Peru Malaria General Malaria Information: Predominantly P

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Peru Malaria General Malaria Information: Predominantly P Peru Malaria General malaria information: predominantly P. vivax (P. falciparum is limited almost exclusively to Loreto Region). Transmission occurs throughout the year. Issues to Consider Factors favoring chemoprophylaxis Location-specific recommendations: • Adventure travel Chemoprophylaxis is recommended for all travelers: elevations below 2,000 m (6,600 ft) in most districts east of the Andes; • Risk-averse and vulnerable travelers certain districts in Tumbes [1] and Ancash [8] regions; areas along the Marañón River Valley; all cities and towns within these • Areas subject to infrequent epidemics areas (including Tumbes) except the central urban areas of Iquitos, Tarapoto, and Pucallpa. • Immigrants visiting friends and relatives Chemoprophylaxis is recommended for certain travelers (see Issues to Consider box): elevations below 2,000 m in • Flexible itineraries certain provinces of the following regions: Tumbes [1], Piura [2], Cajamarca [4], La Libertad [7], Ancash [8], Ucayali, Junín, • Travel longer than 1 month Ayacucho [14], and Madre de Dios (including most areas of Manú National Park); all cities and towns within these areas. • Unreliable medical expertise and/or treatment drugs at destination Insect precautions only are recommended (negligible transmission is reported): the central urban areas of Iquitos, Tarapoto, and Pucallpa; elevations below 2,000 m in certain provinces of the following regions: Piura [2], Lambayeque [3], Factors against chemoprophylaxis Cajamarca [4], Amazonas [5], La Libertad [7], Ancash [8] San Martín [6], Huánuco [9], Pasco [10], Puno, Ica [12], and • Air-conditioned hotels only Arequipa; all cities and towns within these areas except Sullana, Piura, Chiclayo, Trujillo, and Ica. • Urban areas only No preventive measures are necessary (no evidence of transmission exists): Lima, Cusco, Chiclayo, Piura, Sullana, Ica, • Non-transmission season and all other cities not mentioned above; Lake Titicaca; Colca Canyon, Machu Picchu Ruins, most major Machu Picchu trek • Minimal exposure from dusk to dawn routes, and any intermediate tourist points in the Sacred Valley (the only direct route between Cusco and Machu Picchu • Travel shorter than 3 days Ruins); elevations above 2,000 m; all other areas not mentioned above. For more information, see Technical Explanation of Malaria Mapping. Preventive measures: Travelers should observe insect precautions from dusk to dawn in areas with any level of transmission. Atovaquone-proguanil (Malarone or generic), doxycycline, mefloquine, and tafenoquine are protective in this country. G6PD testing is required prior to tafenoquine use. 82°W 79°W 76°W 73°W 70°W 67°W 64°W $ Inca Jungle Trek A" $ Santa Maria $ f COLOMBIA rom A $ b ra M Aguas a ECUADOR la Na ga 2°S po A" Calientes Santa Teresa $ A" U rubam $ ba Machu C P T la $ i ss a g ic $ s r Picchu In t e ca a Tr Tumbes M z Ruins $ ai k l " o a e r Iquitos n r o G" Amazo T o Mancora n a il ! ! ! ! ! ! ! ! ! r Salka ra 1 a i n ! ! ! ! ! ! ! ! ! Loreto Ch u t T oq ueq a$ a ! ! ! ! ! ! ! ! ! $ y $ c ! ! ! ! ! ! ! ! ! $ Tre In ! ! ! ! ! ! ! ! ! 5 irín k h ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! M ig ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! rí H ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! a ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! i v ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! l a ! ! ! A!"! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! a Y $ 5°S ! ! ! ! ! ! !S! !u! !ll!a! !n! !a! ! ! ! ! ! ! ! ! ! ! ! ! Pacaya y ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! M a $ ! ! ! !A"! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! arañ c ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ón ! ! ! ! ! ! ! ! ! ! ! ! !2! ! ! ! ! ! ! ! 4 ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Samiria U Piu! !r!a! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! N.P. ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! $ ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! $ ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !C! !h! !a! !c! h! ! a! !p! !o! !y! a! ! s! ! ! ! ! ! ! ! ! ! ! A" $ ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! A"! ! ! ! ! ! ! ! ! ! ! !M! oyobamba ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 3! