NOTE: The information provided on this site is not exhaustive. Students should consult the country-specific guides distributed by the program manager and other training materials for more detailed information. Updated November 2017.
QUICK LINKS
Climate
Mosquito-borne Diseases
Potable Water and Hydration
Prescription Medication/Eye Wear, Pharmacies, and Drugstores
Sun Safety
Standard of Care
Vaccinations
QUICK LINKS
Climate
Mosquito-borne Diseases
Potable Water and Hydration
Prescription Medication/Eye Wear, Pharmacies, and Drugstores
Sun Safety
Standard of Care
Vaccinations
CLIMATE
Brazil is a tropical country that straddles the Equator; however, due to its sheer size, the climate can often vary considerably from North to South even during the same season. Because it lies in the Southern Hemisphere, seasons in Brazil are exactly the opposite of those in the Northern Hemisphere: Winter - June 22 to September 21, Spring - September 22 to December 21, Summer - December 22 to March 21, and Autumn - March 22 to June 21. With the exception of traveling to some regions in the South and Southeast in the winter, be prepared for a tropical climate. Summer temperatures in some areas can sometimes climb to as high as 43°C (110°F) accompanied by high humidity but such extremes are the exception rather than the rule. Usually you can expect temperatures in the mid to high 30s°C (85 to 95+°F). |
Be aware of this heat in parts of Brazil, especially if you are going in January! Dress using light clothing that is good for layering, but make sure to carry a sweater or light jacket. You will go from “out of the oven” (street) into a “refrigerator” (air-conditioned rooms) and that can be a big shock to your body.
In the winter, if you are traveling anywhere in the South or Southeast (São Paulo State, Rio State, Minas Gerais State, or Espírito Santo State), be aware that it can sometimes get a little nippy even for North Americans and Europeans who are more accustomed to colder temperatures. While rare, there is an occasional dusting of snow in some areas in the far south of the country during the winter months. Again, pants and a light jacket or sweatshirt may be needed, take layers with you. Also, the houses don’t have heating, so you may have to walk around with your jackets inside. Be sure to check the weather forecast each day and if needed, use a temperature converter to convert Celsius to Fahrenheit. |
MOSQUITO-BORNE DISEASES
CHIKUNGUNYA: Chikungunya is transmitted by a virus-carrying mosquito. About 4-7 days later, the infected person develops a sudden fever and severe joint pain. Pain is especially common in the knees, ankles, small joints (especially in hands and feet) and any previously-injured area. Other common symptoms are a rash and headache. There is no specific cure for the disease. Recovery takes several weeks. There is no vaccine. The only way to prevent Chikungunya is to prevent mosquito bites. Wear long sleeves and long pants and use insect repellent.
CHIKUNGUNYA IN BRAZIL: The Pan American Health Organization (PAHO) has reported more than 60,000 Chikungunya cases in Brazil in 2017. According to the CDC, Chikungunya is under a "Watch" status in Brazil, which means that travelers should practice usual cautions. Read more at the Pan American Health Organization's Chikungunya page.
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DENGUE FEVER: Dengue is a viral disease of the tropics and sub-tropics. It is transmitted by the Aedes aegypti mosquito that bites during the daytime and is found in and around human habitation. Symptoms include high fever, severe headaches, joint and muscle pain. A rash often follows. The acute illness can last up to 10 days, but complete recovery can take 2-4 weeks. Occasionally, a potentially fatal form of dengue called severe dengue (previously known as dengue hemorrhagic fever or DHF) occurs. Severe dengue is mostly seen in persons who have been previously infected with dengue - the fatality rate is about 2.5%. A new vaccine has been developed, although availability is limited. Wear long sleeves and long pants, and use insect repellents to prevent mosquito bites.
