- Requirements: None
- Recommended for all travelers ≥9 months of age going to the following areas: the entire states of Acre, Amapá, Amazonas, Distrito Federal (including the capital city of Brasília), Espirito Santo,* Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Paraná,* Rio de Janeiro (including the city of Rio de Janeiro and all coastal islands),* Rio Grande do Sul,* Rondonia, Roraima, Santa Catarina,* São Paulo (including the city of São Paulo and all coastal islands),* and Tocantins and designated areas (Map 2-5) of the following states: Bahia* and Piauí. Vaccination is also recommended for travelers visiting Iguaçu Falls.
- Not recommended for travelers whose itineraries are limited to areas not listed above, including the cities of Fortaleza and Recife (Map 2-5).
- *Note: In 2017, CDC expanded YF vaccination recommendations for travelers to Brazil in response to a large YF outbreak in multiple eastern states. A list of areas in Bahia state for which vaccination is now recommended can be found at www.who.int/ith/ith-country-list.pdf. The expanded YF vaccination recommendations for these states are preliminary. For updates, refer to the CDC Travelers’ Health website at www.cdc.gov/travel.
- Areas with malaria: All areas of the states of Acre, Amapá, Amazonas, Rondonia, and Roraima. Also present in the states of Maranhão, Mato Grosso, and Para, but rare cases in their capital cities. Rare cases in the rural areas of the states of Espirito Santo, Goiás, Mato Grosso do Sul, Piauí, and Tocantins. Rare cases in the rural forested areas of the states of Rio de Janeiro and São Paolo. No malaria in the cities of Brasilia, Rio de Janeiro, São Paolo, and none at Iguaçu Falls (Map 2-6).
- Drug resistance 3: Chloroquine.
- Malaria species: P. vivax 85%, P. falciparum 15%.
- Recommended chemoprophylaxis: States of Acre, Amapá, Amazonas, Rondonia, and Roraima. States of Maranhão, Mato Grosso, and Para (but not their capital cities): Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine. 4 Areas with rare cases: None (practice mosquito avoidance).