Vaccination

  • There are no mandatory vaccination requirements
  • Vaccinations recommandées: DTPolio, Typhoïde, Hépatite A et B
  • Vaccination particulière: fièvre jaune recommandée pour la région amazonienne
 

Keep in mind that a vaccine is never 100% effective. Precaution remains the best prevention (avoid eating raw food!). Although I was vaccinated, I caught typhoid during my stay in Bolivia!

Malaria

  • Parasite infection transmitted by the bite of several species of female mosquitoes (anopheles type), which are generally active between sunset and sunrise (maximum risk is between 22h and 04h).
  • Rural tropical regions (departments of Beni, Chuquisaca, Cochabamba, La Paz, Pando, Santa Cruz and Tarija) of low or medium altitude (<2500m), during the wet season when mosquitoes are breeding.
  • The parasite enters into the cells of the liver and starts reproducing. After a period ranging from one week to a few months, the parasite migrates into the blood cells where it continues to develop. The infected cells die and release the parasite and some toxins. The symptoms of the disease (fever, headache, chills and malaise) appear at that time. In most cases, the illness manifests itself between eight days and one month after the mosquito bite.
  • Four types of malaria exist, two of them are present in Bolivia: Plasmodium vivax (the most common), and Plasmodium falciparum (Pando, borders of the departments of Beni and Santa Cruz with Brazil).
  • Only Plasmodium falciparum is responsible for deadly encephalic cases.
  • One can suffer from relapses of the disease with Plasmodium vivax.
  • South of Bolivia (without falciparum) belongs to Group I (i.e. with no resistance to chloroquine medicine), north of Bolivia and regions harboringPlasmodium  falciparum belong to Group III (i.e. multiple resistance, mefloquine and halofantrine medicine is more efficient).
  • If medication is not prescribed in time, severe complications may appear. The disease is fatal for 0.2% of the cases.
  • Prevention: protect yourself from mosquitoes.
  • No vaccine is available, preventive treatments and specific medicine exist for the different types of malaria.
 

Chagas' disease (American trypanosomiasis)

  • Parasite disease (Trypanosoma Cruzi) transmitted by the bite of a bug called vinchuca, generally occurring while the victim is sleeping.
  • The risk is very high in the valleys near Cochabamba and Sucre, where vinchucas colonize the poorest houses made of mud and straw.
  • The disease is transmitted via the excrement that the vinchuca leaves close to the bite. Clean the wound without scratching. Do not put your hands in contact with your eyes. You can also be infected from raw food contaminated by vinchucas' excrement, or via blood transfusion.
  • If you have been bitten, try to capture the vinchuca alive, if possible, and bring it to a Bolivian medical laboratory for special analysis. Consult an expert in tropical diseases who will take a blood sample to search for the parasite, and subsequently prescribe the appropriate medical treatment.
  • Symptoms: small swelling at the site of the bite, starting with some temporary troubles (like fatigue, fever, vomit, diarrhea...) that disappear after a few weeks. One third of the victims develop the severe form of the disease with heart and intestinal problems (often fatal) after several years (10 to 20 years following the contamination!).
  • Prevention: protect yourself from vinchucas, avoid sleeping outdoors or in some rural houses in endemic regions, or use a mosquito net.
  • No vaccine is available, but specific medical treatments exist.
 

Yellow fever

  • Viral disease transmitted by mosquito bite. The greatest risk occurs at the end of the day.
  • Amazonian regions (high risk in the north of Bolivia. Departments of Beni, Chuquisaca, Cochabamba, La Paz, Pando, Santa Cruz and Tarija) of low and medium altitude (<2500m), particularly during the wet season when mosquitoes are breeding.
  • Generally, the benign form of the disease manifestation exhibists two stages marked by fever and nausea. In some cases, the disease can cause serious kidney and liver problems that may be fatal.
  • Incubation period: 3 to 10 days.
  • A vaccine exists against the disease and is effective for 10 years, but there is no specific medical treatment.
  • Prevention: protect yourself from mosquitoes.
 

