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SOUTH AMERICA
Maps: http://www.paho.org/English/HCP/HCT/malaria_PPTindex.htm
ARGENTINA: In most of
Argentina
there is no risk of malaria at all, and therefore no antimalaria
precautions are necessary. There is only a limited risk of malaria from
October to May in the extreme North of Argentina, only in a few low-lying
rural areas (below 1200 metres), and exclusively
with the mild vivax form: 1) on the border with
Bolivia, in the province of Salta (in the plains of Iruya,
Oran, San Martin and Santa Victoria).
2)
on the border with Paraguay,
in the plains of Misiones and Chaco.
The precautions discussed in NOTE 1 apply for travellers spending the
night in primitive conditions.
Recommendation of the WHO concerning yellow fever vaccination:
"vaccination against yellow fever is strongly recommended
for all travellers from the age of 9 months visiting the following areas in Argentina with risk of yellow
fever transmission: the northern and north-eastern forested areas of
Argentina, including Iguaçu Falls and all areas bordering Brazil and
Paraguay, total territory of the federal provinces of
Formosa and Misiones, specific areas (departments) of the federal
province of Chaco (department of Bermejo), the federal province of Corrientes (departments
of Berón
de Astrada,
Capital,
General Alvear, General Paz, Itatí,
Ituzaingó,
Paso de los
Libres, San Cosme, San Miguel, San Martín
and San Tomé), the federal province of Jujuy
(departments of Ledesma, Santa Bárbara,
San Pedro
and Valle Grande) and the federal province of Salta (departments of Anta,
General José de San Martín,
Orán and Rivadavia).
This recommendation includes visits to Iguaçu Falls."
BOLIVIA:
There is no malaria in the larger towns, nor in the areas above 2500 m. This
means that there is no risk in the following high areas in the southwest:
- in the Oruro province;
- in a number of provinces in
the southwest of the La Paz
region, namely in the provinces Ingavi, Los
Andes, Omasuyos, Pacajes;
- in the southern and central
part of the Potosi
region:
1.
There is Nivaquine-resistant falciparum malaria on the border with Brazil in the Northern provinces Pando and Beni (in a strip of the tropical Amazon basin bordering
on the Brazilian states of Acre and Rondonia,
especially in Cobija, Guayaramerìn and Riberalta), for which the
recommendations discussed in NOTE 2 apply.
2.
There is a limited to very limited malaria risk all year in
the areas below 2500 m (but not in the centre of large towns) in the rest of Bolivia (mainly
the mild vivax malaria) and anti-mosquito measures
are sufficient here. The recommendations discussed in NOTE 1 apply only in the
low-lying rural areas of the provinces Santa Cruz
(also P. falciparum malaria),
Tarija and Chuquisaca on the border with Paraguay
and Argentina.
In case of fever malaria should always be considered.
Recommendation of the WHO concerning yellow fever vaccination:
"vaccination against yellow fever is strongly recommended for travellers
visiting the following risk areas; the provinces of Beni, Cochabamba,
Santa Cruz and the subtropical part of the province of La Paz.
This does not concern the cities of La Paz and Sucre, where there is no risk
of yellow fever.
If you are starting your trip from another country where yellow fever can
occur (Africa, South America), vaccination is officially required.
http://www.who.int/ith/ITH2010countrylist.pdf
BRAZIL: In many areas of Brazil there
is no malaria risk at all.
- There is a possible malaria risk
in the forest areas below 900 metres in the 9
states of the "Legal Amazonia Region": Acre, Amapá, Amazonas, Maranhão
(only in the West), Mato Grosso
(only in the North, not in Mato Grosso do Sul), Pará (except for the city of Belém),
Rondônia, Roraima
and in Tocantins (in the western part, north of Goias). The
measures for the prevention of malaria discussed in NOTE 2 apply only in
these areas. There is no risk in the town of Belém (Pará),
but a low risk in the urban areas of large towns such as Pôrto Velho (Rondônia), Boa Vista (Roraima),
Macapá (Amapà), Manaus (Amazonas), Santarém
(Pará), Cuiaba
(Mato Grosso), Rio Branco & Cruzeiro do Sul (Acre) and Maraba (Pará). Pantanal
National Park is
situated in a low risk area, south of Mato Grosso and there is no need to take antimalaria tablets.
- As stated in the beginning, no
precautions against malaria are necessary in the other areas of Brazil. When visiting
the Foz de Iguaçu waterfalls, measures for
protection against mosquito bites in the evenings and at night will
be sufficient.
Recommendation of the WHO concerning yellow fever vaccination:
"Vaccination against yellow fever is strongly recommended for travellers
from the age of 9 months
visiting the following risk areas; the entire territory of the states of Acre, Amapá, Amazonas,
Distrito Federal (also the capital Brasilia), Goiás, Maranhão,
Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Rondônia,
Roaraima and Tocatins, specific regions of the states:
northwest and west Bahia, Espirito Santo, southwest Piaui, central and west Paraná,
northwest and central-west Rio Grande do Sul, west Santa Catarina
and north and west São Paulo."
