Ecuador

Recommended Vaccinations For Ecuador

For Most Travellers

Hepatitis A Vaccine

There is a significant risk of exposure to hepatitis A for this country, therefore, the vaccination is recommended.

Hepatitis B Vaccine

There is a significant risk of infection with hepatitis B for this country, therefore, the vaccination is recommended.

For Some Travellers

Bacillus Calmette-Guérin (BCG) Vaccine

BCG vaccine is recommended for those at increased risk from coming in close contact with infected persons or for unvaccinated, children under 16 years of age, who are going to live in the country for more than 3 months.

Measles, Mumps, Rubella (MMR) Vaccine

A dose of Measles-mumps-rubella (MMR) vaccine is recommended for infants aged 6 to 11 months.

Rabies Vaccine

Vaccination against rabies is recommended for travellers involved in outdoor activities (e.g., campers, hikers, bikers, adventure travellers, and cavers) who may have direct contact with rabid dogs, bats, and other mammals. Those with occupational risks (such as veterinarians, wildlife professionals, researchers) and long-term travellers and expatriates are at higher risk and should be vaccinated.

Yellow Fever Vaccine

This country requires a yellow fever vaccination certificate for travellers aged 1 year or over arriving from the Democratic Republic of the Congo, Uganda and Brazil, including travellers having transited for more than 12 hours through an airport in the Democratic Republic of the Congo, Uganda and Brazil. However, the vaccination is recommended for all travellers aged 9 months or over going to the following provinces east of the Andes at altitudes below 2300 meters: Morona-Santiago, Napo, Orellana, Pastaza, Sucumbios and Zamora-Chinchipe, and the province west of the cordillera, Esmeraldas. The vaccination is generally not recommended for travellers whose itineraries are limited to the following provinces west of the Andes and at altitudes below 2300 meters: Guayas, Los Rios, Santa Helena, Santo Domingo de los Tsachilas and designated areas of Azuay, Bolivar, Canar, Carchi, Chimborazo, Cotopaxi, El Oro, Imbabura, Loja, Pichincha and Tungurahua. The vaccination is not recommended for travellers whose itineraries are limited to all areas above 2300 meters altitude, the cities of Guayaquil and Quito, and the Galápagos Islands.

Typhoid Fever Vaccine

There is a risk of exposure to typhoid fever in this country through consumption of unsafe food and water. Since exposure to unsafe sources is variable within this country, the vaccination against typhoid fever is generally recommended, especially when visiting smaller cities, rural areas, or staying with friends and family.

Recommended Medications For Ecuador

For Some Travellers

Anti-malarial Drugs

Except for the cities of Guayaquil and Quito and the Galápagos Islands, there is a risk of exposure to malaria at elevations less than 1,500 meters (4,921 ft). Recommended anti-malaria medication includes atovaquone-proguanil, doxycycline, or mefloquine. Anti-malaria drug resistance for chloroquine is present.

Diseases To Be Aware of for Ecuador

For Most Travellers

Chikungunya Fever

Chikungunya fever has occurred in this country.

Hepatitis B

There is a significant risk for acquiring hepatitis B in Ecuador and the Galápagos Islands.

Dengue Fever

Dengue fever outbreaks occur in tropical and semi-tropical areas of Ecuador.

Hepatitis A

There is a significant risk for hepatitis A virus exposure in Ecuador and the Galápagos Islands through contaminated food or water. 

For Some Travellers

West Nile Fever

There is a risk of acquiring West Nile virus in this country.

Leishmaniasis

There is a risk of acquiring Leishmaniasis in this country through sand fly bites.

Hanta Virus

There is a risk of acquiring Hantavirus in this country through the consumption of food and water contaminated by an infected rodent or through rodent bites.

Measles

There is a risk of acquiring Measles in this country.

Zika Fever

There is transmission of the Zika virus in this country.

