it. Joint pain can persist for months. CDC considers routine vaccination generally not recommended for Ecuador; it may be discussed for outbreak settings or extended stays in high-incidence areas.
Zika
PresentZika is transmitted by daytime Aedes mosquitoes in the coastal and Amazon lowlands. Pregnancy and pre-conception planning are the key clinical concerns: pregnant women should avoid travel to lowland risk areas, and couples should use condoms during travel and for 3 months after return. The high Andes and Galápagos are not meaningful risk areas.
General prevention
Food & water
Standard food and water precautions, particularly outside major cities. Use bottled or filtered water for drinking and brushing teeth in rural regions, the coast, and the Amazon. These precautions reduce traveler's diarrhea, hepatitis A, and typhoid risk. Tap water in Quito is generally treated but bottled remains the safer choice for most travelers.
Mosquito protection
Mosquito-bite prevention is essential in the coastal lowlands and the Amazon (Oriente), where dengue, Zika, chikungunya, and malaria occur. Daytime-biting Aedes mosquitoes (dengue, Zika, chikungunya) require day protection; Anopheles (malaria) bite from dusk into the night. Use DEET 30%+ or picaridin 20%, long sleeves, and screened or air-conditioned rooms; permethrin-treated clothing for the Amazon. No mosquito-borne disease risk in the Andean highlands above ~2,300 m (Quito) or, in practice, the Galápagos.
Sources
Based on CDC Travelers’ Health, CDC Yellow Book, and the Swiss Federal Vaccination Schedule (BAG). Always verify current recommendations before travel.
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This brief is for informational purposes and does not replace personalized medical advice.
Consult a travel medicine specialist 4–8 weeks before departure.