Facilities and Health Information:
Medical care is generally good but it varies in quality, particularly in remote areas, and it may not meet U.S. standards outside the major cities. Prescription and over-the-counter medicines are widely available. Emergency services are responsive. Travelers may call a private ambulance company or call 192 and request an ambulance for a public hospital. Callers must stay on the line to provide the location as there is no automatic tracking of phone calls. Other important phone numbers include, Emergency 199, Police 190 and Fire Department 193.
Sao Paulo: Expatriates regularly use the Albert Einstein Hospital in Sao Paulo. It is inspected and certified by the Joint Commission International and offers international service assistance. The hospital phone number is 011-55-11-3747-1233.
Rio de Janeiro: In Rio, many expatriates go to Hospital Samaritano (Rua Bambina 98, Botafogo; tel. 2537-9722; ambulance tel. 2535 4000); or Pro-Cardiaco, which specializes in cardiac care but also offers other specialty services (Rua Dona Mariana 219, Botafogo; tel. 2131-1400 or 2528-1442, ambulance tel. 2527-6060).
Information on vaccinations and other health issues in Brazil, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention's (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) and their " Yellow Book ". For information about outbreaks of infectious diseases abroad and for general and country specific health information for travelers, consult the World Health Organization (WHO).
General Vaccinations: All travelers should visit either their personal physician or a travel health clinic 4-8 weeks before departure, as some vaccines and malaria prophylaxis must be given a few weeks before travel. All travelers to Brazil, and those transiting the country, should have prior vaccinations for Hepatitis A, typhoid, and Hepatitis B. Routine immunizations including MMR (measles, mumps, rubella), Tdap (tetanus, diphtheria, and pertussis), and varicella should be up to date. Neither cholera nor polio vaccines are recommended except under specific circumstances. Consult the Yellow Book for more information.
Insect-borne Illnesses: Insect-borne illnesses are common in Brazil, principally yellow fever, malaria, leishmaniasis, and dengue. Vaccination is available to prevent yellow fever, and prophylactic medication can be used to lower the risk of malaria. Chagas disease (a/k/a American trypanosomiasis ) transmission has been eliminated in every state except Bahia and Tocantins through an aggressive program of insecticide spraying.
The first-line of protection against all insect bites is the use of insect repellents (less than or equal to 30% DEET content for children above two months of age), but mosquito nets, mosquito coils, aerosol sprays, protective clothing, use of screens, or staying in air-conditioned environment when available are also alternatives.
Dengue: There is no vaccine for dengue. Dengue usually presents fever, rash, and body aches, or there are no symptoms and clears relatively quickly; however, it can be rapidly fatal in a minority of severe cases. Consult CDC Yellow Book for the signs and symptoms of severe dengue.
Malaria: Malaria is present throughout the year in forested areas of the Amazon region, but it tends to be seasonal (southern summer) elsewhere in the country; mostly on the periphery of cities and towns in the Amazon region. There is little to no risk of malaria in other areas of Brazil.
Yellow Fever: The yellow fever vaccine is recommended for travelers over nine months of age to the states of Acre, Amapá, Amazones, Distrito Federal (including the capital city of Brasília), Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Rondônia, Roraima, Tocantins, and designated areas of the following states: Piauí, Bahia, São Paulo, Paraná, Santa Catarina, and Rio Grande do Sul. The vaccine is also recommended for travelers visiting Iguaçu Falls. Daytime insect precautions are essential for unvaccinated travelers.
Yellow fever vaccine is not recommended for itineraries limited to the cities of Rio de Janeiro, São Paulo, Salvador, Recife, or Fortaleza, or any other areas not listed above. Travelers over age 65 should consult with their physician prior to receiving yellow fever vaccination.
Rabies: The rabies vaccination is recommended for prolonged stays, with a priority for children and those planning rural travel. For shorter stays, rabies vaccination is recommended for adventure travelers, those with occupational exposure to animals, and those staying in locations more than 24 hours from access to rabies immune globulin.
Travelers' Diarrhea (TD): Travelers' diarrhea is the most common travel-related ailment. The cornerstone of prevention is food and water precautions: (1) do not drink tap water unless it has been boiled, filtered, or chemically disinfected and (2) do not drink unbottled beverages or drinks with ice. Do not eat raw or undercooked meat or fish, including ceviche. The most important treatment measure for TD is rehydration, best performed with oral rehydration solution available in almost all pharmacies in Brazil.
Tuberculosis: Brazil is a high-burden country for tuberculosis, but short-term travelers are not considered at high risk for infection unless visiting crowded environments such as hospitals, prisons, or homeless shelters. If you are at risk, consult with your health care provider or travel health clinic for possible use of tuberculin skin testing before and after returning from Brazil.
Elective Surgery: Plastic and other elective/cosmetic surgery is a major medical industry in Brazil. While Brazil has many plastic surgery facilities that are on par with those found in the United States, the quality of care varies widely. If you are planning to undergo plastic surgery in Brazil, make sure that emergency medical facilities are available. Some "boutique" plastic surgery operations offer luxurious facilities but are not hospitals and are therefore unable to deal with emergencies.
Non-traditional Medicine: Several U.S. citizens have died while visiting non-traditional healers outside of urban areas. While this is not surprising given that this type of treatment often attracts the terminally ill, U.S. citizens are advised to ensure they have access to proper medical care when visiting such sites.
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