Ecuador health: altitude, dengue and vaccines to travel

Ecuador packs very different climates into a few kilometres: the highlands at almost 3,000 metres, the hot humid coast, the Amazon and the Galápagos Islands. That means different health risks depending on your itinerary. This guide summarises the information from the US Centers for Disease Control and Prevention (CDC) and the UK FCDO travel advice, consulted on 7 November 2026. It does not replace a consultation with a travel-medicine professional, which you should have at least eight weeks ahead. For other paperwork see our guide to entry and customs.

Altitude: Quito and the highlands

The FCDO notes that altitude sickness is a risk in parts of the country. The capital is at about 2,850 metres, and excursions such as the Cruz Loma station, at about 4,050 metres, raise the risk. The golden rule is to ascend gradually, rest on the first day, drink plenty of water, avoid alcohol on arrival and sleep well. If you have heart or respiratory conditions or are pregnant, ask first. For Chimborazo you must register at least five days ahead, and climbing glaciated peaks without an accredited guide is illegal. In Quito ultraviolet radiation can be extreme: sunscreen and a hat.

Yellow fever, hepatitis A, typhoid

According to the CDC, the yellow fever vaccine is recommended from 9 months of age for travel to areas below 2,300 metres east of the Andes, in provinces such as Morona-Santiago, Napo, Orellana, Pastaza, Sucumbíos, Tungurahua and Zamora-Chinchipe. It is generally not recommended for the coast west of the Andes, above 2,300 metres, or for Quito, Guayaquil or Galápagos. Hepatitis A is recommended for unvaccinated travellers. Typhoid should be considered if you go to rural areas with poor sanitation, stay a month or longer or visit friends and relatives. None of this is a prescription: see your travel clinic.

Malaria, dengue and mosquitoes

Malaria is transmitted below 1,500 metres in Cotopaxi, Esmeraldas, Morona-Santiago, Orellana, Pastaza and Sucumbíos (rare cases elsewhere below that altitude). There is no transmission in Guayaquil, Quito or Galápagos. If you visit a risk area your doctor may prescribe prophylaxis; chloroquine resistance is reported. Dengue is a year-round risk in many parts of the country and no vaccine is listed in that guidance: use repellent, long clothing at dusk and air-conditioned or screened rooms. The FCDO also mentions Oropouche virus. If you have a fever during or after the trip, seek medical care and mention your travel.

Rabies, water and food

The CDC says there are rabid dogs and bats in Ecuador; post-exposure treatment may be available only in larger urban centres. Avoid petting stray animals and ask whether pre-exposure vaccination suits you. Tap water is not recommended: drink boiled, filtered or bottled water and avoid ice. Wash fruit and vegetables well or peel what you can.

Medical care and insurance

The public system offers the same care to locals and foreigners free of charge, but with appointment delays and medicine shortages. Private care can be very expensive and private hospitals require a credit-card guarantee for admission. Outside the big cities, quality and access to specialists are limited. In Galápagos, San Cristóbal has a relatively well-equipped public hospital, Santa Cruz a basic one under refurbishment and Isabela only a very small health centre, so insurance with air evacuation is essential. Ambulances are requested through 911 and the ECU 911 app lets you ask for help. Pharmacies may accept some prescriptions within limited validity periods; bring your medication and its prescription or medical letter.

Sexual health on the road

Travelling as a couple or in the lifestyle calls for the same precautions as at home: quality condoms, regular testing and clear talk with your partners. For the Dutch Caribbean the CDC also recommends hepatitis B, something we explain in sexual health in the Dutch Caribbean. Bring your own condoms and lubricants from home.

A basic kit and useful habits

A simple kit saves visits: repellent, high-factor sunscreen, your usual painkillers, rehydration salts, dressings and your prescription medicines. For altitude sickness, hydration and rest matter more than any pill; ask your doctor about specific medication before leaving. Tell your partner about your allergies and medical conditions, and both of you carry a copy of the insurance with the assistance phone number.

Sources and limits

This guide relies on official sources consulted on 7 November 2026; travel advice, entry requirements and health recommendations change at short notice and depend on your nationality, so always confirm with your consulate, the country's embassy and a health professional. We have not added data that does not appear in those sources, and where something could not be checked we say so. References:

• https://www.gov.uk/foreign-travel-advice/ecuador/health
• https://wwwnc.cdc.gov/travel/destinations/traveler/none/ecuador

Frequently asked questions

Do I need the yellow fever vaccine for Quito? The CDC does not recommend it for Quito or Guayaquil, but does for eastern Amazon areas below 2,300 metres.

Is there malaria in Galápagos? No, according to the CDC.

How do I avoid altitude sickness? Ascend gradually, hydrate and rest on the first day.

What insurance do I need? One with local medical cover and evacuation; in Galápagos it is mandatory for foreigners.