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! G" A" ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !K! !u! e! !lap A" ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !A"! ! ! ! ! ! ! ! ! Tarapoto Mollepata ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 6 Cachora A ! ! ! ! ! ! ! ! ! ! Chiclayo! ! ! ! ! ! ! ! ! ! A"Cajamarca pu Río BRAZIL rímac Abiseo ! ! ! ! ! ! ! M ! ! ! ! ! ! ! 0 3 6 12 18 24 ! ! ! ! ! ! ! a N.P. 8°S ! ! ! ! ! ! ! KM ! A!"! !T! !r!ujillo r ! ! ! ! ! ! ! a ! ! ! ! ! ! ! ! ! ! ! Pacific Chan ! ! ! ! ! ! ! ! ! ! ! ! ! ! !P! !u! callpa ñ ! ! ! ! ! ! ! ! ! ! ! G" ó ! ! ! ! ! ! ! ! ! ! ! Chan 7 n ! ! ! ! ! ! ! ! ! ! ! Ocean ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Huascar!á!n! ! ! ! ! ! ! ! ! A" 8 ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! N.P. ! ! ! ! ! ! ! ! ! ! ! Choquequirao Trek Chimbote ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! A" ! ! 9! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Classic Inca Trail ! ! ! ! ! ! ! ! ! Huaraz H! !u! !á! !n! u! !c! !o! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! A" ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! U Ucayali ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! High Inca Trail NUMBERED REGIONS ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! r ! ! ! ! ! ! ! ! ! Cerro de ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! u ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !1! !0! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! b ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! a Salkantay Trek PascoA" ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! m 1 - Tumbes ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! b 11°S a 2 - Piura Caral 11 Inca Jungle Trek 3 - Lambayeque Junín Madre Huancayo M A" 16 ad de Dios 4 - Cajamarca ^_ A Manú re p d Puerto Lima u Machu e D r N.P. io s 5 - Amazonas Huancavelica í " Maldonado A" m Picchu ! ! ! ! ! ! ! ! a ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Ruins ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! c ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 6 - San Martín ! ! ! ! ! ! ! ! A" ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Ballestas ! ! ! ! ! ! ! ! ! ! ! ! ! ! !T! a! !m! !b! o! !p!a! !ta! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! A! yacucho ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Islands ! ! ! ! ! ! ! ! ! ! ! ! ! ! !A"! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 7 - La Libertad ! ! ! ! ! A" ! ! ! ! ! ! ! ! ! ! ! !N! !.P! !.! ! ! ! ! ! ! ! ! ! ! ! ! 13 ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! A" Abancay Cusco ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Ica ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 14°S ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 8 - Ancash Paracas A" ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 15 ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! BOLIVIA 9 - Huánuco 14 ! ! ! ! ! ! ! ! ! ! ! ! ! 12 Pun!o! ! ! ! ! ! ! ! ! ! ! ! 10 - Pasco Nazca Arequipa 11 - Lima Lines JuliacaA" Pan Lake -A ca m l ! ! ! ! ! !C! !o!l!c!a! ! ! ! ! ! ! A" Titicaca ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! H o 12 - Ica w ! ! ! ! C! ! a! !n! !y!o! !n! ! ! ! !Puno ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! y C ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Place of interest ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !A"! ! ! ! ! ! ! ! ! 13 - Huancavelica ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! A! ! !r!e! q! ! uipa ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Administrative boundary 17°S 14 - Ayacucho 17 Moquegua A" Park or reserve 15 - Apurímac 18 Tacna 16 - Cusco A" Pan-American Highway 17 - Moquegua 0 100 200 400 600 800 18 - Tacna CHILE KM KEY for Location-Specific Recommendations — Travelers should observe insect precautions from dusk to dawn in areas with any level of transmission. Chemoprophylaxis is recommended for all travelers.* " City where preventive recommendations are the same as the surrounding region. Chemoprophylaxis is recommended for certain travelers; see Issues to Consider box. City where insect precautions only are recommended * (negligible transmission is reported). City where insect precautions only are recommended in the central urban area *; at city outskirts Insect precautions
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