Malaria Risk In Bolivia: Is It Safe To Travel?

Bolivia is a developing nation in South America, with a climate ranging from dry summer to humid equatorial, and some cooler high-altitude areas. The country has a high risk of malaria in the Amazon region, specifically in the department of Pando and northern areas of the departments of Beni and La Paz. The risk is moderate in regions below 2500m south of these high-risk areas, and low in areas below 2500m south of the moderate-risk areas. There is no risk of malaria in areas above 2500m. The World Health Organization (WHO) reports that the risk of malaria is due almost exclusively to P. vivax (99.9%) and exists throughout the year in the entire country below 2500m. The CDC recommends that travellers to certain areas of Bolivia take prescription medication to prevent malaria.

Malaria risk areas in Bolivia

There is a risk of malaria in Bolivia, with the risk highest in the Amazon region in the department of Pando and northern areas of the departments of Beni and La Paz. The risk is moderate in regions below 2500 m, south of the high-risk areas in the department of Beni and in the northern part of the department of La Paz. The risk is low in areas below 2500 m, south of the moderate-risk areas in the department of Beni, the northern region of the department of Santa Cruz, and the eastern part of the department of Tarija. There is no malaria risk in the areas above 2500 m, including the central and southern parts of the country such as the city of La Paz.

The World Health Organization (WHO) reports that the risk of malaria exists throughout the year in the entire country below 2500 m. The risk is highest in the northern departments of Beni and Pando, especially in the localities of Riberalta, Guayaramerín, and Sena. The CDC also reports that malaria risk areas include all areas below 2500 m, with no risk in the city of La Paz.

To prevent malaria, it is recommended to use mosquito-repellent measures from dusk till morning in high and moderate-risk areas, in combination with the use of malaria tablets. In low-risk areas, the use of mosquito-repellent measures from dusk till morning is recommended. For people with an increased risk, preventive malaria tablets or taking an emergency treatment may be considered.

If you have a fever during or after your journey to a malaria-risk area, get tested for malaria as soon as possible. Remember that malaria can develop even up to one year after exposure.

Preventing mosquito bites

Yes, Bolivia is a country with a risk of malaria. The CDC recommends that travellers going to certain areas of Bolivia take prescription medication to prevent malaria.

Cover Your Skin

It is important to cover your skin as much as possible to avoid mosquito bites. Wear long-sleeved shirts, long pants, and hats. Opt for light-coloured, loose-fitting clothing made from tightly woven materials like cotton, denim, nylon, or windbreaker-type fabrics. These materials are more difficult for mosquitoes to penetrate.

Use Insect Repellent

Apply insect repellent to exposed skin. Look for repellents that contain DEET (25-30% concentration for skin application and 50% ideally), Picaridin (also known as KBR 3023, Bayrepel, and icaridin), or oil of lemon eucalyptus (OLE). Always follow the instructions on the product label, and reapply if necessary.

Treat Clothing and Gear

Use permethrin-treated clothing and gear, such as boots, pants, socks, and tents. Permethrin is an insecticide that repels or kills mosquitoes, and it remains effective after multiple washings. Do not apply permethrin directly to the skin.

Sleep Under a Mosquito Net

Sleep under an impregnated mosquito net, especially if you are sleeping in an area that is exposed to the outdoors. An impregnated mosquito net is treated with insecticide, providing an effective barrier against mosquito bites at night.

Choose Protected Accommodation

When selecting accommodation, ensure that it has insect-proof screen doors and windows that close properly. This will help keep mosquitoes out and reduce your risk of being bitten.

Avoid Mosquito Habitats

Mosquitoes are attracted to standing water, so avoid areas with stagnant water, such as ponds, swamps, lakes, puddles, and water-filled containers. Keep your surroundings clean and get rid of any water-holding containers, both indoors and outdoors.

