Hi - going to Peru in September - visiting Lima, Cusco, Aguas Calientes, and Lake Titicaca....would you get any shots?

Flu and up to date on all your normal immunizatons.

Some recommend Hep A/Hep B and typhoid. Since you are going to Lake Titicaca I might get those. That was the only place I got sick enough to take antibiotics in multiple trips to S/A including to the Amazon.

No need for yellow fever on that itinerary.

I find that taking one or two tabs of PeptoBismol a day keeps tummy upsets to a minimum.

The CDC recommends being up-to-date on Hep B and Tetanus, as well as getting Hep A and typhoid. We got Hep A and already had typhoid immunity from another trip. Better to get them and not have to worry. Be aware that Hep A is a two-part series, so make sure you start that early.

Also recommended to get a prescription filled for Diamox (or the generic equivalent like we did) for altitude sickness. You can use preventatively or as a treatment. (I used as treatment, but husband had no need.) Cipro or another antibiotic is also recommended in the case you catch something really bad (think bloody stool). We had no need for it.

Also agree with mlgb to bring PeptoBismol or similar for any general tummy troubles.

In addition to the good advice above, we take an oral vaccine to prevent tummy trouble caused by e coli - it's called DUK ORAL. You take two doses one week apart before you depart (a liquid you pour into water and drink). We take it and Pepto Bismol while in a region and have never had stomach problems.

CDC recommends Hep A/Hep B and typhoid for all travelers. Also good to be up-to-date with tetanus vaccine. We're hiking Salkantay trail in a month. Since we don't want to risk altitude issues or stomach issues while on the trail, we're going to take Cipro and Diomax preventively.

There has been quite a bit of discussion here (and on other travel boards) about prophylactic use of antibiotics for traveler's tummy....I believe many in the medical community advise against it...certainly our Travel Clinic did when we visited Peru, Asia and Egypt. Following is part of an article (link follows) in American Family Physician

Antibiotic prophylaxis for traveler's diarrhea, always a controversial topic, is now recommended only in specific situations, such as in the seriously immunocompromised patient or the seriously ill patient who would not be able to withstand a diarrheal illness. If antibiotic prophylaxis is used, the antibiotic should only be taken for a three-week period. Other exceptions may include persons who plan short-term critical travel, such as a diplomatic mission, or persons who are unable to practice prevention.

http://www.aafp.org/afp/1999/0701/p119.html

The DUKORAL vaccine I mention above is actually an anti-cholera med that has been found effective for e coli based traveler tummy issues. I'm not sure if it available in the US now, though.

It is not available here and is not on the CDC schedule. "This is because the available vaccines offer incomplete protection for a relatively short period of time."

If you have a severe case it responds to antibiotics and mild cases with just rehydration

The only sure way to get accurate, reliable advice on travel medical issues is to consult a Doctor or clinic specialising in travel medicine. Any information found on these forums, no matter how well meaning, is unlikely to be informed and reliable.

Just because one person has travelled without incident doesn't mean that you will.

One note on Pepto, you cannot take it if you are also taking Diamox. If you need some when in Peru, ask for "Bismutol".

Also bring some Immodium and use it when on a day long excursion. Both are available at pharmacies in Peru, you won't find them on the shelves.

Clearly crellston has no experience with some of the for-profit travel clinics here in the US! They are not known for tailoring advice to specific regions of a country, ie they will try to get travelers to take yellow fever shots (very expensive here) when there is no need. Same with typhoid which is not a routine vaccination in the US.

All of my advice is based on recommendations from my own nonprofit medical provider, Kaiser Permanente.

All my advice is based on what the CDC recommends and also what my primary care provider recommended after doing her own research.

I agree that you should not take Cipro preventatively - there is a big issue with overuse of antibiotics and you run the risk of building up a resistance to it and then catching something worse. Likely you won't need it. Also agree with mlgb on Immodium - husband took it most of the trip.

I also agree not to take Cipro as a preventative. If you have any doubt read the package inserts, the side effects can be extremely serious.

Thanks Everyone!