Disease Risks and Precautions
in Temperate South America
provided below is for informational purposes only.
It may not be current, and it should not be considered definitive.
should check the Center for Disease Control (CDC) website
for the most current disease risk and disease prevention information.
DISEASES TRANSMITTED BY INSECTS
DISEASES TRANSMITTED THROUGH
FOOD AND WATER
DISEASES TRANSMITTED THROUGH
RECOMMENDATIONS FOR TEMPERATE
COUNTRIES IN REGION
Argentina, Chile, Falkland Islands, Uruguay
Travelers to Temperate South America may be exposed to potential
diseases from a number of sources. The most frequently reported
illness is traveler's diarrhea, but there are other diseases which
are unique to Mexico and Central America or the tropics. These
diseases are transmitted by insects, contaminated food and water,
or close contact with infected people. Specific diseases are discussed
under each of these topical headings.
In order to reduce the risk of infection travelers must (1) protect
themselves from insects, (2) ensure the quality of their food
and drinking water, and (3) be knowledgeable about potential diseases
in the region to be visited. Finally, diseases are not restricted
to cleanly defined geographical areas, i.e. mosquitoes can fly
over city or country borders, therefore, all travelers should
protect themselves by taking the basic preventive precautions.
DISEASES TRANSMITTED BY INSECTS
Many diseases are transmitted through
the bite of infected insects such as mosquitoes, flies, fleas,
ticks, and lice. In general travelers must protect themselves
from insect bites by wearing proper clothing, using bednets, applying
an insect repellent to exposed skin and clothing, and if possible,
avoiding high risk situations, i.e. outdoor activities during
night time hours from dusk to dawn when mosquitoes bite, unscreened
living accommodations, etc. If a mosquito net is unlikely to be
available, consideration should be given to purchasing a portable
Risk: In Argentina, the risk for malaria infection occurs only
in rural areas of northern Argentina that border Bolivia (Salta
and Jujuy Provinces). In Chile, Falkland Islands, and Uruguay,
there is no risk of malaria.
Prevention: Travelers at risk for malaria should take CHLOROQUINE
to prevent malaria. The weekly dosage for an adult is 500 mg once
a week. This drug should be taken one week before entering a malarious
area, weekly while there, and weekly for 4 weeks after leaving
the malarious area. No other anti-malarial drugs are needed.
In addition to using drugs to prevent malaria and treat a possible
malaria attack, travelers should use measures to reduce exposure
to malaria-carrying mosquitoes, and protect themselves from mosquito
bites. These mosquitoes bite mainly during the evening and night,
from dusk to dawn.
Risk: A low risk of yellow fever infection occurs only in the
northeastern forest areas of Argentina. There is no risk of yellow
fever in Chile, Falkland Islands, or Uruguay.
Prevention: In general, if you are traveling to an area of risk,
the easiest and safest thing to do is to get a yellow fever vaccination
and a signed certificate. Yellow fever vaccination, a one dose
shot, may be administered to adults and children over 9 months
of age. The vaccine is not recommended for persons who are pregnant
or whose immune systems are not functioning normally. In addition
to the vaccine, travelers should use measures to reduce exposure
to mosquitoes, and protect themselves from mosquito bites. These
mosquitoes bite mainly during the evening and morning hours.
CDC recommends a yellow fever vaccination only if you are traveling
to areas of risk (northeastern Argentina, Tropical South America,
or Africa). Argentina, Chile, Falkland Islands, and Uruguay have
no yellow fever vaccination requirements. If your travel plans
include traveling to or from other countries in Africa or South
America, then you should request and read the CDC document "Comprehensive
Yellow Fever Requirements". You may be required to have a
yellow fever vaccination. (Yellow fever vaccine is the ONLY vaccine
that may be officially required for entry into certain countries.)
Yellow Fever Certificate: After immunization an International
Certificate of Vaccination is issued and is valid 10 days after
vaccination to meet entry and exit requirements for all countries.
The Certificate is good for 10 years. You must take the certificate
OTHER INSECT DISEASES
Risks: Other diseases spread by mosquitoes, sand flies, black
flies, or other insects are prevalent, especially in rural areas.
These diseases include: Filariasis (mosquito), leishmaniasis (sandfly),
Onchocerciasis (blackflies), Trypanosomiasis, American Chagas'
Disease ("cone nose or kissing" bug), Oropouche Virus
(gnats or midges), typhus (lice), and Plague (fleas).
