Ecuador
Avoid dental treatment in Ecuador as the standards of hygiene / sterilization cannot be guaranteed.
Some international medication is available from the larger pharmacies in the larger towns and cities. Avoid buying drugs from other sources
Screening is inconsistent in Ecuador, therefore blood supplies should be considered as unsafe
Medical care is available but it varies in quality and generally is below Western standards.
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 ocean 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.
The altitude (9,300 feet - 2,835 meters) can be a problem in Quito. Most people feel some temporary discomfort from the altitude - symptoms may include shortness of breath, fitful sleep, need for more than usual sleep, dizziness, headaches, prolonged respiratory infections, and energy loss.
Because of the thinness of the air, the equatorial sun is intense. One can be seriously burned after only short exposure.
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: 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.
Bartonellosis (Oroya fever) - occurs (sandfly-borne, it occurs in arid river valleys on the western slopes of the Andes up to 3,000 meters)
Dengue fever - occurs (also in urban areas)
Leishmaniasis (cutaneous and mucocutaneous) - occurs
Onchocerciasis (river blindness) - occurs (isolated cases in rural areas; the bites of blackflies, the carrier, may also transmit other filarial parasites or cause unpleasant and sometimes severe hemorrhagic reactions)
Plague - occurs
Trypanosomiasis (Chagas' disease) - occurs
Food-borne and water-borne illness: these diseases are common and include amoebiasis, diarrheal diseases, helminthic infections, and viral hepatitis.
Brucellosis - common
Cholera - occurs
Echinococcosis (hydatid disease) - occurs
Paragonimiasis (oriental lung fluke) - 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 over 1 year of age coming from infected areas.
