Health & Altitude Sickness

Vaccinations

Mandatory vaccination: Yellow fever vaccination is recommended if traveling to the Amazon (below 2,300 m). Some countries require proof when traveling onward from Ecuador. Vaccination at least 10 days before travel.

Recommended vaccinations: Hepatitis A and B, typhoid, rabies (for jungle stays). Refresh standard vaccinations (tetanus, diphtheria, polio, measles).

Altitude Sickness (Soroche)

The greatest health risk in Ecuador is altitude sickness. Quito is at 2,850 m, many attractions in the highlands are even higher (Cotopaxi: 5,897 m, Chimborazo: 6,263 m). Symptoms: headache, nausea, shortness of breath, sleep disturbances, loss of appetite.

• Prevention: Take it easy for the first 1–2 days in Quito. Drink plenty of water (3–4 liters/day). No alcohol in the first 24 hours. Eat lightly.
• Home remedy: Mate de coca (coca leaf tea) helps with mild symptoms — available everywhere in hotels and restaurants. Completely legal and non-intoxicating.
• Medications: Acetazolamide (Diamox) can be taken prophylactically — discuss with your doctor beforehand. Ibuprofen for headaches.
• Warning signal: In case of severe headache, confusion, shortness of breath, or cough: descend immediately! The only effective treatment for severe altitude sickness is descent.

Malaria & Dengue

Malaria exists in low-lying rainforest areas (below 1,500 m) but is extremely rare among tourists. Discuss prophylaxis with a tropical medicine specialist if going deep into the Amazon. In the highlands and on the coast: no risk. Dengue fever occurs on the coast and in lowlands — best protection: mosquito repellent (DEET, long clothing, especially in the morning and evening).

Drinking Water

Tap water in Ecuador is not drinkable. Always buy bottled water (1 USD for 6 liters in supermarkets, 0.50 USD for a 0.5l bottle) or filter water (LifeStraw, SteriPen). Ice cubes in restaurants are usually made from treated water and are safe.

Travel Health Insurance

A foreign health insurance with repatriation is mandatory. Medical care in Quito and Guayaquil is good (private hospitals like Hospital Metropolitano, Hospital de los Valles), but significantly limited in rural areas and on Galápagos. In the event of mountaineering accidents or jungle emergencies, helicopter evacuation may be necessary — without insurance, this costs thousands of dollars.