DENGUE FEVER IN BRAZIL: Cases have been reported in at least half of Brazil's 27 states. Most cases occur in coastal states in the Northeast and Southeast regions. Particularly affected states include Alagoas, Bahia, Ceará, Minas Gerais, Pernambuco, Rio de Janeiro, and São Paulo. Infections have occurred in central states, including Mato Grosso do Sul and Goiás.The disease appears to be intensifying in Brazil. In 2007, case numbers were markedly elevated over previous years and the outbreak continued throughout the winter. Case numbers have remained elevated since with at least half a million cases reported each year. In December 2015, a dengue vaccine was licensed for use in the country. (From ISOS)
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MALARIA: Malaria is transmitted by mosquitoes that usually bite from dusk to dawn. Symptoms can develop as early as six days or as late as several months after exposure. Early malaria symptoms are flu like, such as head/body aches and generally feeling tired and unwell. Untreated, it can cause complications including anemia, seizures, mental confusion, kidney failure and coma. It can be fatal. Prevention includes mosquito-bite prevention and chemoprophylaxis.
MALARIA IN BRAZIL: Malaria is present year-round in parts of Brazil and chloroquine-resistant P. falciparum malaria is present. To mitigate risk of malaria, prevent mosquito bites and if visiting malarial areas, use a medication to prevent chloroquine-resistant P. falciparum malaria. These include: Atovaquone plus proguanil (Malarone® and generics), Doxycycline (many brands and generics), and Mefloquine (Lariam® and generics). Continue malarial prophylaxis while exposed to malaria. Stopping the medication while still exposed leaves you susceptible again to the dangerous consequences of malaria.
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YELLOW FEVER: Yellow fever is caused by a virus spread through mosquito bites. It only occurs in parts of Africa and South America. The symptoms range from a mild flu-like illness to a severe hemorrhagic fever with organ failure. Yellow fever can be deadly, and there is no treatment. However, it can be prevented via vaccination.
Because yellow fever is very contagious, many countries require travelers to show proof that they have been vaccinated before allowing them to enter. You may be required to show proof of vaccination if: you have recently visited a country in an endemic zone, you are visiting a country that requires travelers to be vaccinated, and/or you are visiting an area with known yellow fever risk. In these cases, a signed and stamped International Certificate of Vaccination or Prophylaxis (ICVP) is required. Consult a travel health professional several weeks before your trip. If you will travel to a country where yellow fever is present: prevent mosquito bites, consider yellow fever vaccination, and understand your home country's regulations. You may need a certificate to return after visiting a country with yellow fever.
YELLOW FEVER IN BRAZIL: Much of Brazil is considered at risk for yellow fever transmission (see the International SOS Map of Areas at Risk for Yellow Fever - ISOS membership number required):
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ZIKA VIRUS: Zika fever is a viral disease, mostly transmitted to people by mosquito bites. Zika can be passed from an infected pregnant mother to her baby and can be spread through sexual contact. Transmission via blood transfusion has occurred. Most people who have Zika do not have any symptoms. If symptoms occur, they are similar to Chikungunya or dengue and include fever, rash, joint and muscle pains or conjunctivitis (red eyes) and typically last up to a week. The virus can cause birth defects and serious neurological complications. There is no specific treatment available and no vaccine to prevent the disease. Prevention occurs by preventing mosquito bites. Sexual transmission is prevented through condom use. Due to risk of severe birth defects, many authorities advise pregnant women against traveling to areas where Zika is circulating.
ZIKA IN BRAZIL: Brazil's government declared an end to its public health emergency over Zika in May 2017. The number of suspected and confirmed cases has decreased greatly since the first six months of 2016; however, the disease is still considered an ongoing risk throughout the country, especially in areas below 6500 feet where the mosquitoes that can spread the virus usually live. Mosquito bite prevention is key and the CDC recommends specific types of insect repellants. Take repellents with you to Brazil (there has been a shortage of insect repellents and they are very expensive). If you are pregnant or are planning on getting pregnant, speak with your doctor and and the MIT-Brazil program about the best way forward.