Malaria

There is a low risk of malaria transmission in areas below 1,500m, including the coastal provinces and Amazon basin. Awareness of risk and bite avoidance is recommended. There is no malaria in the city of Guayaquil and the Galápagos Islands.

Chagas Disease

American trypanosomiasis (“Chagas disease”) can occur in rural Ecuador. The risk of travellers acquiring this disease is low unless staying in very poor quality housing or camping.

Yellow Fever

There is a risk of yellow fever transmission in parts of Ecuador.

Tuberculosis

Travellers to this country are at risk for tuberculosis if visiting sick friends or family, working in the healthcare field, or having close prolonged contact with a sick person.

Typhoid Fever

Unvaccinated people can become infected through contaminated food and water in Ecuador and the Galápagos Islands. The risk is higher when visiting smaller cities, villages, or rural areas where food and water sources may be contaminated.

Rabies

Rabies occurs in this country. Travellers involved in outdoor activities (e.g., campers, hikers, bikers, adventure travellers, and cavers) may have direct contact with rabid dogs, bats, and other mammals. Those with occupational risks (such as veterinarians, wildlife professionals, researchers) and long-term travellers and expatriates are at higher risk.

Safety & Security in Ecuador

Personal Safety

Ecuador has experienced a dramatic security deterioration since 2020. The homicide rate jumped from 6 per 100,000 in 2019 to over 46 per 100,000 in 2023, placing it among the most violent countries in South America. In January 2024, President Daniel Noboa declared an internal armed conflict after gang leaders escaped from prison and armed groups stormed a television studio in Guayaquil. The violence stems from rivalry between criminal organizations fighting for control of drug trafficking routes between Colombia and Peru. Most violence is gang-related and concentrated in coastal provinces like Guayas, Esmeraldas, Los Rios, and El Oro. While tourists are rarely targeted directly, you risk being in the wrong place at the wrong time. Kidnappings have increased significantly since 2022, with both express kidnappings for quick cash extraction and longer detentions occurring. Armed robberies, muggings, and pickpocketing happen daily in major cities. Criminals use distraction techniques like staged fights, requests for assistance, or squirting liquids on you before snatching bags. Motorcycle-mounted thieves grab items at knifepoint or gunpoint. Bank and ATM robberies are common, including violent incidents outside banks. Drug spiking with scopolamine occurs on buses, in nightclubs, and bars. Victims become disoriented and vulnerable to robbery or assault. The government maintains states of emergency in multiple provinces with increased military and police presence, curfews in some areas, and restrictions on movement and assembly. The Galapagos Islands remain exceptionally safe with virtually no crime. Other relatively safer destinations include Cuenca, Banos, and mountain towns, though basic precautions still apply everywhere.

Extreme Violence

Ecuador faces an organized crime crisis driven by transnational drug trafficking organizations. Criminal groups including Los Choneros, Los Lobos, Los Tiguerones, Los Chone Killers, and others battle for territorial control. These gangs collaborate with Colombian, Mexican, Albanian, and Venezuelan criminal networks. Violence escalated dramatically from 2021 onward following the death of Los Choneros leader in 2021, which fractured the organization and triggered warfare between rival factions. Violence methods previously unseen in Ecuador have appeared, including dismemberments, decapitations, car bombings, and bodies displayed with narco messages in public spaces. Since March 2023, organized crime gangs have detonated small explosives and made bomb threats in Quito and Guayaquil. Targets include small businesses, gas stations, government offices, bridges, and ATMs. Prison massacres have killed over 600 inmates since 2019, with the September 2021 Guayaquil prison riot becoming one of the bloodiest in Latin American history. Gang violence extends beyond prisons into streets, markets, roads, and universities. Political figures face extreme danger. Presidential candidate Fernando Villavicencio was assassinated in August 2023. The mayor of Manta was killed in July 2023. Multiple mayors, officials, and judges have been murdered. Armed attacks, hostage-taking, and assassinations of security personnel occur regularly. The January 2024 attacks included the live television studio hostage situation, multiple prison riots, kidnappings of police officers and prison guards, and explosions across multiple cities. The government’s military operations have disrupted some gang activities and led to arrests of leaders, but violence continues with mass killings still occurring in 2025. The conflict has created areas where criminal groups operate with impunity and government control is limited.

