PERU VACCINATIONS AND TRAVEL HEALTH INFORMATION

A visit to a travel health physician at least 4-6 weeks before travel is highly recommended
*Our very own Travel Health Center / Dr. Bradley A. Connor*
Contact Nurse Judy: 212 988 2800 or 212 734 3000 - 50 East 69th, NYC 10021
(Mention Dynamic Outdoors or Igor Bass, maybe she will waive the visitation fee)

CDC Recommended Vaccinations
Typhoid*
Polio*
Tetanus-diphtheria*
Measles*
Hepatitis A (series of 3, but one will cover you within 2 weeks of receiving)
International Certificate of Vaccination for Yellow Fever required if arriving FROM an INFECTED AREA  (Further information regarding Yellow Fever Vaccination, may be obtained by calling 1-800-VACCINE or the U.S. Department of Health Center for Disease Control and Prevention's (CDC) International Traveler's Hotline at (404) 332-4559 or the CDC Fax Information Service at (888) 232-3299. Information may also be obtained from travel medicine specialists and/or a local or state Department of Health clinic).
*  you probably have had these but may need a booster

Malaria
Malaria exists in rural areas of the country. Travelers who will visit only Lima and vicinity; coastal areas south of Lima; or the highland tourist areas (Cuzco, Machu Picchu, Lake Titicaca) are NOT at risk

Other health topics
Altitude Sickness
On reaching heights above 3000m, heart pounding and shortness of breath are a normal response to the lack of oxygen in the air. However, for some visitors these symptoms can deteriorate into a conditions known as Soroche (or acute mountain sickness) when you can start to experience headaches, loss of appetite, extreme tiredness, sleeplessness and often nausea. Symptoms usually develop within the first day at altitude, but may be delayed by up to 2 weeks. To prevent Soroche, try to take things easy as soon as you arrive. Once settled in your hotel room have a lie down for a while and drink plenty of fluids. Don't plan any strenuous treks until you've acclimatized for a few days. Avoid alcohol, cigarettes and heavy food. Drinking mate de coca (an infusion of coca leaves - and perfectly legal in Peru ) may help.

Consider bringing DIAMOX for prophylaxis. (highly recommended !)

Traveler’s Diarrhea
Can be avoided by following the appropriate health precautions. Consider bringing ANTIBIOTICS (doxycycline, bactrim, or ciprofloxacin) and over the counter anti-diarrheal medications (ie-Imodium) just in case

Health Precautions
1.  Drink only bottled or boiled water, or carbonated drinks in cans and bottles.  AVOID tap water, fountain drinks, and ice cubes.  If this is not possible, make water safer by filtering through an “absolute 1-micron or less” filter and adding iodine tablets to filtered water.
2.  Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself
3.   Don’t eat dairy products unless you know they have been pasteurized
4.  Protect yourself from insects
5.  Use bottled water for brushing your teeth

To search for a Travel Health Clinic near you can run a search on this web site:  http://www.istm.org/
And www.CDC.gov

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F A Q:
Itinerary: How many nights are in hotels and how many nights are camping?
Hotel 5 / Camping 3

Accommodations: In the hotels, how many people are in a room?
2 participants per room/ 2 participants per tent: single room/ single tent upgrade possible for a fee:

Age/ Gender: What is the usual mix (both age and sex) of the people on the trip?
Usually it is the standard NYC/ Tri-State demographic: age range: 25 to 45 - core in the 30's - there are slightly more girls, one or two couples, some guys...

Dietary Restrictions: I'm a bit of a picky eater (no fish, seafood, dairy).  Is this going to be a problem?
Food is not a problem...

Medical: I have slight asthma although I'm in good shape (I do a lot of road cycling).  Might I have a problem with the altitude?  Is this a very strenuous trip?
We have had people do this trip who have had asthma; HOWEVER, you need your doctor to give you written approval AND you need to be aware that yes,
this is a strenuous trip; altitude and exposure to cold weather at times (in the mountains and in the city, especially at night)

Availability: I would like to find out how many available spaces you still have.
- please see above: the drip down box will indicate how many open spots: as long as you can book the trip, space is available...

