World Country Guide

1
A yellow fever vaccination certificate is required from travellers over one year of age arriving from infected areas. The last outbreaks of yellow fever were in September 2004, when one person died in the municipality of Sucre, Merida State. Sporadic cases are, however, under control due to a countrywide vaccination and surveillance programme.

2
Cases of autochthonous cholera were reported in 1996. Visitors are advised to take necessary precautions. Up-to-date advice should be sought before deciding whether these precautions should include vaccination as medical opinion is divided over its effectiveness. See the Health appendix for more information.

3
Vaccination against typhoid is advised.

4
Malaria risk in the benign vivax form exists throughout the year in some rural areas of Apure, Amazonas, Barinas, Bolvar, Sucre and Tchira states. The malignant falciparum form is restricted to certain jungle areas of Amazonas (Atabapo), Bolvar (Cedeo, Gran Sabana, Raul Leoni, Sifontes and Sucre) and Delta Amacuro (Antonia Diaz, Casacoima and Pedernales) states and is reported to be highly resistant to chloroquine in the interior of Amazonas state. The recommended prophylaxis is chloroquine in vivax risk areas and mefloquine in falciparum risk areas.

Food & drink
Mains water is not drinkable and should be boiled or filtered. Bottled water is available and is advised for the first few weeks of the stay. Drinking water outside main cities and towns may be contaminated and sterilisation is advisable. Milk is pasteurised and dairy products are safe for consumption. Local meat, poultry, seafood, fruit and vegetables are generally considered safe to eat.

Other risks
Bilharzia (schistosomiasis) is present in north-central Venezuela. Avoid swimming and paddling in fresh water; swimming pools that are well chlorinated and maintained are safe. Paragonimiasis (oriental lung fluke) and dengue fever have been reported. Hepatitis A also occurs; hepatitis B and D (delta hepatitis) are highly endemic. Cutaneous and mucocutaneous leishmaniasis occur in rural areas. Visceral leishmaniasis is rarer. In the southeast, some deaths have been caused by mercury in the river water. Dengue fever is increasingly common and there are epidemics of viral encephalitis at times.
Rabies has been reported. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. For more information, consult the Health appendix.

Health care
The best-equipped hospitals are in the state capitals. Emergency treatment is free and most hospitals have intensive care units. However, private hospitals are of a much higher standard, and although health insurance is not mandatory, it is recommended.