Leishmaniasis

  • Parasite disease transmitted by the bite of certain species of flies; greatest risk being at the beginning and at end of the day.
  • Rural areas in tropical and subtropical regions.
  • There are two forms of the disease: cutaneous or visceral (attacking the internal organs).
  • Cutaneous leishmaniasis (skin and cartilage degenerating) develops in the few weeks or months following the infection.
 

Dengue fever

  • Viral disease transmitted by the bite of female mosquitoes (Aedes Aegypti type) mainly during the day (maximum risk during the few hours following the sunrise or preceding the sunset) contrary to mosquitoes responsible for malaria.
  • Tropical and subtropical regions (Departments of Beni, Cochabamba and Santa Cruz), in the vicinity of houses, high risk during epidemics
  • Symptoms of Dengue fever include strong fever, headache and muscular pain.
  • The disease is generally benign, except in case of dengue hemorrhagic fever which represents about 0.5% of the cases but is responsible for 5% of the deaths from the disease.
  • Incubation period: 3 to 14 days.
  • No vaccine and no specific treatment are available.
  • Prevention: protect yourself from mosquitoes.
 

Rabies

  • Viral disease transmitted to human beings by the saliva of an infected animal either through a bite or licking a wound.
  • Once symptoms appear (a few days after the contamination), rabbies can not be cured and is fatal.
  • A vaccine against the disease (effective for 5 years), and emergency medical treatment (post exposure vaccination) before the disease becomes active.
  • Prevention: avoid direct contact with animals presenting a high risk of contamination.
 

Hepatitis A

  • Viral disease transmitted by ingestion of food contaminated by excrement, generally present in raw vegetables washed in an impure water or food that has been manipulated by people who are infected by the virus.
  • Benign and immunizing disease for children (very common in Bolivia), Hepatitis A may be seriously dangerous for adults.
  • The virus attacks the liver, causing fatigue, nausea and fever followed by jaundice (yellow coloration of the skin and eyes). Faeces are discolored and urine is dark. Hepatitis A does not evolve into chronic or long-term infection (unlike hepatitis B or C).
  • Incubation period: 15 to 40 days.
  • Vaccine against the disease (effective for 10 years), there is no specific treatment (stay in bed and follow a very strict diet to rest the liver).
  • Prevention: Hepatitis A is highly contagious. To avoid the disease, one should respect very strict hygiene rules regarding food and drinks.
 

Typhoid fever

  • Disease transmitted by bacteria (Salmonella Enterica) present in unhygienic food or drinks.
  • Typhoid fever is a severe disease, fatal in 4% of the cases (if no medical treatment is prescribed).
  • The disease starts with fever (39-40°), headache and stomach-ache, diarrhea. Diagnosis is done based on the faecal analysis.
  • Vaccine against the disease is not 100% efficient, antibiotic treatment is prescribed for several days.
  • Prevention: avoid non unhygienic food and drinks.
 

Travelers´ Diarrhea

  • This is the most frequent health problem encountered by travelers who have consumed unhealthy food/beverages (presence of germs, e.g Escherichia coli) or caused by the changes in diet.
  • In general more awkward than serious, this gastro-enteritis cures itself in a few days.
  • The treatment for diarrhea consists of re-hydration: One should drink a lot and mix rehydration salts (sold in Bolivian pharmacies). Immodium is a very effective medicine against intestinal troubles.
  • Prevention: avoid unhygienic food and drinks. Peel fruits, avoid raw vegetables. Drink Coca Cola.
 

Altitude sickness

  • It is difficult to escape from the altitude sickness ("soroche") when traveling to La Paz or to the Bolivian altiplano.
  • Some people react differently to altitude problems; some cope well, others suffer badly.
  • Symptoms: respiratory and cardiac problems, nausea, or commonly headache and fatigue.
  • Headache will disappear with aspirin and mate de coca, coca homeopathic pills. Medical treatments exist to prevent and cure altitude sickness.
  • Prevention: Stay in the low lands or gradually get acclimatized to altitude.