CHIKUNGUNYA: Chikungunya is transmitted by a virus-carrying mosquito. About 4-7 days later, the infected person develops a sudden fever and severe joint pain. Pain is especially common in the knees, ankles, small joints (especially in hands and feet) and any previously-injured area. Other common symptoms are a rash and headache. There is no specific cure for the disease. Recovery takes several weeks. There is no vaccine. The only way to prevent Chikungunya is to prevent mosquito bites. Wear long sleeves and long pants and use insect repellent.
CHIKUNGUNYA IN BRAZIL: The Pan American Health Organization (PAHO) has reported more than 60,000 Chikungunya cases in Brazil in 2017. According to the CDC, Chikungunya is under a "Watch" status in Brazil, which means that travelers should practice usual cautions. Read more at the Pan American Health Organization's Chikungunya page.
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DENGUE FEVER: Dengue is a viral disease of the tropics and sub-tropics. It is transmitted by the Aedes aegypti mosquito that bites during the daytime and is found in and around human habitation. Symptoms include high fever, severe headaches, joint and muscle pain. A rash often follows. The acute illness can last up to 10 days, but complete recovery can take 2-4 weeks. Occasionally, a potentially fatal form of dengue called severe dengue (previously known as dengue hemorrhagic fever or DHF) occurs. Severe dengue is mostly seen in persons who have been previously infected with dengue - the fatality rate is about 2.5%. A new vaccine has been developed, although availability is limited. Wear long sleeves and long pants, and use insect repellents to prevent mosquito bites.
DENGUE FEVER IN BRAZIL: Cases have been reported in at least half of Brazil's 27 states. Most cases occur in coastal states in the Northeast and Southeast regions. Particularly affected states include Alagoas, Bahia, Ceará, Minas Gerais, Pernambuco, Rio de Janeiro, and São Paulo. Infections have occurred in central states, including Mato Grosso do Sul and Goiás.The disease appears to be intensifying in Brazil. In 2007, case numbers were markedly elevated over previous years and the outbreak continued throughout the winter. Case numbers have remained elevated since with at least half a million cases reported each year. In December 2015, a dengue vaccine was licensed for use in the country. (From ISOS)
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MALARIA: Malaria is transmitted by mosquitoes that usually bite from dusk to dawn. Symptoms can develop as early as six days or as late as several months after exposure. Early malaria symptoms are flu like, such as head/body aches and generally feeling tired and unwell. Untreated, it can cause complications including anemia, seizures, mental confusion, kidney failure and coma. It can be fatal. Prevention includes mosquito-bite prevention and chemoprophylaxis.
MALARIA IN BRAZIL: Malaria is present year-round in parts of Brazil and chloroquine-resistant P. falciparum malaria is present. To mitigate risk of malaria, prevent mosquito bites and if visiting malarial areas, use a medication to prevent chloroquine-resistant P. falciparum malaria. These include: Atovaquone plus proguanil (Malarone® and generics), Doxycycline (many brands and generics), and Mefloquine (Lariam® and generics). Continue malarial prophylaxis while exposed to malaria. Stopping the medication while still exposed leaves you susceptible again to the dangerous consequences of malaria.
- Risk areas: There is a risk of malaria in the Amazonas and the forested regions (<900m) of Amazon Basin, including the states of: Acre, Amapá, Amazônas, Maranhão, Mato Grosso, Para, Rondônia, Roraima and Tocantins. Risk includes urban areas, including cities of: Boa Vista, Cruzeiro do Sul, Cuiabá City, Macapá, Manaus, Marabá, Porto Velho, Rio Branco and Santarém. Low malaria risk exists in the states of: São Paulo, Minas Gerais, Rio de Janeiro and Espírito Santo. There is no risk of malaria in other parts of the country, including Iguaçu Falls and the cities of Rio de Janeiro, São Paulo, and Brasília. (From ISOS)
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YELLOW FEVER: Yellow fever is caused by a virus spread through mosquito bites. It only occurs in parts of Africa and South America. The symptoms range from a mild flu-like illness to a severe hemorrhagic fever with organ failure. Yellow fever can be deadly, and there is no treatment. However, it can be prevented via vaccination.
