Peru has two distinct health profiles
Most Canadian Peru travellers combine Machu Picchu + Cusco with an optional Amazon extension (Iquitos or Puerto Maldonado). These two parts of the trip have very different health requirements — and confusing them is the most common Peru pre-travel planning mistake.
Part 1: Cusco, Machu Picchu, Sacred Valley
Altitude sickness — the #1 overlooked risk
Cusco sits at 3,400 m. Machu Picchu is at 2,430 m. Most Inca Trail trailheads are above 3,000 m. Acute Mountain Sickness (AMS) affects approximately 25% of travellers arriving in Cusco — even fit, healthy adults.
Symptoms: headache, nausea, fatigue, dizziness, poor sleep. Usually onset within 6–12 hours of arriving at altitude.
Prevention:
- Arrive in Cusco 1–2 days before Machu Picchu — don't fly in and trek the same day
- Rest and avoid alcohol for the first 24 hours
- Stay hydrated (coca tea is a local tradition but evidence is limited)
- Acetazolamide (Diamox): a prescription medication that significantly reduces AMS risk when started 1–2 days before ascending above 2,500 m
Our physician prescribes Diamox and provides a full altitude acclimatization briefing at your pre-travel consultation. This is one of the most valuable parts of a Peru pre-travel visit.
Other vaccines for the Cusco/Machu Picchu route
- Hepatitis A: all travellers — food contamination risk
- Typhoid: all travellers — recommended even for Lima and Cusco
- Dukoral: recommended — Peru has high ETEC rates
No malaria prophylaxis needed for Cusco, Machu Picchu, Lima, or the Sacred Valley — these areas are malaria-free.
Part 2: Amazon Peru (Iquitos, Puerto Maldonado, Madre de Dios)
Yellow Fever — required
Yellow Fever vaccination is required for the Peruvian Amazon. Some lodges and boat operators near Iquitos specifically check vaccination certificates. As a designated Yellow Fever provider, we administer Stamaril and issue the ICVP certificate.
Malaria — required for Amazon regions
Malaria prophylaxis (Malarone or doxycycline) is required for Iquitos, Puerto Maldonado, Madre de Dios, and Amazon jungle lodges. This is a distinct requirement from the Cusco/Machu Picchu portion — if your trip combines both, you need prophylaxis only for the Amazon days, but our physician may recommend taking it through the whole trip for simplicity.
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Book at Virtual Travel Clinic — virtual consultation from Mississauga, Ottawa, and across Ontario.
Sources: PHAC — Peru Travel Health | CDC Yellow Book — Peru
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