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Peru

South America · Physician brief

📝Draft — pending physician review
📝Draft — pending physician review. This brief was compiled from CDC, WHO, and EKRM/HealthyTravel sources (June 2026) and has not yet been verified by a clinician. Confirm specifics with a travel-medicine professional before relying on it.

Yellow fever — regional recommendation

Yellow fever vaccination is recommended for travel to the Amazon/jungle lowlands below about 2300 m (e.g. Loreto, Madre de Dios, Amazonas, San Martín, Ucayali, Junín and Cusco jungle areas). It is NOT recommended for travel limited to Lima, Cusco city, Machu Picchu, the Inca Trail, Lake Titicaca, or other highland areas. Give the single dose at an authorized Swiss YF center at least 10 days before travel; lifelong protection.

CDC Yellow Book / EKRM ↗ · Updated 2026

Altitude illness — Cusco, Machu Picchu, Titicaca

Cusco (~3400 m), the Sacred Valley, the Inca Trail, and Lake Titicaca (~3800 m) sit at high altitude, where acute mountain sickness is common. Plan a gradual ascent and acclimatization days, avoid heavy exertion and alcohol on arrival, and discuss preventive acetazolamide (Diamox) with your travel physician — especially if flying straight into Cusco. Seek care for severe headache, breathlessness at rest, or confusion.

EKRM / HealthyTravel ↗ · Updated 2026

Dengue activity

Peru has experienced large dengue epidemics in recent years, with widespread transmission in low-altitude coastal and jungle regions. Practice strict daytime mosquito-bite prevention in all areas below ~2000 m.

PAHO / CDC Travel Health Notices ↗ · Updated 2026

Malaria

Low

Dengue

Moderate

Yellow fever

Moderate

Chikungunya

Low

Vaccines

VaccineRecommendationReference
Routine vaccines

Make sure you are up-to-date on all routine vaccines before every trip — per the Swiss BAG schedule. These include:

BAG Impfplan
Chikungunya

Same daytime Aedes vector as dengue, with elevated risk in low-altitude regions. Vaccination may be considered for extended stays in high-incidence areas or during outbreaks (see EKRM statement).

—
Dengue

Qdenga® vaccination currently recommended only for travelers with documented prior dengue infection who will be exposed in a high-transmission region. Not for first-time visitors.

—
Hepatitis A

Recommended for all travelers aged 1 year and older. Note for Swiss travelers: hepatitis A is not part of the routine Swiss BAG childhood schedule, so most adult travelers will need vaccination.

CDC Yellow Book
Hepatitis B

CDC recommends hepatitis B for unvaccinated travelers. Routine in the Swiss BAG childhood schedule — younger travelers are usually already covered; older travelers can consider it per individual risk and stay duration.

CDC Yellow Book
Rabies

Pre-exposure recommended for long stays, cyclists, motorcyclists, hikers/trekkers in remote areas, young children, animal workers, and cavers (bat exposure — vampire-bat-transmitted rabies occurs in the Amazon). Pre-exposure simplifies post-bite management.

CDC Yellow Book
Typhoid

Recommended for long-term travelers, those visiting friends and relatives, off-the-beaten-track and Amazon itineraries, or stays in poorer hygienic conditions.

CDC Yellow Book
Yellow fever

Recommended for travel to the Amazon/jungle lowlands below ~2300 m (Loreto, Madre de Dios, Amazonas, San Martín, Ucayali and similar). NOT recommended for Lima, Cusco, Machu Picchu, the Inca Trail, or Lake Titicaca. Single dose ≥10 days before travel at an authorized Swiss YF center; lifelong protection. Live vaccine — contraindicated in immunosuppressed patients, pregnancy, and primary vaccination in adults >60.

CDC Yellow Book

Disease-specific guidance

Malaria

Low

Malaria risk is confined to the Amazon lowlands east of the Andes below ~2500 m — highest in Loreto (Iquitos) and Madre de Dios (Puerto Maldonado), with rare cases reported in Tumbes and Piura. Lima, Cusco, Machu Picchu, the Inca Trail, Lake Titicaca, and the highland tourist core are NO-risk. P. vivax predominates, with P. falciparum mainly in Loreto. Itinerary determines whether prophylaxis is needed.

High risk
Amazon lowlands <2500 m: Loreto (Iquitos), Madre de Dios (Puerto Maldonado)
Low/rare
Tumbes, Piura
No risk
Lima, Cusco, Machu Picchu, Inca Trail, Lake Titicaca
Species
P. vivax predominant; P. falciparum in Loreto
Prophylaxis
Atovaquone-proguanil or doxycycline for the Amazon
Malaria risk areas in Peru (CDC).

Yellow fever

Moderate

Yellow fever is endemic in Peru's Amazon/jungle lowlands. Vaccination is recommended for travel below ~2300 m in regions such as Loreto, Madre de Dios, Amazonas, San Martín, and Ucayali. It is NOT recommended for Lima, Cusco city, Machu Picchu, the Inca Trail, or Lake Titicaca. The classic highland tourist circuit therefore does not require YF vaccine unless it is combined with a jungle extension.

Recommended
Amazon/jungle lowlands <2300 m (Loreto, Madre de Dios, etc.)
Not needed
Lima, Cusco, Machu Picchu, Inca Trail, Titicaca
Vaccine
Single dose, lifelong protection
Timing
≥10 days before travel
Yellow fever vaccine recommendation areas in Peru (CDC).

Dengue

Moderate

Dengue is endemic in Peru's low-altitude coastal and jungle regions, with large epidemics in recent years and year-round transmission that peaks in the warm, rainy season. Risk is highest below ~2000 m; the high-altitude tourist core is essentially dengue-free. Daytime mosquito protection is essential for any lowland or Amazon travel.

Distribution
Coastal & jungle areas below ~2000 m
Season
Year-round; rainy-season peaks; recent epidemics
Vector
Aedes aegypti — daytime biter
Low/no risk
Cusco, Machu Picchu, Titicaca (high altitude)

Chikungunya

Low

Chikungunya circulates in Peru's low-altitude regions, sharing the same daytime Aedes vector as dengue, so the same bite-prevention measures apply. Joint pain can persist for months after the acute illness. Vaccination is considered for extended stays in high-incidence areas or during outbreaks (see EKRM statement).

Distribution
Low-altitude coastal & jungle regions
Vector
Aedes — bites during daytime
Symptoms
Fever + prolonged joint pain

General prevention

Food & water

Food and water precautions are important throughout Peru, especially outside the main tourist hotels and in rural or Amazon regions. Use bottled or filtered water for drinking and brushing teeth, avoid ice from unverified sources, and be cautious with raw produce and street food. These measures reduce the risk of traveler's diarrhea, hepatitis A, and typhoid.

Mosquito protection

Mosquito-bite protection is essential in the Amazon and other low-altitude regions. Daytime-biting Aedes mosquitoes spread dengue, Zika, and chikungunya; dusk-to-dawn Anopheles spread malaria in the Amazon lowlands. Use DEET 30%+ or picaridin, long sleeves, and permethrin-treated clothing for any jungle travel. The high-altitude tourist core (Cusco, Sacred Valley, Machu Picchu, Lake Titicaca) is essentially free of these mosquito-borne diseases.

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.