Because yellow fever is very contagious, many countries require travelers to show proof that they have been vaccinated before allowing them to enter. You may be required to show proof of vaccination if: you have recently visited a country in an endemic zone, you are visiting a country that requires travelers to be vaccinated, and/or you are visiting an area with known yellow fever risk. In these cases, a signed and stamped International Certificate of Vaccination or Prophylaxis (ICVP) is required. Consult a travel health professional several weeks before your trip. If you will travel to a country where yellow fever is present: prevent mosquito bites, consider yellow fever vaccination, and understand your home country's regulations. You may need a certificate to return after visiting a country with yellow fever.
YELLOW FEVER IN BRAZIL: Much of Brazil is considered at risk for yellow fever transmission (see the International SOS Map of Areas at Risk for Yellow Fever - ISOS membership number required):
- All of the states of: Acre, Amapa, Amazonas, Distrito Federal (including the capital city of Brasília), Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Para, Rondônia, Roraima, Tocantins.
- Some areas within the states of: Bahia, Espírito Santo, Parana, Piauí, Rio Grande do Sul, Rio de Janeiro, Santa Catarina, and Sao Paulo state.
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ZIKA VIRUS: Zika fever is a viral disease, mostly transmitted to people by mosquito bites. Zika can be passed from an infected pregnant mother to her baby and can be spread through sexual contact. Transmission via blood transfusion has occurred. Most people who have Zika do not have any symptoms. If symptoms occur, they are similar to Chikungunya or dengue and include fever, rash, joint and muscle pains or conjunctivitis (red eyes) and typically last up to a week. The virus can cause birth defects and serious neurological complications. There is no specific treatment available and no vaccine to prevent the disease. Prevention occurs by preventing mosquito bites. Sexual transmission is prevented through condom use. Due to risk of severe birth defects, many authorities advise pregnant women against traveling to areas where Zika is circulating.
ZIKA IN BRAZIL: Brazil's government declared an end to its public health emergency over Zika in May 2017. The number of suspected and confirmed cases has decreased greatly since the first six months of 2016; however, the disease is still considered an ongoing risk throughout the country, especially in areas below 6500 feet where the mosquitoes that can spread the virus usually live. Mosquito bite prevention is key and the CDC recommends specific types of insect repellants. Take repellents with you to Brazil (there has been a shortage of insect repellents and they are very expensive). If you are pregnant or are planning on getting pregnant, speak with your doctor and and the MIT-Brazil program about the best way forward.
- Sources: Centers for Disease Control and Prevention, International SOS (MIT membership number required), Pan American Health Organization (PAHO)/World Health Organization (WHO), The Atlantic
- Articles of interest: "What Brazil Could Teach US about Zika" (CNN, July 2017) and "How To Fight Zika When Your Country Is In Trouble: Improvise" (NPR, April 2016)
POTABLE WATER AND HYDRATION
It is best to drink only água mineral em garrafa ou copo (bottled mineral water).
Because Brazil is a tropical country, it's very easy to quickly become dehydrated. Brazilian doctors recommend drinking at least two liters of water per day. You should also consider drinking coconut water which is readily available at many beaches and in cities from street vendors as well as restaurants and lanchonetes (snack bars). Coconut water is a natural isotonic beverage with the same electrolytic level as human blood. It contains no cholesterol, is naturally sterile and is full of natural sugars, salts and vitamins to ward off fatigue. It is nature's own 'sports drink' and is better for you than other commercially produced product such as soda.
It is best to drink only água mineral em garrafa ou copo (bottled mineral water).
Because Brazil is a tropical country, it's very easy to quickly become dehydrated. Brazilian doctors recommend drinking at least two liters of water per day. You should also consider drinking coconut water which is readily available at many beaches and in cities from street vendors as well as restaurants and lanchonetes (snack bars). Coconut water is a natural isotonic beverage with the same electrolytic level as human blood. It contains no cholesterol, is naturally sterile and is full of natural sugars, salts and vitamins to ward off fatigue. It is nature's own 'sports drink' and is better for you than other commercially produced product such as soda.
