Health Concerns

Immunizations
No immunizations are required by law to enter the countries we visit. However, the following vaccinations/boosters are advised for most of our destinations:

• Hepatitis A
• Typhoid
• Diphtheria and Tetanus
• Yellow Fever (specific to the Amazon)

The US Center for Disease Control is an excellent source for detailed information on preventing travel related illnesses. Check them out at http://www.cdc.gov. Also see the World Health Organization site.

Malaria
Malaria is endemic to many rainforest areas, though your risk of being exposed may be quite small on a short visit. Although there are no immunizations to protect against malaria, anti-malarial medications are often recommended. Your risk of being exposed to malaria differs substantially from area to area and from season to season. Consult the Center for Disease Control and/or a travel doctor for the latest information.

Popular anti-malarial medications include Chloroquine, Malarone, Doxycycline, and Mefloquine. Side effects vary and some medications are not recommended for children, pregnant/ breast feeding women, or persons with certain psychiatric disorders. Talk with your doctor regarding medication recommendations for your specific circumstances.

Insect bites
Vaccines do not yet exist for many insect-borne diseases. Though these diseases are rare and it is unlikely that they will be encountered by the average traveler, the best prevention is to avoid getting insect bites in the first place. Bites can be minimized with proper clothing and a good repellent. Light, long sleeve shirts and loose-fitting pants provide the very best defense against biting insects. There are also new fabrics that are designed specifically for tropical climates. For example, some travelers recommend ExOfficio's BUZZ OFF clothing that has a built in repellent (though there are mixed reports about its effectiveness).

Insect repellent with a high DEET content is widely regarded as the most effective chemical repellent. DEET, however, is a strong chemical. Travelers should be careful not to touch plastic surfaces such as contact lenses or glasses before washing their hands as the DEET on your hands can actually melt the clear plastic. Some travelers, such as pregnant women or children, may want to check with their doctors before using DEET. Recent studies suggest that insect repellent containing lemon eucalyptus may be equally effective and less toxic, though this repellent needs to be re-applied more often.

Traveler's diarrhea (TD) is one of the most common ailment of visitors to any overseas destination. It's a good idea to ask your doctor for an antibiotic specifically for TD, as over-the-counter medicines such as Imodium and Lomotil will only treat the symptoms and not the cause. Many doctors will prescribe a combination of antibiotics and Imodium to treat both the symptoms and the cause.

Dietary Precautions
The best way to stay fit and enjoy your trip is to start well rested and in good health. Generally, food and sanitation in Latin America is of a good standard. Consider the following advice to avoid traveler's diarrhea and other food-borne illness:

• Avoid unwashed fruits and vegetables or food sold by street vendors. While in our camps or lodges, sanitary precautions are taken while preparing your meals to minimize problems. Your guide can also recommend restaurants that have a good reputation for safe food handling.
  
  
• Wash your hands regularly with soap and water. Moist toilettes or anti-bacterial hand gels such as Purell offer good alternatives.
  
  
• Drink plenty of water to flush toxins out of your system and to prevent dehydration. Soft drinks, liquor, coffee, alcohol and tea do not possess the hydrating qualities of water. Bottled or boiled water is provided on our treks. In the cities bottled water is readily available. Bring a water bottle of your own so that you can fill up from larger containers and minimize plastic waste.

Altitude Sickness
Many of South America's greatest attractions are at high altitudes. Travelers are likely to feel mild effects of soroche (altitude sickness) when arriving in Cusco, Puno, La Paz, Quito, or other areas above 8,000 feet. Symptoms may include fatigue, breathlessness, pounding heart, dehydration, stomach upset, insomnia, and headache. These symptoms generally subside in a day or two and severe symptoms are rare. To minimize symptoms, plan to take it easy during your first couple days at high altitude, get plenty of rest, and drink lots of water. Some locals swear that drinking coca tea, a popular herbal tea in Andean regions, is helpful. Your physician can also prescribe Diamox, a diuretic, to help you adjust to the altitude. Some travelers rave about the effectiveness of this prescription medication, while others question whether or not it makes a difference. Many hotels also have oxygen available to temporarily alleviate symptoms.

Severe altitude sickness is most common in travelers with pre-existing heart or lung conditions. Discuss any pre-existing conditions with your doctor before traveling to minimize the chance of problems occuring. For severe altitude sickness, the only solution is to return to a lower altitude.

Personal First Aid
Bring a small first aid kit for personal use. Include any over-the-counter drugs and prescription drugs you use regularly. Make every effort to bring the medication in the original container, and bring enough for the entire trip as well as a copy of your prescriptions. Other useful items include band-aids, ace bandage, antihistamine, moleskin, sunscreen, chapstick, antifungal lotion, antiseptic cream for minor cuts, and an extra pair of contacts or glasses if you use these. Women should bring enough sanitary supplies for the trip. Some people find moist towelettes for cleaning hands useful. Travelers are required to notify Adventure Life of any pre-existing health conditions, which might affect you or other members of the group during the trip.