Vaccination is strongly recommended for travellers visiting
Foz de Iguaçu.
The complete list with municipalities is
available at
http://www.saude.gov.br/svs
(Febre Amarela). There is no risk of yellow fever in the coastal
regions Rio de Janeiro, São Paulo, Salvador, Recife and
Fortaleza. If you are starting your trip from another country where yellow fever can
occur (Africa, South America), vaccination is officially required from
the age of 9 months (except for the travellers for whom the vaccination
is medically contra-indicated).
CHILE: No malaria risk.
Recommendation of the WHO concerning yellow fever vaccination:
"Vaccination against yellow fever is not obliged nor recommended.
COLOMBIA:
There is no
malaria risk in Bogota
and its surrounding area, nor in the other large towns. Nor is there any risk
in the areas above 800 m on the Cordillera Occidental, Cordillera Central and
Cordillera Oriental. There is no risk in
most of the Caribbean coastal areas (except in Cordoba)
and on the low plains of Colombia,
towards the border with Venezuela.
There is a malaria risk which varies greatly from one area to the next all
year in many rural areas below 1600 m. The underlined provinces have the
highest risk. The recommendations discussed in NOTE 2 apply:
1.
in the Pacific Ocean coastal area – " Pacifico region": in the provinces Nariño, Cauca, Valle del
Cauca and Choco
2.
in the Northern region Uraba-Bajo Cauca:
provinces Chocó, Antioquia, Córdoba
3.
in the tropical rainforest area of the Amazon basin, the
"Amazonian region": provinces Amazonas and Vaupés.
4.
in the remaining regions east of the Andes "orinoquia
region": provinces Arauca, Boyaca, Caqueta, Guainía,
Guaviare, Meta, Norte de Santander, Putamayo,
Vichada.
Recommendation of the WHO concerning yellow fever vaccination:
"vaccination against yellow fever is not obliged, but strongly recommended
for travellers visiting the following risk areas: middle valley of the
Magdalena river, eastern and western foothills of the Cordillera Oriental
from the border with Ecuador to that with Venezuela, Urabá, foothills of the
Sierra Nevada, eastern plaines (Orinoquia) and Amazonia".
ECUADOR:
There is no malaria
risk above 1500 m, nor in the large towns (such as Quito,
Guayaquil and the cities in the Andes region) and on the Galapagos Islands. There is a moderate risk of malaria:
- in the provinces on the west
side of the Andes (Pacific Ocean): Esmeraldas (the Northern province
bordering on Colombia),
Manabi and Pinchinca
(just below Esmeraldas), Los Riós, Guayas (in
the centre), and El Oro (in the South on the border with Peru)
- in the provinces on the
Eastern side of the Andes (Amazon region): Sucumbios
(in the North), Orellana (Napo
river), Pastaza and Morona-Santiago
- and to a lesser extent in some
other provinces: Cotopaxi (central) and Loja (on the border with Peru).
The recommendations discussed in
NOTE 2
apply when staying overnight in primitive conditions below 1500 m.
Recommendation of the WHO concerning yellow fever vaccination: "There
is risk of yellow fever in the eastern part of the country. There is
no risk in Quito, Guayaquil or the Galapagos Islands.
If you are starting your trip from another country where yellow fever can
occur (Africa, South America), vaccination is officially required from
the age of 1 year. Citizens and habitants of Ecuador are obliged to be
vaccinated against yellow fever when visiting another country where yellow
fever can occur (Africa, South-America).
BRITISH GUYANA:
There is no malaria risk in
Georgetown and
New Amsterdam. There is a quite substantial
malaria risk in the rest of the country:
-
highest risk occurs in regions
1(Barimi-Waini), 7 (Cuyuni-Mazaruni), 8 (Potaro-Siparuni), 9 (Upper Takutu-Upper Essequibo)
and 10 (Upper Demerara-Berbice);
-
moderate risk in region 2 (Pomeroon-Supenaam)
and 3 (Demerara-Mahaica)
-
very
low risk in regions 4 (Demerara-Mahaica), 5 (Mahaica-Berbice) and 6 (East Berbice-Corentyne). The recommendations in
NOTE 2
apply.
Recommendation of the WHO concerning yellow fever vaccination:
"Vaccination against yellow fever is strongly recommended. Vaccination
against yellow fever is anyhow officially required for travellers coming
from another country, where yellow fever can
occur (Africa, South America - an exception is being made for travellers
coming from Trinidad, Tobago, Paraguay, Argentina) or from a country mentioned on
http://www.who.int/ith.
FRENCH GUYANA:
There is no malaria risk in
Cayenne and
Kourou, and the malaria risk is very limited in the
rest of the coastal strip. No anti-malaria precautions are necessary.
In the border area with
Brazil (different
regions along the Oiaopoque
river ) and
Surinam
(different regions along the Maroni river) there is a
substantial malaria risk. The guidelines discussed in NOTE 2
apply. In
the rest of the country the risk is low to negligible.
Vaccination against yellow fever is obliged for all travellers from
the age of 1 year.
