Inoculation regulations can change at short notice. Please take medical advice in the case of doubt.

1
A yellow fever vaccination certificate is required from travellers over nine months leaving Paraguay to go to endemic areas (forested areas in the east and west of the country). A certificate is also required from travellers coming from endemic areas.

2
Typhoid is a risk in rural areas.

3
Malaria risk, almost exclusively in the benign vivax form, is moderate in certain municipalities of Alto Paraná, Caaguazú and Canendiyú. In the other 13 departments, there is a negligible risk.

Food & drink
Mains water is normally chlorinated, and whilst relatively safe, may cause mild abdominal upsets. Bottled water is available and is advised for the first few weeks of stay. Drinking water outside main cities and towns is likely to be contaminated and sterilisation is considered essential. Milk may be unpasteurised and, if so, should be boiled. Powdered or tinned milk is also available and is advised, but make sure that it is reconstituted with pure water. Avoid dairy products which are likely to have been made from unboiled milk. Only eat well-cooked meat and fish, preferably served hot. Pork, salad and mayonnaise may carry increased risk. Vegetables should be cooked and fruit peeled.

Other risks
Hepatitis B and D are endemic; hepatitis A is common; hepatitis C occurs. There have been large epidemics of dengue fever across the country in the past few years. Filariasis, leishmaniasis, onchocerciasis and American trypanosomiasis (chagas disease) are present. TB occurs.
Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. For more information, consult the Health appendix.

Health insurance is essential. There is no reciprocal health agreement with the UK.