So, considering the season and the visited regions, you can rule out the risk of getting infected for the most part. Moreover, you can significantly reduce the risk using a series of effective protection measures:

• Always wear long pants, socks and a shirt or T-shirt with long sleeves

• Apply insect repellent cream with a DEET basis (20 to 50%) to the uncovered parts of your body

• Sleep under a mosquito net that is impregnated with permethrine or detamethrine.

Both the mosquito net and the repellent cream can be bought in travel stores such as AS Adventure. However, most of the hotels, especially in the Amazon, provide mosquito nets as well.

 

The use of prophylactic medication (i.e. pills as prevention measure) is therefore recommended only for specific situations where the risk of infection is higher: floods, epidemics, adventure travel or travel to remote communities in the Amazon.

 

Among the most popular prophylactic drugs are:

• Doxiciclina: 1 pill of 100 mg daily, up to 4 weeks after leaving the risk area. Drink plenty of water and use sufficient sun block. Not recommended for children under the age of 14 and pregnant women.

• Malarone (1 pill daily, up to 1 week after leaving the risk area). More expensive.

• Nivaquina (1 pill daily, up to 4 weeks after leaving the risk area). Might cause some side effects.

 

Start taking the malaria pills the day before travelling to the risk area.

 

In the case that you haven’t used prophylactic drugs, but you think that you might have been infected with malaria, do not start a curative treatment on your own. Wait for a laboratory examination to confirm the diagnosis, because very often a treatment won’t be necessary. Moreover, curative treatments are not without side effects.

 

As none of the prophylactic drugs is 100% effective, you always have to consider the possibility of malaria if you suffer from a fever up to 3 months after your return home. Mention your stay in Ecuador to your home doctor.

 

1.3. First-aid kit

Make sure your first-aid kit contains the following:

• An antibiotic to treat traveller’s diarrhoea, e.g.:

o Ofloxacina 400 mg, 3 tablets (1 pill a day for 3 days)o Norfloxacina 400 mg, 6 tablets (2 pills a day for 3 days)

• A treatment against abdominal pain or cramps such as Buscopan or Buscapina 10 mg, 20 tablets
• Imodium 2 mg, 20 tablets, to reduce the number of times you’ll have go to the bathroom. Only to be used in case of acute diarrhoea.
• Paracetamol 500 mg, 20 tablets to treat fever and/or pain.
• Antihistamine tablets, e.g. Loratidine 10 mg or Cetrizina10 mg, 1 tablet at a time, 20 tablets in case of allergies and/or insect bites.
• An anti-allergenic ointment, e.g. Caladryl
• A disinfectant ointment, e.g. Clorhexidina or Iso-betadina
• Hydrogen peroxide, cotton pads, gauze, bandage
• Sun block factor 25
• Condoms
• For a trip to the Galapagos Islands, Domperidone 10 mg or a similar drug against seasickness, 3/4x a day; 20 tablets. The available brand in Ecuador is Turistil.
• If you have plans to go mountain climbing, Diamox 250 mg, 2 times a day although acclimatisation to the altitude is most important.
• In case of an adventurous journey, a water disinfectant
• In case you’re travelling to a malaria risk area, a DEET based insect repellent

 

1.4. Travel insurance 

We strongly recommend you have travel insurance for the duration of your stay. Also, make sure that you are up to date with your health insurance in your home country.

 

2. During your stay

Tropical diseases with all kinds of exotic names may deter the common traveler at first. However, usually this is nothing more than fear of the unknown, since the causes of possible health problems very often are the same as in your home country. Of course, it is true that the fatigue of the long journey, the climate of the coast and the Amazon, the altitude of the Andes mountains, and the hygiene conditions generate a number of additional risks. Elderly people or people with some health problems should take extra precautions. Therefore, in case of doubt, consult a doctor who has experience with journies to tropical destinations.

 

2.1. Common country-wide problems

2.1.1. What to do in case of vomiting or diarrhoea?

Given the occasionally poor hygiene conditions, diarrhoea and vomiting are the most common health issues among travellers. Drink only disinfected or bottled water and avoid, if possible, eating raw vegetables. However, if you are making a long and adventurous journey, it is very likely that you’ll have to deal with diarrhoea and/or vomiting at some point during your trip.

 

If you get diarrhoea, in order to prevent dehydration, it is important to take as many fluids as possible: in the traditional way by drinking rice water, using sugar and salt solutions mixed with boiling water or through commercial products (in Ecuador you’ll find the brands Hidra Plus and Pedialyte). Rice water should be prepared as follows: Boil 5 spoons of rice in one liter of water for 20 minutes. Then, to replace the evaporated water, refill until you have one liter of water again. Afterwards, sift the rice.

