The most common types of illnesses are caused by contaminated food and water. Especially in developing countries, drink only bottled, boiled, or purified water and drinks; don't drink from public fountains or use ice. It’s even prudent to use bottled water to brush your teeth. Make sure food has been thoroughly cooked and is served to you fresh and hot; avoid vegetables and fruits that you haven't washed (in bottled or purified water) or peeled yourself. If you have problems, mild cases of traveler's diarrhea may respond to over-the-counter medications. Be sure to drink plenty of fluids; if you can't keep fluids down, seek medical help immediately.
Infectious diseases can be airborne or passed via mosquitoes and ticks and through direct or indirect physical contact with animals or people. Some, including Norwalk-like viruses that affect your digestive tract, can be passed along through contaminated food. If you're traveling in an area where malaria is prevalent, use a repellent containing DEET and take malaria-prevention medication before, during, and after your trip as directed by your physician. Speak with your physician and/or check the CDC or World Health Organization websites for health alerts, particularly if you're pregnant, traveling with children, or have a chronic illness.
English-speaking medical assistance in Brazil is rare. It's best to contact your consulate or embassy if you need medical help. Seek private clinics or hospitals, since getting an appointment in the government's health-care system is a slow process.
If you're traveling to the Amazon, extra precautions are necessary.
Do not fly within 24 hours of scuba diving. Neophyte divers should have a complete physical exam before undertaking a dive. If you have travel insurance that covers evacuations, make sure your policy applies to scuba-related injuries, as not all companies provide this coverage.
Food and Drink
The major health risk in Brazil is traveler's diarrhea, caused by eating contaminated fruit or vegetables or drinking contaminated water. So watch what you eat—on and off the beaten path. Avoid ice, uncooked food, and unpasteurized milk and milk products, and drink only bottled water or water that has been boiled for at least 20 minutes, even when brushing your teeth. The use of bottled water for brushing your teeth is not necessary in large cities, where water is treated. Don't use ice unless you know it's made from purified water. (Ice in city restaurants is usually safe.) Peel or thoroughly wash fresh fruits and vegetables. Avoid eating food from street vendors.
Choose industrially packaged beverages when you can. Order tropical juices only from places that appear clean and reliable.
Infectious Diseases and Viruses
The Amazon and a few other remote areas are the only places in Brazil where you really need worry about infectious diseases. Most travelers to Brazil return home unscathed. However, you should visit a doctor at least six weeks prior to traveling to discuss recommended vaccinations, some of which require multiple shots over a period of weeks. If you get sick weeks, months, or in rare cases, years after your trip, make sure your doctor administers blood tests for tropical diseases.
Meningococcal meningitis and typhoid fever are common in certain areas of Brazil—and not only in remote areas like the Amazon. Meningitis has been a problem around São Paulo in recent years. Dengue fever and malaria—both caused by mosquito bites—are common in Brazil or in certain areas of Brazil, like Rio de Janeiro. Both are usually only a problem in the Amazon, but dengue can affect urban areas and malaria is sometimes found in urban peripheries. Talk with your doctor about what precautions to take.
Pests and Other Hazards
You'll likely encounter more insects than you're used to in Brazil, but they generally only present health problems in the Amazon.
Heatstroke and heat prostration are common though easily preventable maladies throughout Brazil. The symptoms for either can vary but always start with headaches, nausea, and dizziness. If ignored, these symptoms can worsen until you require medical attention. In hot weather be sure to rehydrate regularly, wear loose lightweight clothing, and avoid overexerting yourself.
Mild cases of diarrhea may respond to Imodium (known generically as loperamide) or Pepto-Bismol (not as strong), both of which can be purchased over the counter at a farmácia (pharmacy). Drink plenty of purified water or chá (tea)—camomila (chamomile) is a good folk remedy, as is dissolving a tablespoon of cornstarch in a mix of lime juice and water. In severe cases rehydrate yourself with a salt–sugar solution: ½ teaspoon sal (salt) and 4 tablespoons açúcar (sugar) per quart of agua (water).
An effective home remedy for diarrhea is the same as the rehydrating concoction: a teaspoon of sugar plus a quarter teaspoon of salt in a liter of water.
Aspirin is aspirina; Tylenol (acetaminophen; paracetamol) is pronounced tee-luh-nawl. Advil (ibuprofen) is ah-jee-viu.
Shots and Medications
If you travel a lot internationally—particularly to developing nations—refer to the CDC's Health Information for International Travel (aka Traveler's Health Yellow Book). Info from it is posted on the CDC website (wwwnc.cdc.gov/travel).
The best recommendation to avoid health problems is to see a doctor before and after traveling, just to be on the safe side. Some vaccines must be applied long before traveling so that their protective effect is guaranteed, and some prophylactic medicines must be taken also in advance so that the doctor and the patient are aware of possible side effects.
Vaccinations against hepatitis A and B, meningitis, typhoid, and yellow fever are highly recommended. Consult your doctor about whether to get a rabies vaccination. Check with the CDC's International Travelers' Hotline if you plan to visit remote regions or stay for more than six weeks.
Discuss the option of taking antimalarial drugs with your doctor. Note that in parts of northern Brazil a particularly aggressive strain of malaria has become resistant to one antimalarial drug—chloroquine. Some antimalarial drugs have rather unpleasant side effects—from headaches, nausea, and dizziness to psychosis, convulsions, and hallucinations.
For travel anywhere in Brazil, it's recommended that you have updated vaccines for diphtheria, tetanus, and polio. Children must additionally have current inoculations against measles, mumps, and rubella.
Yellow fever immunization is compulsory to enter Brazil if you're traveling directly from one of the following countries in South America (or from one of several African countries): Bolivia; Colombia; Ecuador; French Guiana; Peru; or Venezuela. You must have an International Certificate of Immunization proving that you've been vaccinated.
National Centers for Disease Control & Prevention. 800/232–4636; www.cdc.gov.
World Health Organization. www.who.int.