PREVENTING INSECT BITES
To reduce mosquito bites travelers should remain in well-screened
areas, use mosquito nets, and wear clothes that cover most of
the body. Travelers should also take insect repellent with them
to use on any exposed areas of the skin. The most effective repellent
is DEET (N,N-diethyl meta-toluamide) an ingredient in most insect
repellents. Travelers should also purchase a flying insect-killing
spray to use in living and sleeping areas during the evening and
night. For greater protection clothing and bednets can be soaked
in or sprayed with PERMETHRIN, which is an insect repellent licensed
for use on clothing. If applied according to the directions, permethrin
will repel insects from clothing for several weeks.
DISEASES TRANSMITTED THROUGH FOOD AND
Food and waterborne diseases are the number
one cause of illness to travelers and are very common in Temperate
South America. Traveler's diarrhea is the most frequent health
problem for travelers. It can be caused by viruses, bacteria,
or parasites which are found universally throughout the region.
Transmission is most often through contaminated food or water.
Infections cause diarrhea and vomiting (typhoid fever, cholera,
and parasites), liver damage (hepatitis), or muscle paralysis
Risk: A recent epidemic of cholera has swept through the entire
South American area. The majority of cases have been reported
from Peru, Ecuador, Colombia, Guatemala, and Mexico. Cholera has
been reported in coastal cities and inland areas of most of these
countries. Cholera has also been reported in Cuzco in Peru and
in the Galapagos Islands of Ecuador. Other countries to report
cases include Argentina, Belize, Bolivia, Brazil, Chile, Costa
Rica, El Salvador, French Guiana, Guyana, Honduras, Nicaragua,
Panama, Suriname, and Venezuela. Bolivia has reported cases from
the departments of Oruro and La Paz. Cholera has been reported
from five states in Brazil: Amazonas, Mato Grosso, Rondonia, Amapa,
and Para. Several municipalities near the mouth of the Amazon
River have been affected. Cholera cases were first recognized
in Peru in the last week of January 1991. Cholera has been reported
in a small number of U.S. residents traveling to Peru and Ecuador.
The risk of infection to the U. S. traveler is very low, especially
those that are following the usual tourist itineraries and staying
in standard accommodations. Travelers should consider the vaccine
if they have any problems with their stomach, such as anti-acid
therapy, ulcers, or if they will be living in less than sanitary
conditions in areas of high cholera activity.
Prevention: Travelers to cholera infected areas should follow
the standard food and water precautions of eating only thoroughly
cooked food, peeling their own fruit, and drinking either boiled
water, bottled carbonated water, or bottled carbonated soft drinks.
Persons with severe cases respond well to simple fluid and electrolyte-replacement
therapy, but medical attention must be sought quickly when cholera
is suspected. The available vaccine is only 50% effective in reducing
the illness, and is not recommended routinely for travelers.
Risk: Travelers to Temperate South America are at risk for typhoid
fever, especially when traveling to smaller cities, villages,
or rural areas. Typhoid fever is more common in Chile.
Prevention: By drinking only bottled or boiled water and eating
only thoroughly cooked food, a traveler lowers the risk of infection.
Currently available vaccines have been shown to protect 70- 90%
of the recipients. Therefore, even vaccinated travelers should
be cautious in selecting their food and water. Two available vaccines
provide equivalent protection against typhoid fever- oral and
Recommendations: CDC recommends a typhoid vaccination for those
travelers who are going off the usual tourist itineraries, traveling
to smaller cities and rural areas, or staying long term, that
is, a traveler for six weeks or more. Typhoid vaccination is not
required for international travel.
Risk: Travelers are at high risk for Hepatitis A, especially if
travel plans include visiting rural areas and extensive travel
in the countryside, frequent close contact with local persons,
or eating in settings of poor sanitation. A study has shown that
many cases of travel-related hepatitis A occur in travelers to
developing countries with "standard" itineraries, accommodations,
and food consumption behaviors.
Prevention: The virus is inactivated by boiling or cooking to
85 degrees centigrade for one minute, therefore eating thoroughly
cooked foods and drinking only treated water serve as general
precautions. Havrix, the hepatitis A vaccine currently licensed
for use in the U.S., or immune globulin (IG) is recommended before
travel for persons 2 years of age orolder. Hepatitis A vaccine
is preferred for persons who plan to travel repeatedly or reside
for long periods of time in intermediate or high risk areas.
Recommendations: CDC recommends hepatitis A vaccine or IG for
protection against hepatitis A. Immune globulin should be used
for travelers < 2 years of age. Immune globulin is recommended
for persons of all ages who desire only short term protection.
