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Brazil

South America · South America· Physician brief

Major dengue activity ongoing

Brazil declared a national dengue emergency in 2024 and case numbers have remained elevated through 2025–2026. Risk is highest in urban areas and during the rainy season (December–May). Strict daytime mosquito protection is essential for every traveler, including those visiting cities with no malaria risk.

PAHO — Pan American Health Organization ↗

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Level 1 - Oropouche in the Americas

Areas in several countries are reporting a low number of cases of Oropouche. Oropouche is spread primarily through the bites of infected midges (small flies) and mosquitoes. Country List : Brazil, Peru, Cuba, Panama

CDC Travel Health Notices · Sep 18, 2025

Malaria

Moderate

Dengue

High

Yellow fever

Recommended

Chikungunya

High

Vaccines

VaccineRecommendationReference
Routine vaccines

Make sure you are up-to-date on all routine vaccines before every trip — per the Swiss BAG schedule. These include:

BAG Impfplan
Chikungunya

The IXCHIQ vaccine can be considered in case of an active local outbreak or for travelers heading to high-incidence regions for extended stays. Not routine for short tourist visits.

—
Dengue

Qdenga is recommended only for travelers with a prior confirmed dengue infection who are travelling to high-transmission regions. Two doses, 3 months apart. Not for first-time visitors — primary infection after vaccination can be more severe.

—
Hepatitis A

Recommended for all travelers to Brazil. Two doses 6–12 months apart give long-term protection; a single dose covers the trip.

CDC Yellow Book
Hepatitis B

Consider for travelers who may receive medical or dental care, get tattoos or piercings, have new sexual contacts, or stay >4 weeks. Already part of routine Swiss childhood vaccination since 2019 — most younger travelers are likely already protected.

CDC Yellow Book
Rabies

Pre-exposure recommended for long stays, cyclists, motorcyclists, hikers in remote areas, young children, animal workers, and cavers (significant bat exposure in some regions). Pre-exposure simplifies post-bite management — only 2 vaccine doses needed afterwards, and immunoglobulin is not required.

CDC Yellow Book
Typhoid

Recommended for long-stay travelers, those visiting friends and relatives, off-the-beaten-track itineraries, and travelers with reduced gastric acidity. Less essential for short stays in tourist hubs.

CDC Yellow Book
Yellow fever

Per the Swiss Expert Committee (EKRM/ECTM), yellow fever vaccination should be considered for ALL regions of Brazil — not only the historical risk zones — given continued geographic expansion since 2016. A single dose provides lifelong protection. Must be given at least 10 days before travel at an authorized Swiss YF center. Live vaccine: contraindicated in immunosuppressed patients, pregnant women, and adults >60 starting a primary series (specialist consultation required for these groups).

CDC Yellow Book

Disease-specific guidance

Malaria

Moderate

Plasmodium vivax predominates in Brazil (unusual compared to Africa where P. falciparum dominates), with falciparum more frequent in parts of the Amazon. Risk is highly geographic: high in Amazon basin areas, none in the major tourist cities (Rio, São Paulo, Brasília, Iguaçu Falls). Itinerary — not the country itself — determines whether prophylaxis is needed.

High risk
Amazon: parts of Acre, Amapá, Amazonas, Roraima; NE/SW Pará
Moderate
Parts of Amapá, Rondônia, W Pará, W Mato Grosso; Manaus, Boa Vista, Porto Velho
Low risk
Rest of Amazon states, Pantanal, rural NE forests
No risk
Brasília, Rio, São Paulo, Recife, Salvador, Fortaleza, Iguaçu Falls
Predominant species
P. vivax (most areas)
Prophylaxis
AP or doxycycline for high-risk Amazon
Standby treatment
Consider for moderate-risk regions
Malaria risk areas in Brasil (CDC).

Yellow fever

Recommended

Yellow fever is endemic across most of Brazil, with circulation expanding since 2016 to areas previously declared free — including São Paulo and Rio de Janeiro. The Swiss Expert Committee (EKRM/ECTM) now recommends considering vaccination for ALL of Brazil, beyond the WHO's regional list. No entry certificate is required; the rationale is medical protection.

Vaccine
Single dose, lifelong protection
Timing
≥10 days before travel
Where to get it
Authorized Swiss YF centers only
Entry rule
Not required
Swiss recommendation
Consider for ALL regions
Iguaçu Falls
Vaccination advised

Dengue

High

Dengue is hyperendemic across Brazil, with year-round transmission and large outbreaks during the rainy season (December–May). 2024 saw the largest outbreak on record, with elevated transmission continuing through 2026. All four serotypes circulate. Daytime mosquito protection is essential for every traveler, including those staying only in cities with no malaria risk.

Transmission
Year-round, all of Brazil
Peak season
December–May (rainy)
Vector
Aedes aegypti — daytime biter
Serotypes
All 4 circulating
Vaccine (Qdenga)
Only if previously infected

Chikungunya

High

Chikungunya is endemic in Brazil with periodic outbreaks, particularly in the Northeast and Southeast. Same Aedes mosquito vector as dengue, so the same daytime protection applies. Joint pain can persist for months after acute infection. The IXCHIQ vaccine is considered for outbreak settings or extended high-risk stays.

General prevention

Food & water

Standard food and water precautions, particularly outside major cities and resort areas. Bottled or filtered water for drinking and brushing teeth, especially in the Amazon and rural northeast. Street food in tourist hubs is generally safer than in remote regions.

Mosquito protection

Strict mosquito-bite prevention is essential. Brazil has year-round transmission of dengue, Zika, and chikungunya in addition to malaria in Amazonian regions. Daytime-biting Aedes mosquitoes (dengue, Zika, chikungunya) demand daytime protection; Anopheles (malaria) bite from dusk into the night. DEET 30%+ or picaridin 20%, long sleeves at peaks, screened or air-conditioned accommodation.

Sources

Based on CDC Travelers’ Health, CDC Yellow Book, and the Swiss Federal Vaccination Schedule (BAG). Always verify current recommendations before travel.

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This brief is for informational purposes and does not replace personalized medical advice.
Consult a travel medicine specialist 4–8 weeks before departure.