PRESCRIPTION MEDICATIONS/EYE WEAR, PHARMACIES, AND DRUGSTORES
If you need to carry prescription medications with you, be sure that your name, the prescribing doctor's name, the dispensing pharmacy/pharmacist, and other such information is on a sticker attached to the bottle or box of medication or carry your prescription with you. If you do not have the original prescription, carry a xerox copy of your prescription or a note from your doctor. This is to avoid any possibility of running afoul of Brazil's laws.
Since brand names vary, know the generic (chemical) names of your medications. It is always advisable to bring an adequate supply of prescription and other medications from your home country. Check the expiration date on all medications.
If you wear glasses or contacts, it's a good idea to carry a copy of your prescription with you in the event you lose or break a lens. Brazilian opticians have replacement contact lenses and/or can easily make a replacement lens or completely new pair of glasses for you.
Numerous farmácias (pharmacies) or drogarias (drug stores) are located throughout Brazil. Many farmacêuticos (pharmacists) can help you with minor ailments and provide remédios (medicines) that can get you back on your feet. Of course, unless you stumble across an English speaking farmacêutico (pharmacist), this will depend on the level of your Portuguese language skills. Many farmácias (pharmacies) specialize in homeopathic medicines.
Don't confuse farmácias (pharmacies) and drogarias (drug stores). Farmácias (pharmacies) only dispense medicines while drogarias (drug stores) dispense medicines and stock almost every personal toiletry item you may want or need including well known international marcas (brands) such as Colgate, Close Up, Sensodyne, Oral-B, Listerine, Palmolive, Schick, Gilette, Johnson & Johnson, Nivea, L'Oréal, and many others in addition to Brazilian brands.
If you need to carry prescription medications with you, be sure that your name, the prescribing doctor's name, the dispensing pharmacy/pharmacist, and other such information is on a sticker attached to the bottle or box of medication or carry your prescription with you. If you do not have the original prescription, carry a xerox copy of your prescription or a note from your doctor. This is to avoid any possibility of running afoul of Brazil's laws.
Since brand names vary, know the generic (chemical) names of your medications. It is always advisable to bring an adequate supply of prescription and other medications from your home country. Check the expiration date on all medications.
If you wear glasses or contacts, it's a good idea to carry a copy of your prescription with you in the event you lose or break a lens. Brazilian opticians have replacement contact lenses and/or can easily make a replacement lens or completely new pair of glasses for you.
Numerous farmácias (pharmacies) or drogarias (drug stores) are located throughout Brazil. Many farmacêuticos (pharmacists) can help you with minor ailments and provide remédios (medicines) that can get you back on your feet. Of course, unless you stumble across an English speaking farmacêutico (pharmacist), this will depend on the level of your Portuguese language skills. Many farmácias (pharmacies) specialize in homeopathic medicines.
Don't confuse farmácias (pharmacies) and drogarias (drug stores). Farmácias (pharmacies) only dispense medicines while drogarias (drug stores) dispense medicines and stock almost every personal toiletry item you may want or need including well known international marcas (brands) such as Colgate, Close Up, Sensodyne, Oral-B, Listerine, Palmolive, Schick, Gilette, Johnson & Johnson, Nivea, L'Oréal, and many others in addition to Brazilian brands.
STANDARD OF CARE
Remember to call ISOS if you have an emergency and with any questions regarding medical care (including mental health questions). ISOS can help you navigate Brazil's healthcare system, make appointments, and coordinate insurance payments and claims.
Private medical care in São Paulo offer the highest standard of care in Brazil and the most complex cases are referred there. However private facilities in Rio de Janeiro and Salvador also offer an international standard of care with all specialties available. Private facilities generally have more resources, provide a higher level of care and have more English-speaking staff. Many physicians trained or have had post-graduate training in the United States and Canada.
