Central and South America offer incredible diversity, from the ancient ruins of Peru and Mexico to the Amazon rainforest, the Galápagos Islands, and the vibrant cities of Colombia, Argentina, and Brazil. Health risks vary significantly by country and altitude. The Amazon basin and lowland tropical areas present the highest risk, with malaria, Yellow Fever, and dengue all present. Highland areas (Cusco, Quito, Bogotá, Mexico City) have lower mosquito-borne disease risk but altitude sickness becomes a consideration. This region requires careful pre-travel planning, particularly for travellers venturing beyond major cities.
Most travellers to Central & South America should consider the following vaccines:
Malaria risk in Central and South America is concentrated in lowland tropical areas, particularly the Amazon basin. Brazil, Peru, Colombia, Ecuador, and Bolivia all have malaria-endemic areas in their Amazon lowlands. Risk is generally lower than in Sub-Saharan Africa. Highland cities (Cusco, Quito, Bogotá, La Paz, Mexico City) are malaria-free. Argentina and most of Mexico have negligible risk. Cuba and Costa Rica's main tourist areas have negligible risk. Both Plasmodium vivax and Plasmodium falciparum are present, with vivax being more common. Prophylaxis is recommended for travel to the Amazon basin and rural lowland areas.
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Yellow Fever vaccination is recommended for travel to the Amazon basin in Brazil, Peru, Colombia, Ecuador, and Bolivia. Brazil requires it for entry into specific states. Bolivia and some other countries require proof of Yellow Fever vaccination for all arriving travellers. Argentina and Costa Rica do not require it for direct arrivals but may require proof if arriving from an endemic area. The vaccine must be given at an authorised Yellow Fever vaccination centre at least 10 days before arrival. It is valid for life after a single dose.
Hepatitis A and Typhoid vaccinations are recommended for all travellers to Peru. Yellow Fever vaccination is recommended if visiting the Amazon lowlands (Iquitos, Madre de Dios, Puerto Maldonado) and is required for entry to some areas. Rabies pre-exposure vaccination is recommended for adventure travellers and those visiting the Amazon. Hepatitis B is recommended for longer stays. Antimalarial prophylaxis is recommended for the Amazon basin but not for Lima, Cusco, or the Sacred Valley. Ensure routine vaccinations are current.
It depends on your itinerary. The Amazon basin in Brazil, Peru, Colombia, Ecuador, and Bolivia has malaria risk, and prophylaxis is recommended. Highland cities (Cusco, Quito, Bogotá, La Paz), coastal areas, and major urban centres generally do not require prophylaxis. Argentina, Cuba, and Costa Rica's main tourist areas have negligible risk. The malaria in South America is generally less intense than in Africa, but the Amazon region carries genuine risk. Consult a travel health professional about your specific itinerary.
Yes, altitude sickness is a significant risk in the Andes. Cusco (3,400m), Machu Picchu access town Aguas Calientes (2,040m), La Paz (3,640m), Quito (2,850m), and Bogotá (2,640m) are all at altitude. Symptoms include headache, nausea, fatigue, and breathlessness, usually appearing within 6–12 hours of arrival. Ascend gradually, stay well hydrated, avoid alcohol for the first day, and rest on arrival. Serious cases can be life-threatening. Acetazolamide (Diamox) can help prevent symptoms — discuss with your doctor before departure.
Expect $400–$1,000 depending on your itinerary. Yellow Fever vaccine costs $150–$250 (including the international certificate). Hepatitis A $60–$90, Typhoid $50–$70, Rabies $300–$360 for the full course. Antimalarial medication adds $30–$120 depending on the drug and duration. If visiting the Amazon, costs will be at the higher end. Urban-only trips to Buenos Aires or Mexico City require far less vaccination. GP consultation fees apply on top. Most travel vaccines are not covered by Medicare.
Zika virus remains present in lowland tropical areas of Central and South America, though major outbreaks have subsided since 2016–2017. The virus is transmitted by Aedes mosquitoes (the same ones that carry dengue). The main concern is for pregnant women, as Zika infection during pregnancy can cause birth defects. Pregnant women or those planning pregnancy should consult their doctor before travelling. All travellers should use insect repellent and wear protective clothing. There is no vaccine or specific treatment for Zika.
Tap water is generally not safe to drink across Central and South America, with a few exceptions. Argentina (Buenos Aires) and Costa Rica have generally safe tap water in cities, though bottled water is still widely consumed. In Peru, Colombia, Brazil, Mexico, Cuba, Ecuador, and Bolivia, always drink bottled or purified water. Avoid ice unless you are certain it was made from purified water. Be cautious with salads and unpeeled fruit washed in tap water.
The Amazon basin has the highest health risk profile in the Americas. Malaria (prophylaxis essential), Yellow Fever (vaccination recommended or required), dengue, Zika, and chikungunya are all present. Other risks include leishmaniasis, Chagas disease (from triatomid bugs in rustic accommodation), piranha and caiman exposure, and venomous snakes and insects. Use a high-strength DEET repellent, sleep under a treated bed net, wear long clothing, and ensure you have comprehensive travel insurance with evacuation cover. Medical facilities in the Amazon are extremely limited.
Last updated: April 2026