Preventing and treating animal bites

Yes, Bolivia is a country that carries a risk of malaria. Here are some tips for preventing and treating animal bites in Bolivia:

Prevention

• Do not touch or feed any unfamiliar animals.
• Avoid animals licking open wounds, and keep animal saliva away from your eyes and mouth.
• Stay away from rodents and their urine and faeces.
• Supervise pets closely and do not let them come into contact with local animals.
• Be extra cautious around dogs, bats, monkeys, sea animals such as jellyfish, and snakes.
• Wear high boots and long, bright-coloured clothing.
• Make some noise, stomp the ground, and shake out your clothes and shoes before getting dressed.
• Use insect repellent on exposed skin and clothing.
• Sleep in air-conditioned or screened rooms, or under a mosquito net.
• Stay away from fresh, unchlorinated water, such as lakes, ponds, or rivers.

Treatment

• If you are bitten or scratched by an animal, immediately wash the wound with soap and clean water and seek medical attention.
• Tell your doctor about the injury when you return home.
• Consider purchasing medical evacuation insurance, as rabies is deadly and treatment may not be readily available in some countries.

Vaccinations for Bolivia

Vaccinations are highly recommended for anyone travelling to Bolivia. The CDC and WHO recommend the following vaccinations:

• Typhoid
• Hepatitis A
• Polio
• Yellow Fever
• Chikungunya
• Rabies
• Hepatitis B
• Influenza
• COVID-19
• Pneumonia
• Meningitis
• Chickenpox
• Shingles
• Tdap (tetanus, diphtheria and pertussis)
• Measles, Mumps and Rubella (MMR)

It is also important to be up to date on all routine vaccinations, including:

• Chickenpox (Varicella)
• Diphtheria-Tetanus-Pertussis
• Measles-Mumps-Rubella (MMR)
• COVID-19

Some vaccinations are required for travel to certain areas of Bolivia. For example, a yellow fever vaccination certificate is required for travellers over 1 year old arriving from countries with a risk of yellow fever transmission. Additionally, antimalarial medication is recommended for all travellers to the country, as there is currently no vaccine for malaria.

Other recommended measures to prevent disease include:

• Practising good hygiene, especially around food and water
• Avoiding insect bites
• Preventing and treating animal bites

Other health risks in Bolivia

While malaria is a risk in some parts of Bolivia, there are other health risks to be aware of when visiting the country.

Food and Waterborne Diseases

Food and waterborne diseases are a common issue in Bolivia, with bacterial diarrhea, hepatitis A, and typhoid fever being the most prevalent. These diseases are spread by consuming contaminated food or water or by touching things that have been contaminated and then touching your mouth. To reduce your risk, follow food and water safety guidelines and make sure to wash your hands regularly, especially before eating.

Vectorborne Diseases

In addition to malaria, other vectorborne diseases are present in Bolivia, including dengue fever, yellow fever, and Chagas disease. These diseases are spread by the bite of infected insects such as mosquitoes and midges. To protect yourself, take steps to prevent insect bites by covering exposed skin, using insect repellent, and sleeping under a mosquito net.

Water Contact Diseases

Leptospirosis is a water contact disease found in Bolivia. It is spread by touching or swimming in contaminated fresh water, such as lakes, ponds, or rivers. To stay safe, avoid swimming in fresh, unchlorinated water and take precautions to avoid contact with contaminated water.

Animal-Borne Diseases

Rabies is a serious concern in Bolivia, with infected dogs and bats being commonly found. Animal bites and scratches can also lead to other diseases. To protect yourself, avoid touching or feeding unknown animals, and seek medical care if you are bitten or scratched.

Other Health Concerns

• Heat-related illnesses: Heat stroke can be deadly, so it is important to stay hydrated, wear lightweight clothing, and limit physical activity during high temperatures.
• UV radiation: Protect yourself from the sun by using sunscreen, wearing protective clothing, and seeking shade during the hottest times of the day.
• Cold temperatures: If visiting high-altitude areas, dress in layers to stay warm and protect yourself from the cold.
• Road safety: Motor vehicle crashes are a leading cause of death for US citizens in foreign countries, so take precautions when travelling by road.
• Drug use: Bolivia's cocaine industry has led to addiction issues, particularly among youth. Be aware of the risks associated with drug use and seek help if you or someone you know is struggling with addiction.

Frequently asked questions