PARAGUAY:
In most of Paraguay
there is no risk of malaria at all, and therefore no antimalaria
precautions are necessary. There is no risk in the towns, nor in the tourist
resorts and the surrounding areas, such as the Iguaçu waterfalls.
There is only a limited risk from October to May in some rural
areas:
1.
in the West, on the border with Bolivia
2.
in the East on the border with Brazil in the provinces Alto
Paraná (towards Foz do Iguaçu), Caaguazu and Canendiyu. The recommendations discussed in
NOTE 1 apply for overnight stays in more primitive conditions.
Recommendation of the WHO concerning yellow fever vaccination:
"Vaccination against yellow fever is strongly recommended for all travellers
from the age of 9 months.
If you are starting your trip from another country where yellow fever can
occur (Africa, South America), vaccination is officially required
from the age of 1 year on."
PERU:
- There is no risk of
malaria in the large towns (except in the suburbs of Iquitos), nor in
areas higher than 2000 m. No preventive antimalaria
measures are therefore necessary here.
- In the coastal areas to the
West of the Andes (except for the
Northern provinces listed below) the malaria risk is very low to
negligible. The precautions against mosquito bites from dusk
till dawn are sufficient for travellers staying in primitive conditions in
rural areas (in case of fever malaria should always be considered).
- A risk of malaria exists
(including the dangerous Plasmodium falciparum
type)
1.
In the Northern provinces in the coastal area on the Pacific
Ocean bordering on Ecuador
(Tumbes, Piura,
Lambayeque) and
2.
in the Amazon region: especially in the provinces Loreto (+ Iquitos),
San Martin, Ucayali and the lower provinces of Amazonas (incl. the Chachapoyas area), Cajamarca and Jaen. The recommendations discussed in NOTE
2 apply.
3.
The recommendations in NOTE 1 apply when spending nights under
primitive conditions in rural areas in the rest of the country (predominantly
the mild P.Vivax), (Madre de Dios province, town of
Puerto Maldonado and the lower provinces of La
Libertad, Ayacucho, Pasco, Cusco,
Huancavelica, Junin and Huànuco).
People staying in luxury hotels in the centres of
large towns in these regions do not need to take antimalaria
tablets but anti-mosquito precautions are just as important here (in case of
fever malaria should always be considered).
Recommendation of the WHO concerning yellow fever vaccination:
"Vaccination against yellow fever is not obliged, but strongly recommended
for travellers visiting the jungle areas below 2300m. Vaccination against
yellow fever is NOT necessary for travellers visiting Cuzco and Machu
Picchu."
SURINAM:
- The risk of malaria in Paramaribo and the
seven other coastal districts (north of latitude 5° north) is very low to
negligible. Malaria tablets do not need to be taken.
- In the interior there is a
great risk of malaria caused by Plasmodium falciparum (in the three
Southern districts south of latitude 5° north; beyond the coastal
savannah area, with highest risk along the eastern border and in gold mining
areas), and the recommendations discussed in NOTE 2 apply.
Recommendation of the WHO concerning yellow fever vaccination:
"Vaccination against yellow fever is strongly recommended.
If you are starting your trip from another country where yellow fever can
occur (Africa, South America), vaccination is officially required
from the age of 1 year on.
TRINIDAD - TOBAGO:
There is no malaria risk.
Recommendation of the WHO concerning
yellow fever vaccination: "Vaccination against yellow fever is strongly
recommended for all travellers from the age of 9 months visiting Trinidad;
vaccination is not indicated for travellers only visiting Tobago.
If you are starting your trip from another country where yellow fever can
occur (Africa, South America), vaccination is officially required from
the age of 1 year."
VENEZUELA:
Most of the country is malaria-free. There is no malaria risk in the towns.
There is no malaria risk on Margarita
Island.
- There is a risk of (falciparum) malaria in a number of low-lying
rainforest areas of the states of Amazonas (Alto
Orinoco, Atabapo, Atures, Autana, Manapiare, Rio Negro),
Anzoàtegui
and Bolivar (Caroni, Cedeño, El Callao, Heres, Gran Sabana,
Piar, Raul Leoni, Rocio, Sifontes
and Sucre) (South of the Orinoco River,
on the border with Brazil),
Monagas,
Sucre and Delta Amacuro (Antonia Diaz, Casacoima, Pedernales; around the delta of the Orinoco). The measures discussed under NOTE 2
could apply here for overnight stays in rainforest areas under
adventure-type conditions (incl. for the Angel
Falls and Canaima National Park).
- In a number of rural areas of
the states Apure,
Monagas, Sucre and Zulia (north of the Orinoco
river) there is a limited risk of (especially the) mild vivax
malaria. The measures discussed under NOTE 1 apply for overnight stays
in primitive, adventure-type conditions.
- In the remaining provinces
there is no risk of malaria at all. This means that malaria tablets need
not be taken for most well-organised tourist
trips, even to some rainforest areas, and that measures for protection
against mosquito bites in the evenings and at night are sufficient here.
Recommendation of the WHO concerning yellow fever vaccination:
"Vaccination against yellow fever is not obliged, but strongly recommended."
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