Bolivia
Avoid dental treatment in Bolivia as the standards of care and hygiene cannot be guaranteed.
The quality of medication in Bolivia can not be guaranteed. Some pharmacies will stock international brands. Local brands are best avoided
Blood supplies should be considered as unsafe in Bolivia
Medical care in large cities is adequate for most purposes but of varying quality. Medical facilities, even in La Paz, are not adequate to handle serious medical conditions, such as cardiac problems.
Recent medical and dental exams should ensure that the traveler is in good health. Carry appropriate health and accident insurance documents and copies of any important medical records. Bring an adequate supply of all prescription and other medications as well as any necessary personal hygiene items, including a spare pair of eyeglasses or contact lenses if necessary.
Drink only bottled beverages (including water) or beverages made with boiled water. Do not use ice cubes or eat raw seafood, rare meat or dairy products. Eat well-cooked foods while they are still hot and fruits that can be peeled without contamination. Avoid roadside stands and street vendors.
Swim only in well-maintained, chlorinated pools or water known to be free from pollution. Wear clothing which reduces exposed skin and apply repellents containing DEET to remaining areas. Sleep in well-screened accommodations. Carry anti-diarrheal medication. Reduce problems related to sun exposure by using sunglasses, wide-brimmed hats, sunscreen lotions and lip protection.
AIDS occurs. Blood supply may not be adequately screened and/or single-use, disposable needles and syringes may be unavailable. When possible, travelers should defer medical treatment until reaching a facility where safety can be assured.
Altitude in many parts (including La Paz at 14,000 feet) may cause lightheadedness, insomnia, slight headache, shortness of breath, nausea or vomiting. Travelers are advised to avoid overeating, alcoholic beverages or undue exertion until such symptoms have disappeared. Persons with cardiac or pulmonary conditions should consult their physicians prior to travel.
Snakes and leeches may be hazards in some areas.
Cholera: Although limited in effectiveness, vaccination may be appropriate for persons living and/or working in less than sanitary conditions for more than 3 months where medical facilities are unavailable. Vaccination may also be appropriate for travelers with impaired gastric defenses who are planning an extended visit or being exposed to unsanitary conditions. Vaccination is not advised for pregnant women, infants younger than 6 months old, or persons with a history of severe reaction to the vaccine.
Hepatitis A: Consider active immunization with hepatitis A vaccine or passive immunization with immune globulin (IG) for all susceptible travelers. Especially consider choosing active immunization for persons planning to reside for a long period or for persons who take frequent short-term trips to risk areas. The importance of protection against hepatitis A increases as length of stay increases. It is particularly important for persons who will be living in or visiting rural areas, eating or drinking in settings of poor or uncertain sanitation, or who will have close contact with local persons (especially young children) in settings with poor sanitary conditions.
Hepatitis B: If destined for Amazon basin areas, vaccination is advised for health care workers, persons anticipating direct contact with blood from or sexual contact with inhabitants, and persons planning extended stays of 6 months or greater (especially those who anticipate using local health care facilities, staying in rural areas, or having intimate contact with the local population).
Plague: Vaccination is recommended only for those persons whose occupation or circumstances make avoidance of fleas and rodents difficult when traveling or working in rural or urban areas where plague is known to be active in wild rodents or has been reported to exist in humans and/or commensal rats.
Rabies: Preexposure vaccination should be considered for persons staying longer than 30 days who are expected to be at risk to bites from domestic and/or wild animals (particularly dogs), or for persons engaged in high risk activities such as spelunking or animal handling. Need for vaccination is more important if potential exposure is in rural areas and if adequate postexposure care is not readily available.
Typhoid: Vaccination should be considered for persons staying longer than 3 weeks, adventurous eaters, and those who will venture off the usual tourist routes into small cities, villages and rural areas. Importance of vaccination increases as access to reasonable medical care becomes limited. Contraindications depend on vaccine type.
Yellow fever: Vaccination is recommended for travelers over 9 months of age going outside of urban areas.
Note: All routine vaccines (such as DTP or Td, Hib, MMR, polio, varicella, influenza and pneumococcal) should be kept up-to-date as a matter of good health practice unrelated to travel.
Insect-borne illness: these diseases, including malaria and yellow fever, are an important cause of ill health in rural areas.
Leishmaniasis (cutaneous and mucocutaneous) - occurs
Leishmaniasis (visceral) - occurs
Plague - occurs
Trypanosomiasis (Chagas' disease) - occurs (prevalent in the provinces of Chuouisaca, Cochabamba, Santa Cruz and Tarija)
Food-borne and water-borne illness: these diseases are common and include amoebiasis, diarrheal diseases, helminthic infections, and viral hepatitis.
Cholera - occurs
Brucellosis - common
Echinococcosis (hydatid disease) - occurs
Hemorrhagic fever (viral type which may be food-borne) - occurs
Other hazards:
Diseases such as measles and diphtheria are commonly reported.
Influenza risk extends throughout the year.
Rabies - occurs
Yellow fever: A yellow fever vaccination certificate is required from travelers coming from infected areas. Vaccination is recommended for incoming travelers from noninfected zones visiting risk areas such as the departments of Cochabamba, El Beni and Santa Cruz, and the subtropical part of La Paz Department.
