Moderate riskAmericas · South AmericaEcuador Travel Health Guide
Moderate risk
Ecuador carries a CDC Level 1 travel health notice. Malaria risk exists in certain provinces below 5,000 feet elevation. Key travel vaccines: COVID-19, Hepatitis A, Hepatitis B. Required for entry (applies below 2300m)
Compiled by Voyax Health from CDC Travelers' Health: Ecuador. Editorial sections reviewed by Voyax Health pharmacists ·
Overall risk
Moderate risk
Malaria
Present
Best time to visit
June to September is drier in the highlands and Amazon. The Galápagos are good year-round; December to May is warmer with calmer seas.
Travel health in Ecuador
Ecuador's four worlds each need their own plan. Quito, at 9,350 ft, gives many arrivals a day of altitude symptoms and is the gateway to higher volcano hikes. The Amazon (Oriente) carries malaria and yellow fever risk, and yellow fever vaccination is recommended for anyone heading east of the Andes below about 7,500 ft. The Pacific coast has dengue and some malaria in rural Esmeraldas. The Galápagos are the easy part: no malaria, no yellow fever, and the main risks are sun, seasickness and travelers' diarrhea.
Recommended vaccines
Routine vaccines
Make sure all your routine vaccines are up to date, including chickenpox, tetanus, flu, MMR, polio, and shingles vaccines.
COVID-19
Stay up to date with your COVID-19 vaccines before traveling.
Hepatitis A
Hepatitis A vaccine is recommended for all travelers to Ecuador who haven't been vaccinated. Infants 6-11 months should also get vaccinated.
Hepatitis B
Hepatitis B vaccine is recommended for unvaccinated travelers under 60. Those 60 and older may also consider getting vaccinated.
Measles
Measles cases are increasing worldwide. All travelers should be fully vaccinated with MMR vaccine at least 2 weeks before travel. Infants 6-11 months need an early dose.
Typhoid
Typhoid vaccine is recommended for most travelers to Ecuador, especially if you're staying with friends/relatives or visiting smaller cities or rural areas.
Rabies
Rabies is present in dogs and bats in Ecuador. Consider pre-exposure vaccination if you'll be around animals or in remote areas where treatment might not be readily available.
Yellow Fever
Yellow fever vaccine is recommended if you're going to areas east of the Andes Mountains below 7,550 feet elevation. It's required for entry if you're coming from certain South American countries or have been in DRC/Uganda.
Chikungunya
Chikungunya vaccine is generally not recommended. Focus on preventing mosquito bites instead.
Disease risks
Malaria
Malaria risk exists in certain provinces below 5,000 feet elevation. Take antimalarial medication if visiting Cotopaxi, Esmeraldas, Morona-Santiago, Orellana, Pastaza, or Sucumbíos provinces. No risk in Quito, Guayaquil, or Galápagos Islands.
Altitude Sickness
Quito (2,850m), Papallacta (3,300m); volcanic highlands; hydrate and avoid alcohol first days.
Traveler's Diarrhea
Amazon region, Esmeraldas; low risk in Quito, Guayaquil, Galápagos.
Malaria risk
Malaria risk is limited to certain areas. Whether you need antimalarial medication depends on your itinerary — see details.
Malaria risk exists in certain provinces below 5,000 feet elevation. Take antimalarial medication if visiting Cotopaxi, Esmeraldas, Morona-Santiago, Orellana, Pastaza, or Sucumbíos provinces. No risk in Quito, Guayaquil, or Galápagos Islands.
Seasonal timing
When health risks peak through the year — plan around them.
Peak
Year-round
Altitude sickness
Quito (9,350 ft) and Cotopaxi or Chimborazo hikes. Take the first day slowly; acetazolamide for rapid ascents to the volcanoes.
Peak
January to May
Dengue
Coastal lowlands including Guayaquil, Manta and Esmeraldas, and the Amazon. Not in Quito or the Galápagos.
Peak
Year-round
Yellow fever
Amazon provinces (Morona Santiago, Napo, Orellana, Pastaza, Sucumbíos, Zamora Chinchipe). Vaccination recommended for Amazon lodges.
Water & food safety
Water
Do not drink tap water on the mainland. Quito's water is treated but most travellers and many residents use bottled or filtered water. In the Galápagos, all drinking water is bottled or desalinated by hotels and boats.
Food
Cooked highland food (locro, hornado) is safe when hot. Ceviche on the coast is a raw preparation to approach carefully; Ecuadorian ceviche is often cooked shrimp, which is safer. Avoid salads and unpeeled fruit outside good restaurants.
Medications
Pharmacies (Fybeca, Pharmacys, Sana Sana) are well stocked in Quito, Guayaquil and Cuenca; many medications are sold without prescription. In the Galápagos and Amazon, supply is limited: bring everything you need.
On the ground
Medical facilities
Quito (Hospital Metropolitano, Vozandes) and Guayaquil have good private hospitals. The Galápagos have a small hospital on Santa Cruz and basic clinics; serious cases fly to the mainland. Amazon lodges are hours from care.
Travel insurance
Travel medical insurance with evacuation cover is advised, and should cover altitude for volcano hikes and diving in the Galápagos if planned.
Emergency numbers
Police
911
Medical / Ambulance
911
Fire
911
U.S. Embassy
+57-1-275-2000
Ecuador travel health FAQ
Do I need the yellow fever vaccine for Ecuador and the Galápagos?▼
Not for the Galápagos, Quito, Cuenca or the coast. The CDC recommends it for the Amazon provinces east of the Andes below about 7,500 ft, so if your trip includes an Amazon lodge, get vaccinated at least 10 days before. Ecuador does not require the certificate for entry from the US.
Do I need malaria pills for Ecuador?▼
Only for the Amazon lowlands and rural parts of Esmeraldas province on the coast. There is no malaria in Quito, Cuenca, the Galápagos, or most coastal beach towns.
How do I handle Quito's altitude?▼
At 9,350 ft, expect mild headache, breathlessness and poor sleep for a day or two. Arrive rested, hydrate, avoid alcohol the first night, and schedule light activities. Acetazolamide is rarely needed for Quito alone but is worth discussing if you will climb higher or have had altitude problems before.
More country guides
ArgentinaLow riskArgentina carries a CDC Level 1 travel health notice. No malaria risk. Key travel vaccines: COVID-19, Hepatitis A, Hepatitis B.
BoliviaModerate riskBolivia carries a CDC Level 2 travel health notice. Malaria risk exists in areas below 2,500m elevation. Key travel vaccines: COVID-19, Chikungunya, Hepatitis A. Required for entry (applies below 2300m)
BrazilHigh riskBrazil carries a CDC Level 1 travel health notice. Malaria risk exists in certain areas of Brazil. Key travel vaccines: COVID-19, Hepatitis A, Hepatitis B.
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Build my Trip KitSources: CDC Travelers' Health: Ecuador · WHO International Travel and Health. Last updated 2026-07-31. Health conditions and entry rules change — verify with the CDC, WHO and your destination’s authorities before travel. This page is informational and not a substitute for advice from a travel-medicine provider.