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Peru: Indigenous Peoples and Globalization

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Peru: Indigenous Peoples and Globalization Peru: Indigenous Peoples and Globalization TABLE OF CONTENTS GENERAL INFORMATION ................................. 2 PREVENTION OF INSECT-BORNE ILLNESSES ........................................................................... 2 PREVENTION OF FOOD- AND WATER-BORNE ILLNESSES ........................................................ 3 OTHER DISEASES ............................................ 5 IMMUNIZATIONS ............................................... 7 IMMUNIZATION SCHEDULE ............................. 8 GENERAL INFORMATION SIT Study Abroad programs may venture off the To protect your health in Peru, you need certain pre- usual tourist track. Pay careful attention to departure immunizations followed by reasonable health and safety guidelines. health precautions while in the country. The following health guidelines and requirements are based on years of experience and the current PREVENTION OF INSECT- recommendations from the US Centers for Disease Control and Prevention. They are designed to inform BORNE ILLNESSES you of health concerns that may be present in Peru Malaria especially as you venture to smaller cities off the Malaria is not a problem in Cuzco city; and Macchu usual tourist track, or spend time in small villages Picchu, so prophylaxis is unnecessary there. and rural areas for extended periods. Although no However, students venturing into certain other areas information sheet can address every conceivable of Peru (below 2,000m/6,600 ft.), including the contingency, the following health guidelines and Peruvian Amazon, must protect themselves. CDC requirements are an attempt to provide you with a guidelines suggest that prevention of malaria is standard, which if followed, should optimize good possible if you carefully follow personal protective health during your stay abroad. measures as described below and take one of the following antimalarial drugs (listed alphabetically) as You may find that local customs and practice, as directed by your health care provider: well as varying US physicians’ approaches, at times atovaquone/proguanil (Malarone), doxycycline, conflict with these guidelines. It is essential that you mefloquine, or tafenoquine (Arakoda). G6PD testing review these health guidelines and requirements is required prior to tafenoquine use. The selection with your physician, to discuss individual issues should be discussed with your physician or such as pre-existing medical problems and allergies health-care provider. If, in spite of adherence to to specific drugs. Any further questions or concerns these preventive measures, you develop symptoms should be directed to the US Centers for Disease of malaria, prompt medical attention lessens the Control and Prevention (CDC) in Atlanta severity of the illness. (www.cdc.gov/travel) or to your own physician. Personal Protective Measures The following insect precautions should be followed, especially after dark, to prevent mosquito bites that may transmit malaria: • Wear long-sleeved shirts and long pants. 2 Peru 2019 • Use insect repellents on bedding and netting. (especially during peak times (early morning and (e.g. permethrin – commonly known as late afternoon) are the main prevention strategy. Permanone). • Use insect repellents on skin and clothing. Zika DEET-containing products (e.g. Off, Off Deep Zika is a viral infection that is also transmitted by the Woods, Jungle Juice, and Muskol) may be used bite of the Aedes mosquitoes. Symptoms include on skin in concentrations up to 30–40% and on mild fever, rash, conjunctivitis (red eyes), joint or clothing in higher concentrations. Permethrin muscle pain and headache. The disease causes (Permanone) may also be used on clothing. considerable discomfort, but is mild and self-limited, SIT Study Abroad suggests that if you have further lasting for several days to a week. Low risk exists at questions, do not hesitate to contact the Malarial elevations below 2,300m (7,500 ft); including the Division of CDC at 888-232-3228 for recorded Amazonas. information or visit the CDC website: There are no vaccines or medications available to http://www.cdc.gov/malaria/travelers/index.html prevent or treat Zika infections therefore students should be vigilant in using insect precautions and Dengue personal protection measures against day-biting This is a viral disease and is transmitted by mosquitoes (see insect precautions section above). mosquitoes which bite primarily in the daytime. It CDC recommends that pregnant women consider occurs in urban as well as rural areas. Low risk postponing travel to countries where the Zika virus exists in Lima and Cuzco. There is no licensed is prevalent. vaccine against it, but personal protective