Parasitic infections are acquired by eating or drinking contaminated
food or water, through direct contact with soil or water containing
parasites or their larva, or by contact with biting insects.
Symptoms and evidence of infection may
include, but are not limited to fever, swollen lymph nodes, rashes
or itchy skin, digestive problems such as abdominal pain or diarrhea,
eye problems, and anaemia.
Risk: Travelers to Temperate South America are at risk of parasitic
infections. There are many types of parasites and infection may
occur in several ways: by eating undercooked meats infected with
parasites or their larva; by eating food or drinking water contaminated
with parasites or their eggs; by contact with soil or water infected
with parasites; or through insect bites. Several types of parasites
can penetrate intact skin and travelers are advised to wear shoes
and avoid swimming, wading, or washing in fresh water.
Prevention: Travelers should eat only thoroughly cooked food,
drink safe water, wear shoes, refrain from swimming in fresh water,
and avoid contact with insects, particularly mosquitoes, biting
flies, gnats, and midges.
DISEASES TRANSMITTED THROUGH INTIMATE CONTACT
HIV / AIDS
Risk: AIDS is found throughout the region. In Temperate America,
heterosexual transmission is now the predominant mode of transmission,
with the largest number of cases in males, and there are high
numbers of HIV-positive injecting drug users. The risk to a traveler
depends on whether the traveler will be involved in sexual or
needle-sharing contact with a person who is infected with HIV.
Receipt of unscreened blood for transfusion poses a risk for HIV
Prevention: No effective vaccine has been developed for HIV. Travelers
should avoid sexual or needle-sharing contact with a person who
is infected with HIV. If a blood transfusion is necessary, screened
blood should be from an HIV-negative blood donor.
Recommendations: Travelers should avoid activities known to carry
risks for infection with HIV.
Risk: The risk of Hepatitis B virus infection is modrate for Temperate
South America. The risk to the individual international traveler
is determined by the extent of: (1) direct contact with blood
or other body fluids, etc.; (2) intimate sexual contact with an
infected person; (3) the duration of travel.
Prevention: The primary prevention consists of either vaccination
and/or reducing intimate contact with those suspected of being
infected. For those travelers expecting to reside in countries
of high risk, as well as all health workers, vaccination is strongly
recommended. Vaccination should ideally begin 6 months before
Recommendations: CDC recommends vaccination for any of the following
people: any health care worker (medical, dental, or laboratory)
whose activities might result in blood exposure; any traveler
who may have intimate sexual contact with the local population;
any long-term (6 months or more)
traveler, e.g. teachers, who will reside in rural areas or have
daily physical contact with the local population; or any traveler
who is likely to seek either medical, dental, or other treatment
in local facilities during their stay. Hepatitis B vaccination
is not required for travel to any country.
Risk: For most countries in Temperate South America, there is
a risk of rabies infection particularly in rural areas, or in
areas where large numbers of dogs are found.
Prevention: Do not handle any animals! Any animal bite should
receive prompt attention. When wounds are thoroughly cleaned with
large amounts of soap and water, the risk of rabies infection
is reduced. Exposed individuals should receive prompt medical
attention and advice on post-exposure preventive treatment.
Recommendations: There are no requirements for vaccination, but
pre-exposure vaccination is recommended for:
- travelers visiting, for more than 30 days, foreign areas where
rabies is known to exist;
- veterinarians and animal handlers;
- spelunkers; and
- certain laboratory workers.
Pre-exposure vaccination does not nullify the need for post exposure
vaccine, but reduces the number of injections.
Recommendations for TEMPERATE SOUTH AMERICA
Travelers should (1) take appropriate country specific malaria
prevention measures (chloroquine - in northern Argentina only),
(2) follow precautions to prevent insect bites, (3) pay attention
to the quality of their drinking water and food, (4) have a dose
of Immune Globulin (IG) or the Hepatitis A vaccine, and (5) consider
booster doses of tetanus (Td) and polio (eIPV) vaccines. (6) Depending
on the locations to be visited, planned activities, and health
of the traveler, the following vaccines should be considered:
Hepatitis B, Japanese Encephalitis, Typhoid, Rabies (pre-exposure),
and Cholera. (7) Finally, the normal "childhood" vaccines
should be up-to-date: Measles, Mumps, Rubella (MMR Vaccine); Diphtheria,
Tetanus, Pertussis (DTP Vaccine) [ < 7 years of age], and Polio
Disease risks and precautions