The public health system (SUS) generally offers a lower standard of care. Public hospitals may not be suitable for critical patients and complicated cases due to overcrowding, shortages of staff, supplies and medical equipment and suboptimal infection control practices.
In other larger cities, private facilities and public (university) hospitals offer a variable standard of care. Selection of quality providers is critical. Medical care in rural areas can be quite basic. (From ISOS)
Remember to call ISOS if you have an emergency and with any questions regarding medical care (including mental health questions). ISOS can help you navigate Brazil's healthcare system, make appointments, and coordinate insurance payments and claims.
Private medical care in São Paulo offer the highest standard of care in Brazil and the most complex cases are referred there. However private facilities in Rio de Janeiro and Salvador also offer an international standard of care with all specialties available. Private facilities generally have more resources, provide a higher level of care and have more English-speaking staff. Many physicians trained or have had post-graduate training in the United States and Canada.
The public health system (SUS) generally offers a lower standard of care. Public hospitals may not be suitable for critical patients and complicated cases due to overcrowding, shortages of staff, supplies and medical equipment and suboptimal infection control practices.
In other larger cities, private facilities and public (university) hospitals offer a variable standard of care. Selection of quality providers is critical. Medical care in rural areas can be quite basic. (From ISOS)
SUN SAFETY
If your travel plans include time at the beach (it's also good practice to wear sunscreen daily!), limit your exposure to the sun to recommended time limits and use a protetor solar (sunscreen) of 30 SPF or more. More than a few North American and European tourists have been almost fried on Brazilian beaches. Numerous marcas (brands) of sun block are available at most drogarias (drug stores). Photo at right: the Nivea Doll, made with UV-sensitive material that "burns" in the sun without sunscreen. The Doll was featured in a 2015 Nivea ad produced by the Brazilian agency FCB Brasil. |
VACCINATIONS
As of November 2017, Brazil does not require specific vaccinations to enter the country according to the CDC. The CDC recommends the following vaccination protocol for travelers:
As of November 2017, Brazil does not require specific vaccinations to enter the country according to the CDC. The CDC recommends the following vaccination protocol for travelers:
- All: Make sure you are up-to-date on routine vaccinations (MMR, diphtheria-tetanus-pertussis, varicella (chickenpox), polio, and flu.
- Most: Hepatitis A (can get through contaminated food or water regardless of where you are eating or staying) and Typhoid (can get through contaminated food or water).
- Some: Ask your doctor or visit the MIT Medical's Travel Health Clinic to determine what vaccines and medicines you need based on where you are going and for how long, what you will be doing, and if you are traveling from a country other than the US.
- Hepatitis B: You can get this through sexual contact, contaminated needles, and blood products.
- Rabies: Present in dogs, bats, and or other mammals in Brazil. Students who will work with or around animals (e.g. wildlife researchers) and/or be involved in outdoor and other activities in remote areas should speak with their doctor.
- Malaria: You should avoid mosquito bites to prevent malaria. You may need to take prescription medicine before, during and after your trip to prevent malaria. The schedule depends on where you are going, when you are traveling and if you will spending a lot of time outdoors or will sleep outside.
- Yellow fever: Risk exists in various states and municipalities in Brazil. If your travel plans include areas in the North, Northeast or Center West of the country (specifically, the states of Acre, Amapá, Amazonas, the Federal District of Brasilia, Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Pará, Rondônia, Roraima, and/or Tocantins), a yellow fever vaccination (good for ten years) is advised. If, within the last 90 days, you've traveled in Angola, Bolivia, Benin, Burkina, Cameroon, Colombia, the Congo, Ecuador, French Guyana, Gabon, Ghana, Gambia, Guinea, Liberia, Nigeria, Peru, Sierra Leone, Sudan or Venezuela, you may be asked to provide proof that you've had a yellow fever vaccination. Make sure that you carry a record of your yellow fever immunization. Visit the CDC's alert on Yellow Fever in Brazil for specific information and vaccination recommendations.