Physical: How good of a hiker should you be?
- Good shape !  The better shape you are in, the more fun the trip will be !

Preparation: Any suggestion on how to prepare for the trip?

How good a hiker should I be to handle it?
- It would be very good to go to the gym on a regular basis. Make sure your hiking boots are broken in !
We will have a few spring hikes to prepare you for the trip.
- Hit the gym a few more times than usual, come on Hiking Trips when posted: http://dynamicoutdoors.com/page3.html

Gear List: Any additional equipment other then what you mentioned on the site?
- Final and full gear list will be sent in a few weeks:

Was wondering if the porters have a weight limit and does that include the sleeping bag/mat. I am assuming we throw the sleeping bag/mat into the duffel, yes?
>> yes - will double check and get back to you with the exact number...   but yes, bag/ mat into duffel and the porters will carry it...

What about water? should i take with me tablets to filter it?
>> no need to bring tablets or filter unless you really want to.

Do you think low hiking boots will be fine or i should get high ones?
>> we have had people hiking this trail in sneakers; they were fine; however, we strongly urge and recommend high top hiking boots for ankle support !

Supplemental: Also any additional info that you can provided ?
- Please review the links and look for Peru:
JFK    http://www.jfk-airport.org/term_airln.htm      
Foreign Exchange        http://www.xe.com/  
Elextrical Outlets        http://www.interpower.com/ic/guide.htm  
International Dialing Codes:            http://www.countrycallingcodes.com/
Weather:    http://www.weather.com/      
http://international-electrical-supplies.com/electricguide.html       

The Trail: We are taking not the regular Inca trail, but the higher and longer one,  right? From what I could find,  this trail is  usually 5 days.
- Correct ! But we are doing a 4 day variation of it:
Are there any Inca ruins on the way?
- Yes, but slightly less of those until you get to Machu Picchu; there you will have view of the Inca City which only few people will get to see !

Can we hike Wayna Picchu Mountain - Limited Tickets - http://en.wikipedia.org/wiki/Huayna_Picchu
- Yes, we will get tickets as soon as we enter Machu Picchu...

What about high altitude: what do u think about taking any medication:           
 
Preventive Medications - Diamox (Acetazolamide) allows you to breathe faster so that you metabolize more oxygen, thereby minimizing the symptoms caused by poor oxygenation. This is especially helpful at night when respiratory drive is decreased. Since it takes a while for Diamox to have an effect, it is advisable to start taking it 24 hours before you go to altitude and continue for at least five days at higher altitude. The recommendation of the Himalayan Rescue Association Medical Clinic is 125 mg. twice a day (morning and night). (The standard dose was 250 mg., but their research showed no difference for most people with the lower dose, although some individuals may need 250 mg.) Possible side effects include tingling of the lips and finger tips, blurring of vision, and alteration of taste. These side effects may be reduced with the 125 mg. dose. Side effects subside when the drug is stopped. Contact your physician for a prescription. Since Diamox is a sulfonamide drug, people who are allergic to sulfa drugs should not take

>> We recommend that you take some Diamox with you ! However, most people are usually fine without it: if you are alergic to Sulfa (Sulfonamide) we recommend you take the local substitute: Sorojchi Pills.  Or stick with coca tea...

- Duffle bags - I don't have one. I am traveling with my large back pack (60L) and a day back pack. I have another bag where I can put my city clothes at the hotel, but most of the stuff I'm taking is for the hike. Is that ok that the porter takes my half empty 60l back pack?
 >> that is fine - the porters can take the 60L back pack; however, there will be a weight limit on how much they will carry:
(Yvonne will go over this locally...)

- Tipping: >> Tipping and Porter Costs:
Tipping: $45 - covers the tips for the local guides, hiking guides, tipping porters, the chef, hotel staff etc...  it is only about 2.25 % of your trip costs...
Personal Porters/ Personal Back-Up Mules: Costs: $80 ($40 per person) covers the cost of your luggage transport for 5 days (It actually also covers the costs of extra / emergency mules to carry people if they get tired, sick, or by chance hurt and need evacuation)
You can certainly skip this part and carry the pack yourself (60L); however, I would strongly advise against it...