measures against mosquito bites are effective in prevention. Leishmaniasis Insect repellents, protective clothing such as long- Leishmaniasis is a protozoan infection that causes sleeved shirts and pants, are therefore essential. skin ulcers and is transmitted by the bite of sand The disease causes considerable discomfort (fever, flies. It occurs in the jungle regions. Daytime and body aching), but is self-limited in adults. nighttime insect precautions are important in Peru. Yellow Fever This is a viral disease transmitted by mosquitoes that occurs only in parts of Africa and South America. Yellow fever is characterized by severe hepatitis with fever. It may be prevented by avoiding mosquito bites (personal protective measures) and by getting the vaccination shots that are available at any yellow fever vaccination center (consult your physician for the nearest center). Chikungunya Chikungunya is an arboviral infection that is transmitted by day-biting Aedes mosquitoes. It is prevalent in tropical Africa and Asia, parts of Central and South America, and the Caribbean. Low risks PREVENTION OF FOOD- AND exists throughout the country mainly in elevations WATER-BORNE ILLNESSES below 2,300 m (7,500 ft) especially in areas east of Diarrhea-Producing Infections the Andes Mountains and Tumbes and Piura regions. “Traveler’s diarrhea” is the most common form of Symptoms are typically fever and joint pain. There is diarrhea in Peru. This is a self-limited diarrhea no licensed vaccine against it, but insect lasting from a few to several days, characterized by precautions and personal protective measures watery, non-bloody bowel movements. Traveler’s diarrhea usually requires no treatment other than 3 Peru 2019 fluid replacement including ORS (the World Health • Tap water in larger cities is often safe, but the Organization’s oral rehydration solution which water in rural areas is probably not, so be sure comes in package form) or other homemade to check with a reliable source before using, and solutions such as 1 teaspoon salt, 1/2 teaspoon if in any doubt, take all the recommended baking soda, and 2–3 tablespoons sugar or honey precautions. in 1 liter of clean water; or carbonated soda diluted by one half. Antidiarrheals such as Imodium or DO USE • Lomotil may be used short-term in some Commercial iodide or tinctured liquid iodine to treat water, ONLY if bottled water (from a trusted circumstances. Pepto Bismol in large amounts and source) is not available and boiling water is not certain antibiotics (doxycycline, sulfa-TMP, possible. Chlorine in various forms is less ciprofloxacin) can prevent or attenuate the infection. reliable than iodine. These provide substantial Antibiotics are indicated for more severe cases of protection when added to tap water. traveler’s diarrhea. DO EAT More protracted and disabling diarrheal illnesses • Cooked vegetables, fruits with thick covering may be due to giardiasis and amoebic dysentery (citrus, bananas, and melons); and well-washed (caused by parasites) and bacillary dysentery raw fruits and vegetables. (caused by bacteria), including cholera and typhoid. • Meat or fish that is thoroughly cooked (pork and These infections (as well as “traveler’s diarrhea”) lamb should be very well done). are caused by contaminated food and water. • Pasteurized dairy products from large Therefore, the best way to avoid such infections is commercial dairies. to respect certain do’s and don’ts: DON’T EAT • Unwashed or unpeeled raw fruits and vegetables. • Fruits that do not have a thick, disposable outside covering. • Rare or raw meat or fish or shellfish. • Dairy products from small, independent vendors without pasteurizing facilities, including food of any kind that has been left out in the sun, especially custards, creams, and mayonnaise. • Raw (unpasteurized) milk or milk products. Tuberculosis and brucellosis, both serious diseases are transmitted in this way, so the DO WASH your hands scrupulously with non- consumption of unpasteurized milk and milk contaminated water and soap before eating and products should be strictly avoided. snacking. There may be times when refusing an offer of food DO DRINK or beverage, even a drink with ice or avoiding a • Bottled or canned beverages (water, soda, soft salad will be considered rude. You must decide for drinks) from a trusted source (ensure caps are yourself, but polite refusals, thought out in advance, sealed). are often handy. Discuss these alternatives with • Hot beverages (coffee, tea). your Academic Director(s). • Water that reached a rolling boil for at least one minute at sea level (longer at higher altitudes). Avoid swimming or wading • Carbonated mineral water. A note on swimming: in fresh water. Many parasites and bacteria live in DON’T DRINK water and can cause serious illness. Properly • Tap water, even in ice; don’t
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