We are travelling to Peru in about two weeks (will be there for a good chunk of the month of October) We will be three days in the Amazon plus three days borderline (Cock of the Rock lodge near Manu Park) and the rest Lima, coastal south of Lima, Cuzco, Sacred Valley, etc.

We are planning to take Picaridin and perhaps other repellents to apply to the skin but wondering about the need/value of Permethrin treatment for our clothes also. A couple of members of our party are unable to take Malaria meds so will rely totally on repellent for the three days in the Amazon.

Does Permethrin add value for mosquitoes or other pests in Peru? (I hear more about it for Lyme ticks in the US, but I've seen reference to use of it for Africa and South America.)

Never found mozzies a problem in Lima, the costal regions or the sacred valley. For the rain forest I always use 50% deet day and night but even that doesn't prevent all bites. Covering as much as possible is the best option an de making sure ALL exposed areas are sprayed. I failed miserably in my attempts not to get bitten on our last visit!

Tried treating clothes a couple of times and it didn't help much.

We travel a lot in malarial areas so it is just not practical for us to take prophylactics for extended period but having had malaria once, I always carry a treatment course with me. Probably overkill for 3 days as you won't know if you have it until you get back.

I brought those DEET wipe packets this time...and of course the one time I should have used them I didn't. This was in a climate I believe similar to Cock of the Rock lodge (so-called ceja de selva).

The really nasty pests for me are the Lutzomyia sand flies which you find in these areas as well as Machu Picchu. Not only do they cause huge welts if you are allergic, they carry some nasty diseases. Don't assume you need insect repellent only in the tropical jungles. These guys thrive in moist, temperate valleys..not the low jungle.

In the jungle with the mosquitoes I like a head net. You can buy them online at Walmart etc.

Lima and Cusco city should be fine (either high or dry). Once you start getting into coastal areas with marshland nearby I'd be cautious.