Amazon Health Information

Vaccinations for the Brazilian Amazon

As far as we are aware, at the time of writing the only inoculation you may be officially required to have for entry to Brazil is Yellow Fever - otherwise you should be guided by the appropriate health authority in your own country. Having said this, you may find that many local medical sources know just as much as you.  If you want to decide for yourself, there are several good sites on the internet, one of which is http://www.thetraveldoctor.co.uk.  Currently, the regimen specified on this website is as per the table below, but you should check independently - Visit Manaus is no medical authority.  In any case, you will want to select the specific anti-malarial currently recommended for this area (see note on malaria and dengue below).  

One thing you can’t vaccinate against is dehydration, and

Malaria	Recommended
Yellow Fever	Recommended/may be required
Hepatitis A	Recommended
Typhoid	Recommended
Tetanus	Recommended
Polio	Recommended

this is probably the one ailment that most affects visitors to the region. Perhaps this is because in the ambient humidity people may not feel so thirsty, but the fact is that dehydration is perfectly easy to avoid by drinking plenty of fluids, and there are plenty of fluids available here. So there’s no excuse. Remember that dehydration can make you feel seriously unwell (as well as potentially being a killer), so make a mental note (or write it on a piece of paper - or on your forehead) to DRINK MORE WATER.

If you do become dehydrated, there are plenty of rehydration solutions you can buy, or you can make up your own disgusting (but effective) mix by adding sugar and salt to mineral water.  

Also note that if you get diarrhoea, you should drink even more fluid, to avoid  dehydration. On the subject of dodgy tummies, you are not that likely to get food poisoning here, provided you’re sensible. If you do though, it should pass (literally) within 24 - 36 hours or so. If symptoms persist  - and particularly if you have a temperature - you should consider the small chance that you have malaria or dengue, and take appropriate action to monitor or test this.  

 

A note on malaria (and dengue) in the Amazon.

Laugh heartily when people tell you there’s no Malaria (or Dengue) in Manaus, on the Rio Negro, at their lodge/hotel/home etc. It is true that the incidence (on black water) is lower, but it is not true that it does not exist. There is a whole world of difference between having no bullets in the gun and having maybe one. Your decision, of course.

Apart from taking any malaria prophylaxis, the best advice - often given and equally often ignored  - is that the best way to avoid malaria, dengue, yellow fever or japanese encephalitis is to not get bitten in the first place. Consider that at any point in time the majority of mosquitoes around you are probably not disease carriers: that just leaves the chance that there is (for example) one anopheles mosquito in range, and that this anopheles mosquito also happens to be female (required for the transmission of malaria), AND that this female anopheles just happens to be carrying the disease. Well, if you are suitably armed with repellent and/or a long-sleeved shirt and trousers, that lone mosquito, competing for your blood with the other biting insects, doesn´t stand much chance of getting its teeth (or proboscis, at any rate) into your juicy flesh. And also bear in mind that during the heat of the day - between 08:00 and 16:00 - mozzies are pretty inactive anyway, and after dark also less active, so the real covering up only has to be done for a couple of hours around dawn and dusk. So our advice is - just do it!

Health care in Manaus

 
There is a reasonable level of public health care in Brazil, however most of it is provided in an A&E context - medical consultation and medicines are generally only available privately.  

If you become ill during your stay,  your first point of contact should be the place in which you are staying. Your hotel or guesthouse will be able to get you the attention you need, but you will normally have to pay - and obviously if you have insurance you should be familiar with who to contact (or who your hosts should contact).  

If you have an accident here, you will be taken to the nearest public A&E hospital facility, where you will receive treatment free of charge. If you have insurance you can then arrange a transfer to the appropriate place, and under these circumstances there may be provision for the reimbursement to the public health authorities of costs incurred. Most public hospitals here are fairly unpleasant places to be, but the standard of treatment is generally at least competent, and often very good.  Besides, if you’ve just been hit by a car while attempting to use a pedestrian crossing (see note on safety, below), you probably won’t be in a fit state to appreciate the finer points of hospital décor or the quality of the bed.  

If during your visit you suspect you have malaria, dengue, yellow fever, or any other tropical disease, you should go to the centre for tropical diseases (Fundação de Medicina Tropical do Amazonas), on Avenida Pedro Teixeira in the Dom Pedro district, where you will be tested and generally receive the result and a consultation within 48 hours (and often on the same day). This excellent service is currently free. 

If you require over-the-counter medicines (and many medicines which would be prescription-only in your own country), you will find numerous chemists (drug stores) in Manaus, many of which offer a delivery service. If you know what you want, you will usually find it here (apart from anti-malarials, which you won’t find at all), but otherwise you should be careful about taking anything chemist staff recommend to you, and also check expiry dates and - if possible - the authenticity of the medicine.