Travel Tips for Visiting Ecuador
Immunizations
In addition to having routine immunizations up to date, it is recommended to be vaccinated for several other communicable diseases specific to the region. The vaccination series can take 4-6 weeks so be sure to allow the necessary time needed for your vaccinations to become effective.
For travel to Ecuador the following vaccines are recommended: Hepatitis A, Hepatitis B, Typhoid, Rabies, measles and tetanus-diphtheria. A certificate of yellow fever vaccination is required for entry into the country. Some vaccines are available through your regular health care provider while others, like yellow fever, are only available at Travel Health clinics.
Malaria
Malaria is a serious disease transmitted to humans by the bite of an infected female Anopheles mosquito. It is always a serious disease and can be fatal. Symptoms may include fever and flu-like illness, including chills, headache, muscle aches, and fatigue. Malaria may cause anemia and jaundice and if not promptly treated, may cause kidney failure, coma, and death. Although the risk of becoming infected with malaria varies across the country, prophylaxis is highly recommended. The best course for prevention is an anti-malarial drug protocol and diligent efforts to prevent mosquito bites.
There are three choices for anti-malarial drugs: Malarone (atovaquone/proguanil), Lariam (mefloquine) or the antibiotic doxycycline. It is important to speak with your health care provider when choosing a protocol and to request a back-up protocol should you experience a reaction to your primary anti-malarial drug while traveling.
Malarone is taken daily starting 1-2 days prior to travel and for one week after returning home. The possible side effects include abdominal pain, nausea, vomiting and headache. I choose Malarone as my primary anti-malarial drug when traveling to Ecuador and did not have a pleasant experience. The side effects began on day three of my journey when I was deep in the Amazon. First was unbearable pain in my lower back and kidney region, then violent gastrointestinal disturbances. The manager of the lodge I was staying in knew immediately the symptoms were caused by the medication as he had seen similar reactions in previous visitors. Cessation of the medication was the only relief.
Lariam is taken once weekly starting one week prior to travel and for four weeks after returning home. The potential side effects are neuropsychiatric in nature and can include headache, nausea, dizziness, anxiety, psychosis, hallucinations and seizures. From personal experience, the side effects were mild, not unpleasant and did not interfere with enjoyment of my trip. I experienced only slight visual disturbance in my periphery vision.
Doxycycline is a broad spectrum antibiotic related to tetracycline. It should be taken daily starting 1-2 days prior to travel and for four weeks after returning home. The potential side effects from taking this medication include increased photo-sensitivity, nausea, stomach pain and esophageal irritation. The increased sun sensitivity does not make it ideal for travel to the equator but this can be overcome with proper sun protection.
Insect and Tick bite prevention
Preventing insect bites in Ecuador will help deter illness and discomfort. Insect infestation varies throughout the country’s diverse terrain but being prepared will make your trip that much more enjoyable.
Although natural or botanical insect repellents may be the ideal choice for a barbeque in New England, while in Ecuador use products with 20-30% DEET. Repellents with DEET should be applied to exposed skin and can also be applied to clothing. Permethrin should not be applied to exposed skin but can be used on equipment and clothing for additional protection. Permethrin is not an insect repellent, it is a contact insecticide used to kill ticks, mosquitoes, chiggers and mites.
It is also possible to purchase insect repellent clothing. BUZZ OFF insect shield / insect repellent clothing has become a popular choice for fending off insect bites. The line offers shorts, pants and both long and short sleeve shirts. You may also want to bring along your own mosquito netting and mosquito coils for use at campsites or lodges. It is likely these will be provided but it doesn’t hurt to have extra.
Food and Water Precautions
Experiencing regional food is part of the travel experience. You do not have to live off crackers just for fear of getting a stomach bug. Just use sound judgment and don’t worry if others find you overly cautious.
Do not drink tap water unless it has been boiled, filtered or chemically treated. Since it’s near impossible to always know where your drinking water has been, I recommend bringing your own water treatment program just to be sure. Iodine tablets are easy to carry and effective for disinfecting water. I like to bring my own water container and keep a fresh batch on hand. The taste may be unpleasant to some but can be altered with tea bags or powdered drink mixes. Gatorade powder has the added benefit of keeping your electrolytes in proper balance.
You can also opt to bring a water filter or water purifier. These can be effective, found in compact, portable sizes and cost between $60-180. Water filters will remove bacteria and protozoan cysts. Water purifiers will remove bacteria, protozoan cysts and viruses such as Hepatitis A. Visit your local camping store or try online retailers like REI and CampMor.
Don’t forget your water rules when eating food or drinking other types of drinks. It’s not uncommon for fruits and vegetables to be washed in water that has a lower standard than drinking water. Don’t eat fruits or vegetables unless they have been peeled or cooked. That includes salad. It might be a tempting treat but you’ll survive the couple weeks without it. Avoid ice cream and other unpasteurized milk products and don’t eat raw or undercooked meat or fish. And remember, even though it’s lemonade now, it was water and lemons an hour ago. Have a beer instead and don’t pour anything over ice!
No matter how careful you are it’s likely that you’ll experience some gastrointestinal discomfort. It is wise to bring a general antibiotic and an over the counter antidiarrheal such as Imodium.
General Health & Safety
Even if you are in good health, do a little inventory before your trip. Schedule a visit to your regular doctor even if you are getting vaccinations elsewhere. Use the time to discuss any questions or concerns about vaccines or anti-malarial protocols. Be sure you have plenty of any medications you take regularly and have your doctor refill them if necessary. Have them in original containers, clearly marked and if possible have a letter from your physician justifying the prescription. Have extra glasses or contacts available to bring on your trip. Carry all of these in your personal luggage or on your person. Along with these items, it is also a good idea to bring a personal medical kit and be sure it includes medication for motion sickness, pain relief and an anti-diarrheal. Camping stores often have super sets that are compact and fairly inexpensive.
Altitude sickness is not unlikely as the capital of Quito is at 9,840 feet (3,000 meters). This altitude is considered “high” (1500-3000 meters). Acetazolamide is a medication that can be used to prevent altitude sickness but is not usually recommended unless you have previously experienced altitude sickness. Decent acclimatization time (one night) is the best approach. It is also helpful to avoid alcohol, sleeping pills or narcotic pain medications. Talk to your doctor about any concerns.
It is a good idea to check with your insurance company about medical coverage abroad. Bring your insurance card with you along with numbers for your health care providers in the states. You can obtain emergency numbers for doctors and hospitals in Ecuador from the US Embassy or US State Department.
It is also a good idea for US citizens traveling to Ecuador to register with the US Embassy in Quito or the Consulate General in Guayaquil. By registering, US citizens make it easier for the embassy or consulate to contact them in case of an emergency. Another good practice is to make photocopies of your passport. Leave one with friends in the US (along with a copy of your itinerary) and pack others safely in your gear (hidden in books or zippers).
After all this preparation, try to keep it simple. Bring the important stuff and plenty of it but travel as light as you can manage. Keep hydrated, get enough rest and enjoy your trip!
