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Country Guide > South America > Bolivia | |
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Health
1 A yellow fever vaccination certificate is required from travellers arriving from infected countries. Vaccination is recommended for incoming travellers from non-infected zones visiting risk areas such as the Departments of Beni, Cochabamba, Santa Cruz and the subtropical part of the La Paz Department. 2 Following WHO guidelines issued in 1973, a cholera vaccination certificate is no longer a condition of entry to Bolivia. However, cases of cholera were reported in 1996 and precautions are essential. Up-to-date advice should be sought before deciding whether these precautions should include vaccination as medical opinion is divided over its effectiveness; see the Health appendix for more information. 3 A moderate to high risk of typhoid exists, especially outside main cities and tourist areas. 4 Malaria risk exists throughout the year below 2500m, in the Departments of Beni, Pando, Santa Cruz and Tarija, and provinces of Lacareja, Rurenabaque, and North and South Yungas in the La Paz Department. Resistance to chloroquine and sulfadoxine-pyrimethamine has been reported. The recommended prophylaxis is general mosquito bite prevention plus chloroquine chemoprophylaxis, except on the northern affected parts of Bolivia - mefloquine, doxycycline or atovaquone. The disease occurs predominantly in the benign vivax form but falciparum malaria occurs in Beni and Pando, especially within the localities of Guayaramerín, Puerto Rico and Riberalta. There is lower-risk Malaria in Cochabamba and Chuquisaca. Food & drink Water used for drinking, brushing teeth or making ice should be boiled or otherwise sterilised. Milk is unpasteurised and should be boiled. Powdered or tinned milk is available and is advised, but make sure that it is reconstituted with pure water. Avoid all dairy products which are likely to have been made from unboiled milk. Only eat well-cooked meat and fish, preferably served hot. Pork, salad and mayonnaise may carry increased risk. Vegetables should be cooked and fruit peeled. Other risks Diarrhoeal diseases and hepatitis A are common. American trypanosomiasis (Chagas disease) and cutaneous and mucocutaneous leishmaniasis occur. Hepatitis B and C, Japanese encephalitis and TB are a risk. Epidemics of viral encephalitis and dengue fever may occur. Plague has been reported in natural foci. Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. For more information, consult the Health appendix. Health care There is no reciprocal health agreement with the UK. Medical insurance is strongly recommended. All travellers, but especially those with heart conditions, should allow time to acclimatise to the high altitude of La Paz. In case of a medical emergency, La Paz has a good US clinic. |