 

Take any of the above preparations continuously in small quantities. If you are suffering from vomiting, don’t worry, it will usually disappear after a few hours.

 

Since traveller’s diarrhoea is mostly due to a bacterium, we suggest taking an antibiotic from the beginning in case of annoying or severe diarrhoea, in order to reduce the physical burden. Some of the recommended brands are: Ofloxacina 400 mg (1 tablet per day for 3 days) and Norfloxacina 400 mg (2 tablets per day for 3 days).

 

Additionally , you can also use:

• Buscapina (or a similar drug): 1 pill, 4 times a day, in case of severe abdominal cramps

• Imodium, 1 pill after each stool, in case of fulminating diarrhoea, to reduce the number of times you’ll have go to the bathroom.

 

If there is no improvement in 2 to 3 days, we recommend a faeces examination for protozoa (i.e. single celled parasites), such as amoebas. The examination is called 'coproparasitológico' and is based on a fresh sample of your faeces.

 

2.1.2. Sexually Transmitted Infections (STIs) and HIV/AIDS

Even more in this case, it is an unwritten law that prevention is better than cure. Avoid having casual sexual contacts; if not, always use a condom. Sexually Transmitted Infections (STIs) are common, but are often not recognized nor treated appropriately. HIV/AIDS is also an Ecuadorian reality, although the prevalence rates cannot be compared to those of some African countries. The number of people living with HIV is probably still less than 1% of the population of reproductive age. Yet, the risk of infection is real throughout the whole country, especially in the coastal cities and the Amazon.

 

2.2. The altitude

2.2.1. On arrival in Quito 

Some people may suffer from the altitude in Quito (2800m above sea level). Therefore, on arrival, limit your physical activities and try to rest for at least the first 24 hours. Avoid eating heavy meals and drinking alcohol. Should the inconvenience (lack of oxygen, a feeling of tightness in your chest) continue, you can drink a tea of coca leaves, which you can find in nature shops or in the bookstore Abya-Yala on Avenida 10 de Octubre, next to the Universidad Salesiana in Quito. If you’re still experiencing discomfort, it is better to visit a doctor or to travel to lower located parts of the country.

 

2.2.2. Prevention of altitude illness 

Take at least a few days for your body to acclimatize to the altitude, and preferably an entire week. If you're planning to climb Cotopaxi or any of the other volcanoes of over 5000m, we recommend climbing one of the smaller volcanoes such as the Imbabura volcano, a few days before.

 

You can also take Diamox (125 to 250 mg), 2 times a day, starting one day before the climb. Possible side effects are tingling sensations in your hands or feet, and having to urinate more often.

 

2.3. Accidents

• When mountain hiking, always do so accompanied by someone else. There may be sudden changes in weather conditions, or you may fall or get lost. In a group of two or more, these situations can be solved. Going on your own, is looking for trouble.

• Always take a geographical map of the area (which can be bought in El Instituto Geográfico Militar in Quito http://www.igm.gov.ec with you. A compass or GPS are also useful.

• Make sure to bring warm clothing, even when the sun is shining at the beginning of your trip: sudden weather changes (cold, rain,...) are very common in the mountains.

• If you're planning to climb to a mountain summit, only do so with an experienced guide and hire the necessary equipment: special shoes, crampons, harness, ice axe, and so on. It won’t make your trip cheap, but it's the only way to safely enjoy an unforgettable experience.

 

2.4 Trip to the Galapagos

Most tours to the Galapagos are done by boat, which goes from one island to another at night. Avoid taking very small boats of less than 16 passengers, since they’re less stable, which increases the risk of getting sea sick. Bring Turistil or another drug against seasickness with you.

 

2.5 Trip to the Amazon or the beach in the rainy season

When travelling to the Amazon or the beach in the rainy season you might suffer from insect bites. Therefore, apply a DEET based (20 to 50%) repellent cream, use an impregnated mosquito net and wear clothes that cover most of your body (long pants and a shirt or T-shirt with long sleeves). These malaria prevention measures are protecting you at the same time from other diseases such as dengue. Dengue is transmitted by the Aedes mosquito and is more prevalent in urban areas. Dengue, which is similar to a very severe flu, causes high fever and muscle aches all over your body for about 7 days. There is no specific treatment. Nonetheless, you should avoid taking aspirins in case of suspected dengue, as it can cause extra bleeding. To reduce the itching caused by insect bites, you can take antihistamine pills (Cetrizide or Laratidine 10 mg, 1 pill per day) and apply an ointment such as Caladryl.

 

2.6 Security problems

Although not a health issue, we would like to dedicate a specific section to security problems since, unfortunately, they happen relatively often. Take proper precautions to be able to enjoy your trip as you intended.