According to the World Health Organization, an estimated 30,000 international travelers fall ill with malaria each year. For first-time travelers to Peru, the risk of malaria is often of great concern. In general, however, the risk is low.
The Centers for Disease Control and Prevention (CDC) states that there are less than five cases reported each year in the United States of malaria acquired in Peru (Peru receives approximately 300,000 US residents annually).
Malaria Risk Areas in Peru
The risk of malaria varies throughout Peru. Areas with no risk of malaria include:
- Lima and surrounding areas
- coastal cities south of Lima including Ica and Nazca
- southern cities including Arequipa, Puno, Tacna and Moquegua
- highland areas such as Cusco, Machu Picchu and Lake Titicaca, and other areas located above 6,560 feet (2,000 m)
Areas with malaria include all regions located below 6,560 feet (2,000 m), with the exception of those listed above. The main malaria risk areas are located in the Peruvian Amazon.
The Centers for Disease Control and Prevention (CDC) considers the jungle cities of Iquitos and Puerto Maldonado (and surrounds) as malaria risk areas. Both cities are popular gateways for jungle lodges, riverboat cruises and rainforest expeditions. Antimalarials may be recommended for travelers in these areas, depending upon length of stay and activities pursued.
The Piura region of northern Peru is also a risk area, as well as some locations along the Peru-Ecuador border.
Peru Malaria Maps
When you visit a doctor before you go to Peru (always a good idea, especially for recommended vaccinations), you may be shown a malaria map of the country. Malaria maps offer a rough guideline to the locations in which antimalarial drugs may be recommended (antimalarials are never a requirement for entering Peru).
The maps themselves can be confusing, especially when a) they seem too general or b) they differ from other malaria maps of Peru. The confusion stems, in part, from shifting malaria patterns, as well as the data used to create the maps. As a visual guide, however, they are useful. You can find malaria maps of Peru at the following websites:
- Fit For Travel (NHS) -- Peru Malaria Map (a good general guide)
- Pan American Health Organization -- Epidemiological Map by Risk Levels, Peru, 1999
- Pan American Health Organization -- Malaria Distribution in the Americas, Malaria Report 2008
- World Health Organization -- World Malaria Report 2011 (see page 74 for Peru map and stats)
Malaria Prevention in Peru
If you are heading to a risk area, there are two main ways to guard against malaria:
- Antimalarial Drugs (Chemoprophylaxis) -- Various antimalarial drugs exist, each with their own distinct pros and cons. The CDC recommends atovaquone-proguanil, doxycycline or mefloquine. You should always consult your doctor before deciding which antimalarial to take -- if deemed necessary. The CDC also recommends buying your antimalarials before traveling, as some drugs manufactured abroad may not be effective.
- Prevent Mosquito Bites -- You can help prevent mosquito bites (which can also transmit yellow fever, dengue fever and potentially the chikungunya virus) by covering up as much bare skin as possible, using insect repellent, avoiding peak exposure times and by using mosquito nets.
When considering malaria symptoms, you must first be aware of the incubation period. Symptoms occur at least seven days after a bite by an infected mosquito.
According to the World Health Organization, you should “Immediately seek diagnosis and treatment if a fever develops one week or more after entering an area where there is a malaria risk, and up to 3 months after departure.”
Along with a fever, malaria symptoms can include a combination of chills, sweats, headaches, fatigue, nausea and body aches.