Political Unrest

Ecuador experiences frequent demonstrations and protests, often motivated by political and economic factors. Indigenous groups led by the Confederation of Indigenous Nationalities of Ecuador (CONAIE) organize major nationwide mobilizations, particularly over fuel subsidies, mining projects, and economic policies. Previous large-scale protests in 2019 and 2022 involved violent clashes, road blockages, and disruption of essential services. In September 2025, CONAIE called a national strike after the government eliminated diesel subsidies, causing prices to jump from $1.80 to $2.80 per gallon. Protests have resulted in at least one death, over 100 arrests, dozens of injuries, and violent confrontations between demonstrators and security forces. The government declared states of emergency in multiple provinces with curfews imposed in several areas. Security forces have been accused of excessive use of force, arbitrary detentions, and enforced disappearances during protests. International human rights organizations and the UN have expressed concern over the government’s response to demonstrations. Road blockages during protests can occur without prior notice and disrupt access to airports, major highways, and critical infrastructure, sometimes for days or weeks. Protests can turn violent quickly. The government restricts freedom of assembly during states of emergency but does not prohibit peaceful demonstrations. Foreigners participating in political activities or demonstrations face detention and potential deportation. A journalist was deported in 2025 while covering protests. Bank accounts of protest leaders and their legal representatives have been frozen. Criminal proceedings have been opened against protesters and social leaders. While most protests remain peaceful, clashes between demonstrators and security forces, attacks on government convoys, and confrontations between pro-government and opposition groups can occur. Political instability has characterized recent years with impeachment attempts, the dissolution of the National Assembly in 2023, and frequent changes in government.

Areas To Avoid

Avoid all areas within 20 kilometers of the Colombia border except the official border crossing at Tulcan due to high risk of kidnapping, drug trafficking, and armed group activity. Colombian criminal organizations operate in border regions. Do not travel to Esmeraldas city and all areas north of Esmeraldas city due to extremely high violent crime rates. The province recorded 33 homicides per 100,000 residents, tied for the highest in the country. Murder, armed robbery, and gang violence are pervasive. Exercise extreme caution in Guayaquil, particularly south of Portete de Tarqui Avenue. The murder rate is very high, primarily gang-related. The city center, southern parts, and port areas are especially dangerous. Armed robberies, express kidnappings, and violent crime occur daily. The canton of Duran, adjacent to Guayaquil, should be avoided due to rampant gang violence. It ranked among the world’s most violent municipalities with 145 homicides per 100,000 in 2023. Avoid Huaquillas and Arenillas in El Oro province, and Quevedo, Quinsaloma, and Pueblo Viejo in Los Rios province. All have elevated crime driven by drug trafficking and gang activity. The provinces of Sucumbios, Manabi, Santa Elena, and Santo Domingo face increasing violence from transnational criminal groups. Carchi and Orellana provinces near the Colombian border present high risks. In Quito, avoid the neighborhoods of La Marin, La Tola, La Michelina, San Roque, Lucha de los Pobres, La Ferroviaria, Solanda, Chillogallo, and Inaquito. These areas have high rates of pickpocketing, petty theft, and robbery. Avoid Montañita beach town despite its tourist popularity. Serious sexual assaults and attacks against foreign women have been reported there. The 20-kilometer Colombian border zone includes parts of Carchi, Sucumbios, and Esmeraldas provinces. Avoid areas within 2 kilometers of the Peru border in Zamora-Chinchipe due to unmarked minefields. The Galapagos Islands are safe. Cuenca is considered one of Ecuador’s safest cities. Mountain towns like Banos, Otavalo, and areas in the Amazon outside conflict zones remain relatively calm. Coastal regions are generally more dangerous than highland areas.