It is not unusual for many travelers to incur mild stomach upsets or even diarrhea. The latter condition tends to diminish as immunity levels are built up and the stomach becomes accustomed to its new diet, in any case drink plenty of fluids to avoid dehydration such as mineral water and soft drinks, avoid milk and caffeine beverages as well as ice in your drinks if possible.

Two excellent websites outlining the major precautions are: www.cdc.gov and www.who.int which are the official sites for the centers of disease control prevention and the World health organization respectively.

Exposure to health risks will vary climatically as well as within Ecuador wildlife and vegetation. For example the lowland tropical provinces house different health hazards in comparison to the high land areas, where the main risks will be more related to water, food or altitude sickness.

Never eat from street vendors stalls due to contamination of the handlers or street pollution from passing vehicles or drink the local water unless you have purification tablets, preferably iodine based.

Use bottled water when possible as the iodine taste can be overpowering. Also, always wash and clean fruits thoroughly before eating as well as your washing and drying your hands on clean hand towels or paper tissues.

Pre-departure health checkups are essential for any major Latin American trip so do check in with your doctor for vaccinations in plenty of time before journeying or even a Latin American specialist if your doctor is not qualified sufficient to help. Today immunizations against smallpox and Cholera are not necessary or recognized even by the World Health Organization.

The major vaccinations recommended for Latin America travel to combat diseases are as follows: Typhoid, Yellow Fever, Malaria, Tetanus, Poliomyelitis, Infectious Hepatitis, & Rabies in the Oriente and jungle areas or other epidemics that may have recently sprung up such as Meningitis

Avoid at all costs street food stalls that is often undercooked or often reheated, namely eggs, meat, fish or uncooked vegetables and salads. Street pollution along with unwanted mosquitos is another thing to watch out for and avoid again mainly street food along with raw foods, also peel your own fruit.

Avoid raw fish as well as shellfish which often have toxins in them causing various types of food poisoning, even when prepared do not drink excessive alcohol as the mixture can also upset the stomach.

Pasteurized cheese and yogurt along with Heat treated milk (UHT) sterilized or pasteurized in cardboard boxes are safe but avoid plastic bagged milk. If you buy the later at least ensure it is boiled.

Buy filtered or bottled water only in Ecuador as it is not safe to drink the local water. If you have to drink the water, boil it first and use also for washing vegetables and fruits if no filtered water is unavailable. Water-purifying tablets are not recommended as the hepatitis virus may remain. If you do buy tablets at least ensure they have iodine solution in them, 4 drops can make a liter of water. Also, avoid iced drinks if possible as this is a further risk to catching disease.

Please note that if you travel to areas higher than Quito, which is 2,850m above sea level you may experience what is locally referred to as "Soroche" (acute altitude sickness). This condition may hit the visitor within hours or take a few days to appear and causes tiredness, headaches, occasional dizziness, some vomiting and often a loss of appetite all due to a lack of oxygen as a result of exertion. This latter condition can be avoided if the visitor ascends and acclimatizes to higher altitudes over 1 or 2 days in preference to ascending 3,000m and over in one day.

To help further in adapting to new heights do try to avoid cigarettes and alcohol and also use deep breathing exercises along with sufficient fluid intake at 4,000m and higher.

It is also very necessary due to large climatic drops over night to bring very warm jackets and sweaters while cotton is the best material to wear in the day time for the heat.

Sunburn

Always use a high S.P.F. sun block minimum 30-50 for face and shoulders S.P.F 15 for the body and a Vaseline in the evening for lips and areas of dryer skin where appropriate. The ultraviolet levels at these heights can literally burn your skin to a crisp. A good hat is also needed when ascending to high levels and is essential to protect the head and further dehydration levels.

For beach bathers the same protection applies but do use sun blocks on your feet to avoid burning, this is often overlooked once shoes are removed and tourists simply forget this area.

To avoid being bitten always purchase a couple of bottles of "DETAN" from the local pharmacy chain Fybeca, who also stock aerosols containing Pyrethrum to spray the rooms you are living or sleeping in. Keep the doors closed for up to two hours before allowing air circulation from other rooms.

If you are bitten badly especially on the feet or in between the toes do avoid scratching as this often amplifies the discomfort further and causes bites to open and repair slower as well as become further infected. Instead try rubbing on calamine or use hydrocortisone cream, if you don't have lotion or cremes try soaking in a bath filled with baking-soda.

Take good care of your hair in while traveling in tropical and jungle areas because lice often frequent body hair and can cause much irritation and rashes to occur, the best shampoo to use is one containing benzene hexachloride. Bedding as well as clothes if required should also use the same treatment in hot water.

Rabies although prevalent in certain areas of Ecuador does not usually exist in the highland (Sierra) but is more common in the Oriente, jungle and coastal areas. A clue into rabid dogs is often their erratic behavior be it wild or domesticated, if you are bitten it is worth seeking medical checks immediately with a local doctor.

The reporting of such animals whether they have rabies or not is always a good idea so the animal can be captured and inspected. Human diploid is today the best vaccination on the market and is also available in most of Ecuador and if you begin a treatment make sure you complete the course at all times.

Malarial Mosquitos do not exist above 2,500m so, if you aren't visiting the coastal lowlands (check on seasonal changes) and the jungles then you will not need to take any measures against Malaria, this applies also to the Galapagos.

