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Peru 4B group, summer 2019

VACCINATION INFORMATION FOR THE PERU PROGRAM

Hello upcoming Peru travelers!

As you are all likely beginning to visit travel doctors and make a plan for vaccinations and medication, we wanted to take this opportunity to provide some additional information regarding malaria risk, rabies inoculation, and other vaccines that are recommended by the CDC for travel to South America.

Dragons has no specific stipulations or requirements regarding vaccines and you should know that it is up to your discretion. We do, however, strongly recommend that students obtain a COVID vaccine prior to travel. We hope the following information from us can supplement info you’ve already received.

As a caveat, and in line with all of our literature, please consult your travel doctor for ALL medical recommendations. We do our best to provide clear information, but also recognize that we at Dragons are not medical professionals and cannot give specific medical advice.  Please also keep in mind that is is not uncommon for doctors to provide blanket prescriptions while not considering the specific details of their clients travels, so the information below can be used to inform those conversations. You can also refer to the Center for Disease Control’s travel page on Peru for additional information.

Mosquito-borne illness:

  • Yellow Fever: Yellow fever is a risk in some tropical areas of Peru, and the CDC generally recommends the Yellow Fever vaccine  for travel in the tropical lowlands at altitudes below 2,300 m (7,546 ft). Please note that the Peru itinerary this summer will spend the bulk of its time in highland areas above 2,300 meters. The group will spend approximately 5 days in the Madre de Dios department in the Amazon, at altitudes considered at risk of Yellow Fever exposure. Many of our students and staff do have the Yellow Fever vaccine, although we have never had a confirmed case of Yellow Fever on our programming in Peru.
  • Malaria: The CDC lists malaria as a risk in Peru at altitudes below <2,000 m (6,562 ft). Your course itinerary will largely be concentrated in highland areas around Cusco and the Sacred Valley at altitudes between 2400 and 5000 meters above sea level. The group will descend to the Amazon lowlands to altitudes between 400 and 1600 meters in the Puerto Maldonado area for no more than 7 days of the program.  Students who decide to take anti-malaria medication for this portion of the course can plan ahead with the instructors to begin their malaria medication before traveling to the lowlands, and complete their prescription upon return to the highlands. Please note that many malaria prophylactics have side effects that should be considered before purchasing malaria medication, and it is not recommended to take malaria medication for the entire duration of the program. In addition, keep in mind that medications for malaria do not prevent you from contracting the disease, but they do lessen the associated symptoms. In our experience the risk of contracting malaria in this region of Peru is relatively low, but we can not rule out the risk of exposure.

Foodborne illness:

Two other vaccines that are recommended by the CDC for travel in Peru are Typhoid and Hepatitis A. Foodborne illness can be common in the region, and most of our students experience some gastrointestinal upset during their time in-country. Most of these cases are mild and resolve themselves on their own, but in some instances students need to be evaluated at a local clinic. The Typhoid and Hep A vaccines can help reduce the chances of more serious travellers’ diarrhea.

Rabies risk and pre-exposure inoculation: 

We would like to call your attention to the rabies pre-exposure inoculation. Please reference the inoculation information in your Course Preparation Manual for the following response:

Q: Should we get the pre-exposure for rabies?

A: We recommend it for this course, but please consult with a professional physician first. Rabies is a uniformly fatal disease transmitted by the bite of a rabid animal. In the developing world, dogs are the most common carriers of rabies. A rabies pre-exposure vaccine exists and is effective, but even with these vaccines, exposure to rabies requires follow-up therapy. The pre-exposure vaccination does not eliminate the need for additional therapy after a rabies exposure; however, it simplifies therapy by eliminating the need for human rabies immune globulin (HRIG). HRIG, suggested by the Center for Disease Control as part of the post-exposure treatment, is NOT AVAILABLE in many developing countries, and families who wish to treat potential exposure with HRIG may have to evacuate to a country where HRIG is available. Students who have been inoculated with pre-exposure vaccine will most likely not need to evacuate the country if bitten. Students who have not been inoculated with the pre-exposure vaccine and who require evacuation will incur evacuation costs not covered by Dragons. Please note: Rabies pre-exposure vaccine involves a series of shots which need to be started at least a month before departure. Please make sure to plan accordingly.

Our experiences in Latin America have shown that dogs are a prevalent risk that we actively mitigate through training and other proactive measures. However, we have also learned that in the case of a dog bite, HRIG is not readily available in most Latin American countries. Therefore, depending on the circumstances of the bite, students without the rabies pre-exposure inoculations would likely need to be evacuated to the US or another country where HRIG is available.

While Dragons cannot formally recommend any inoculation, we want to clearly communicate the benefits of the pre-exposure vaccine, available through any travel clinic and through most family physicians, since in the rare event of an animal bite it may allow a student to remain in-country without program disruption and additional expense.

 

Please feel free to be in touch with us with further questions!

Sincerely,
Julianne Chandler and the Dragons Administration