Health in Brazil: vaccines, mosquitoes and safer sex for couples

Before booking a flight to the Northeast, the Centre-West or the Amazon, set aside time for health. Brazil is huge and risks change a lot between states: what applies to Fortaleza does not apply to Manaus. This guide summarises the US CDC traveller page (last reviewed 3 September 2026) and adds general safer-sex advice. It is no substitute for a travel-medicine consultation, which you should book four to six weeks before departure.

Yellow fever: it depends where you go

According to the CDC, vaccination is recommended from 9 months of age for travel to, among others, Amazonas, the Federal District (Brasília), Goiás, Maranhão, Piauí, Pará and "designated areas" of Bahia, as well as Iguaçu Falls. It is not recommended if travel is limited to other areas, including the cities of Fortaleza and Recife. It is not required for entry. Salvador is in Bahia, so check the CDC map to see whether your route falls within a designated area. Yellow fever and malaria information was updated on 23 April 2025.

Malaria: Manaus yes, Brasília no

Malaria is transmitted throughout Acre, Amapá, Amazonas, Rondônia and Roraima; Manaus is in Amazonas. The CDC says there is no transmission in Brasília, Rio de Janeiro or São Paulo city. In transmission areas, preventive drugs such as atovaquone-proguanil, doxycycline, mefloquine or tafenoquine may be prescribed, and chloroquine is not effective there. This is a medical decision: bring your itinerary to the consultation.

Dengue, Zika and chikungunya

These are mosquito-borne and prevention means avoiding bites: repellent, long sleeves at dawn and dusk, nets or air conditioning. For chikungunya the CDC notes elevated risk and says vaccination may be considered for stays of six months or more. Zika can pass from a pregnant person to the baby, so anyone pregnant or planning pregnancy should talk to a doctor.

Other recommended vaccines

• Hepatitis A: recommended from age 1 if unvaccinated.
• Hepatitis B: recommended for unvaccinated travellers under 60.
• MMR (measles): all international travellers should be fully vaccinated.
• Typhoid: consider for rural travel, poor sanitation or stays of a month or more.
• Rabies: dogs, wildlife and bats can carry it; discuss with your doctor.

Fresh water and food

The CDC warns of schistosomiasis in fresh water: do not swim in untreated rivers or lakes. Drink bottled or treated water and eat where food turns over quickly.

Safer sex as a couple

Travelling as a couple and sharing experiences with others means talking about health in advance. The WHO reminds us that many sexually transmitted infections may have no symptoms and that correct, consistent condom use is one of the most effective prevention tools. Practical ideas:

• Get tested before travelling and share results frankly.
• Bring condoms and lubricant from home; do not count on buying them on the spot.
• Agree beforehand on what is and is not on the table, and remember anyone can say "no" at any time.
• If symptoms appear, stop and see a doctor; do not self-medicate.

Insurance and care

Buy insurance with medical cover and repatriation. Keep a copy of your regular medication in its original packaging and carry the prescription.

Frequently asked questions

Do I need yellow fever vaccine for Recife or Fortaleza? The CDC does not recommend it if you only visit those cities.

Is there malaria in Brasília? No, according to the CDC; yes in Amazonas state, home to Manaus.

Is any vaccine required for entry? No, yellow fever is not required for entry.

What about mosquitoes? Repellent, long sleeves and physical barriers.

Preparing your consultation and first-aid kit

Bring to the consultation your exact itinerary (cities, dates and whether you will visit rural or jungle areas), your vaccination record and regular medication. Ask about the right repellent, sunscreen and treatment for traveller's diarrhoea. A first-aid kit should include painkillers, oral rehydration salts, antihistamines, a thermometer, dressings and the condoms and lubricant mentioned above. Keep essential medication in your hand luggage.