Ecuador, Including the GaláPagos Islands
- Requirements: Required if traveling from a country with risk of YF virus transmission and ≥1 year of age. 1
- Recommended for all travelers ≥9 months of age traveling to areas <2,300 m (7,546 ft) in elevation in the following provinces east of the Andes Mountains: Morona Santiago, Napo, Orellana, Pastaza, Sucumbios, and Zamora-Chinchipe (Map 2-11).
- Generally not recommended for travelers whose itineraries are limited to areas <2,300 m (7,546 ft) in elevation in the following provinces west of the Andes mountains: Esmeraldas,* Guayas, Los Rios, Santa Elena, Santo Domingo de los Tsachilas, and designated areas of Azuay, Bolivar, Canar, Carchi, Chimborazo, Cotopaxi, El Oro, Imbabura, Loja, Pichincha, and Tungurahua (Map 2-11).
- Not recommended for travelers whose itineraries are limited to all areas >2,300 m (7,546 ft) in elevation, the cities of Guayaquil and Quito, or the Galápagos Islands (Map 2-11).
- *The CDC vaccination recommendation for Esmeraldas Province differs from that published on the WHO International Travel and Health website.
- Areas with malaria: Areas at altitudes <1,500 m (4,921 ft) in the provinces of Carchi, Esmeraldas, Morona Santiago, Orellana, and Pastaza. Rare cases in other provinces in areas <1,500 m (4,921 ft). Not present in the cities of Guayaquil and Quito or the Galápagos Islands (Map 2-12).
- Drug resistance 3: Chloroquine.
- Malaria species: P. vivax 72%, P. falciparum 28%.
- Recommended chemoprophylaxis: Areas with malaria in Carchi, Esmeraldas, Morona Santiago, Orellana, and Pastaza Provinces: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine. 4 Other areas with rare cases of malaria: None (practice mosquito avoidance).