Avoiding Malaria in Peru

Risk Areas, Maps, Prevention, and Symptoms

A boat floating into the rainforest

TripSavvy / Lauren Breedlove

According to the World Health Organization, an estimated 30,000 international travelers fall ill with malaria each year. For first-time visitors of Peru, the risk of malaria is often of great concern. In general, though, the risk is low.

The Centers for Disease Control and Prevention (CDC) states that out of the 30,000 U.S. residents who visit Peru annually, less than five of them acquire malaria from the South American country.

Risk Areas

The risk of malaria varies throughout Peru. The low- to no-risk areas (the safest places to visit, that is) include:

  • Lima and surrounding areas
  • Coastal cities south of Lima including Ica and Nazca
  • Southern cities including Arequipa, Puno, Tacna and Moquegua
  • Highland areas such as Cusco, Machu Picchu, and Lake Titicaca, and other areas located above 6,560 feet (2,000 m)

All regions located below 6,560 feet (2,000 m)—with the exception of those listed above—have a higher risk. The main malaria risk areas are located in the Peruvian Amazon.

The CDC considers the jungle cities of Iquitos and Puerto Maldonado (and surrounds) as malaria risk areas. Both cities are popular gateways for jungle lodges, riverboat cruises, and rainforest expeditions. Antimalarials may be recommended for travelers in these areas, depending on the length of stay and activities pursued.

The Piura region of northern Peru is also a risk area, as well as some locations along the Ecuador border.

Malaria Maps

Malaria maps of Peru offer a rough guideline to the locations in which antimalarial drugs may be recommended (antimalarials are never a requirement for entering Peru).

The maps, themselves, can be confusing, especially because some seem too general or differ from other malaria maps of the country. The confusion stems, in part, from shifting malaria patterns, as well as the data used to create the maps. In any case, they provide a helpful visual on which to base your preliminary itinerary.

Malaria Prevention

If you are heading to a risk area, there are two main ways to guard against malaria:

  • Antimalarial Drugs (Chemoprophylaxis): Various antimalarial drugs exist, each with their own distinct pros and cons. The CDC recommends atovaquone-proguanil, doxycycline, or mefloquine. You should always consult your doctor before deciding which antimalarial to take. The CDC also recommends buying your antimalarials before traveling, as some drugs manufactured abroad may not be effective.
  • Prevent Mosquito Bites: You can help prevent mosquito bites (which can also transmit yellow fever, dengue fever, and potentially the chikungunya virus) by covering up as much bare skin as possible, using insect repellent, avoiding peak exposure times and by using mosquito nets.

Malaria Symptoms

When considering malaria symptoms, you must first be aware of the incubation period. Symptoms occur at least seven days after a bite by an infected mosquito.

According to the World Health Organization, you should “immediately seek diagnosis and treatment if a fever develops one week or more after entering an area where there is a malaria risk, and up to 3 months after departure.”

Along with a fever, malaria symptoms can include a combination of chills, sweats, headaches, fatigue, nausea, and body aches.

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