If you are in malarial areas always wear long trousers and longer sleeved shirts and ensure you have a mosquito net while you sleep that should be coated in permethrin. The best deterrent against Mosquitos in the day is a repellent called DEET that is stocked by many pharmacies in Ecuador.

It is recommended to begin your anti-malarial course of pills a week before you depart to the jungle or coastal route and continue after your adventure at least 4-6 weeks depending on the type you purchase. It is a good idea to make checks with the locals in Ecuador on the types of malaria prevalent in the area you'll be visiting to ensure you buy the right anti-malarial tablets. If you don't purchase your tablets in your own country, Ecuador offers two effective preventative called Chloroquine (Aralen) and Fansidar. Also look out for newer remedy's including Mefloquine (Larium) and the most recommended type today due to anti-resistant strains and outbreaks of chloroquine malaria along with Proguanil (Paludrine) at most pharmacies and physicians.

Pregnant women should check with their local doctors as their risk is higher in complications through the intake of these drugs. If you do catch Malaria you will need to increase your dosage by up to 4 times, Malaria gives the victims a series of sweats and chills so your temperature will fluctuate widely but is treatable as explained by increasing the level of intake to stave off the condition.

The same clothing, repellent, netting precautions should be followed as with the advice under malaria because Mosquitos transmit this disease also which is prevalent in the jungle (Oriente) and Lowlands of the coast but again if you plan to visit the high lands or Galapagos you do not need to take preventative measures.

Ecuador unlike the rest of South America doesn't require prior to entering the country, the exception is if you are leaving a country that is regarded as a Yellow fever prone area so do check with an Ecuadorian Consulate or Embassy in your country before departure if you have any doubt. For North American visitors the vaccine can be dispensed only in Yellow Fever Vaccine Centers controlled through your health office in the state you reside.

The immunity from Yellow Fever is good for 10 years and though it is far more prevalent in Africa and other South American tropical zones the disease causes fatalities so, ignore this injection at your own peril!, the side effects are very minimal and it is almost 100% effective. An International certificate for Yellow Fever vaccine is always available from your dispensing authority so do make sure you ask for your copy which is often required for presentation in most countries when entering so always have a copy available when you travel.

Typhoid inoculations are very necessary and are effective for 3 years. The newest Brand, Typhin Vi, causes minimal side effects in comparison to the earlier types such as TAB and monovalent typhoid but are more costly.

The vaccine may also be taken orally in 3 or 4 doses and lasts 5 years but must be completed one week before starting the malaria treatment. The Fever is caught normally from unsavory non-sanitary handling of food or drinks and the washing of cups and plates by infected carriers and originates from dirty water such as contaminated sewage or from Salmonella typhi bacterias.

This disease is not common in Ecuador or the rest of the world but is worth guarding against for regular visitors to Ecuador and is effective up to 3 years. The disease is very serious if you become infected so either take in oral form if available in your country or use the injection method if this is all that is available.

Pre-tetanus injections followed by six week boosters are not required anymore to visit Ecuador.

Intestinal worms are frequent in the system when eating foods in other countries, yogurt has live bio-cultures in its make up and is a recommended food to help clear these parasites. The hookworm condition can be caught by not wearing sandals or flip flops on beaches and infested terrain so make sure you don't allow these worms to enmesh and bury themselves into your feet by wearing at least minimum foot protection.

Leptospirosis occurs through bacteria's in the urine of rodents. Be careful if you have suffered any new cuts or scratches. Exposure occurs through either fresh water or moist earth contact.

There is no remedy for this fever but the same procedures for protection as explained under the malaria section apply as this is also carried by Mosquitos, the specific variety is known as Aedes aegypti. Although it is not common in Ecuador (Esmeraldas was the only Province with outbreaks) and totals only 3% In Latin America of the worlds total area, if you catch the fever it may take a full month to recover although signs of recovery are often made after a few days. The main symptoms are body pains through muscular swelling and high temperatures which may be accompanied by pink rashes which spreads to the facial areas. Take plenty of rest and pain killers when appropriate if you catch this disease.

Hepatitis "A" is the most common of the other main types B, C and D which are transmitted sexually through body fluids or unclean medical syringes, contaminated blood or even insects. B and C are also more serious than A and can take a recovery period of up to 6 months in comparison to the former that can last up to 4 weeks unless you're unlucky.

The best remedy is a combination injection covering all possibilities and is available in most country's. To minimize the risks drink only bottled water, avoid salads along with unpeeled fruit or uncooked fruits and always wash your hands while drying them on clean towels or tissues. Also take great care with your toilet practice as this is another major area of hygiene that must be strictly adhered to.

The vaccines are usually good for up to 10 years and if you are traveling to rural areas or even trekking by horse you will be prone to infection so take care. If you have experienced jaundice before take a blood test to check your immunity level to the various vaccinations that are also available in Ecuador in order to take the right vaccine.

The term Yellow Jaundice was given to those who have caught the condition due to the body and whites of the eyes turning yellow as well as making you perpetually tired, also there is no cure. If this occurs seek a good hotel for a few weeks and have high protein foods low in fat served daily to you and take full rest, also avoid alcohol for a minimum of 4 to 6 months, check with your local physician on your monthly progress.