Standards for hygiene and public health in Brazil are generally high. Before leaving, however, check with your doctor or with the Centers for Disease Control (www.cdc.gov) for specific advisories. Use common sense when eating on the street or in restaurants.
Dengue Fever -- Dengue fever is a viral infection transmitted by mosquitoes. It's unfortunately common in Rio de Janeiro. It's characterized by sudden-onset high fever, severe headaches, joint and muscle pain, nausea/vomiting, and rash. (The rash may not appear until 3-4 days after the fever.) Proper diagnosis requires a blood test. The illness may last up to 10 days, but complete recovery can take 2 to 4 weeks. Dengue is rarely fatal.
The risk for dengue fever is highest during periods of heat and rain, where stagnant pools of water allow mosquitoes to breed. Though it strikes most often in poorer communities, the disease has infiltrated Rio's more affluent neighborhoods. There is no vaccine for dengue fever. Symptoms can be treated with bed rest, fluids, and medications to reduce fever, such as acetaminophen (Tylenol); aspirin should be avoided. The most important precaution a traveler can take is to avoid mosquito bites in dengue-prone areas. Try to remain in well-screened or air-conditioned areas, use mosquito repellents (preferably those containing DEET) on skin and clothing, and sleep with bed nets. For up-to-date information on the status of dengue fever in Brazil, consult the Centers for Disease Control website (www.cdc.gov) before departing.
Sun Exposure -- The Brazilian sun is very strong, particularly in summer (the North American winter, when many travelers from above the Equator can be quite pale). Sunscreen of at least SPF 15 should be applied frequently.
Insect/Animal Bites -- Tourists rarely encounter snakes and are even more rarely bitten. You'll find ticks most everywhere in Brazil, but the only place I considered them a nuisance was hiking in highland areas like the Chapada Diamantina inland from Salvador or the Chapada Guimarães near Cuiabá.
Malaria -- There is malaria endemic to the Amazon or the Pantanal, though it's not very common. Still, a malaria prophylaxis (usually pills that you take daily) may be recommended.
AIDS & STDs -- According to recent UN statistics, Brazil has the dubious honor of ranking third in the world for total number of people with HIV infections. Though condom usage is becoming more accepted -- thanks in part to the examples shown in popular nighttime soaps on TV -- the reality is that some people still won't use them, and AIDS and other STDs are still being spread. So be careful and be safe -- always insist on using a condom. Though condoms are readily available in Brazilian pharmacies, it's best to bring your own; brands are more reliable in North America and Europe. To purchase condoms in Brazil ask for a preservativo or a camisinha (kah-mee-zeen-ya), literally a small shirt; the latter word is the commonly used term for condom.
What to Do If You Get Sick Away from Home
If you worry about getting sick away from home, consider purchasing medical travel insurance. In most cases, however, your existing health plan will provide all the coverage you need. However it is wise to check any conditions and/or limitations on your coverage. Be sure to carry your identification card in your wallet.
Pack prescription medications in your carry-on luggage. Carry written prescriptions in generic, not brand-name, form, and dispense all prescription medications from their original labeled vials. Also bring along copies of your prescriptions in case you lose your pills or run out.
If you do wind up with traveler's tummy or some other ailment (upset stomach, diarrhea, sunburn, or rash), Brazilian pharmacies are a wonder. Each has a licensed pharmacist who is trained to deal with small medical emergencies and can make recommendations for treatment. The service is free and medication is fairly inexpensive. If you take medication that may need replacement while in Brazil, ask your doctor to write out the active ingredients of the prescription, as many drugs are sold under different trade names in Brazil. Many drugs available by prescription only in the U.S. and Canada are available over-the-counter in Brazil. While this is incredibly convenient, the downside is that Brazilians are the world's biggest pill-poppers who will happily "prescribe" drugs for themselves or their relatives or friends at the slightest whiff of sickness.
Contact the International Association for Medical Assistance to Travelers (IAMAT; tel. 716/754-4883 in the U.S. and Canada or 416/652-0137; www.iamat.org). This organization offers tips on travel and health concerns in the countries you'll be visiting, and lists many local English-speaking doctors. When you're abroad, any local consulate can provide a list of area doctors who speak English (though it may be hard to find one with more than a basic knowledge of English, even in larger cities). If you do get sick, you may want to ask the concierge at your hotel to recommend a local doctor -- even his or her own. This will probably yield a better recommendation than any 800 number would. If you can't find a doctor who can help you right away, try the emergency room at the local hospital.
Sometime in the 1980s Brazil began developing a world reputation for violence and crime. Rio especially was seen as the sort of place where walking down the street was openly asking for a mugging. Some of this was pure sensationalism, but there was a good measure of truth as well. Brazil at the time was massively in debt to First World banks, and the combination of crippling interest payments and International Monetary Fund austerity measures left governments at all levels with no money for basics, such as street lighting and police, much less schools and hospitals.
Fortunately, in the early '90s things began to turn around. The debt crisis eased, leaving governments with some discretionary spending, and with the advent of the 1992 World Environment Conference in Rio, Brazilians realized they had a serious image problem on their hands. Governments began putting money back into basic services, starting with policing. Cops were stationed on city streets, on public beaches, and anywhere else there seemed to be a problem. At the same time governments began working on extending water and sanitation to some of the city's poorer residents in the favelas (shantytowns).
The long expansion that followed made massive new investments in tourism infrastructure feasible. Many cities got brand-new airports. A domestic tourism boom ensued, making the protection of tourists even more of a political imperative. Nowadays, though still not perfect by any means, Rio, São Paulo, and Brazil's other big cities have bounced back to the point where they're as safe as some large international cities.
Statistically, of course, Rio and other big Brazilian cities still have very high crime rates, including high rates of violent crime. Most of that crime, however, takes place in the favelas and shantytowns of the far-off industrial outskirts. Brazil is a highly unequal society and the burden of crime and violence falls disproportionately (and unfairly) on the country's poor. But unless you go wandering unaccompanied into a hillside favela (not recommended), you're unlikely to be affected.
That said, in large centers such as São Paulo, Rio, Salvador, and Recife, common-sense rules still apply. Don't flash your valuables. Diamond rings and Rolex wristwatches are a no-no. Always have a few small bills ready in your pocket or bag to avoid pulling out your wallet in public places. Plan your sightseeing trips to the city's central core during office hours when there are lots of people about. By all means bring your camera or video camera, but keep it inside a backpack or purse, and only take it out when you want to use it. Don't stroll Copacabana beach at 3am with R$1,000 in your pocket and a video camera pressed to your eyeball (a true story, alas). And though public transit is safe during the day and evening, watch for pickpockets when it gets really packed, and come nightfall, use taxis instead. Be careful at night; stick to the main streets where there is traffic and other pedestrians, and avoid dark alleys or deserted streets.
Perhaps even more importantly, keep your wits about you in traffic! Brazilian drivers (with a few exceptions) show no respect for pedestrians and there's no such thing as pedestrian right of way. So be very careful when crossing the street, particularly at night when drivers will often run red lights. Also pay special attention when crossing one-way streets; many drivers, especially those who drive motorcycles or delivery bicycles, think that the one-way rule does not apply to them and will happily go the wrong way.
Note: This information was accurate when it was published, but can change without notice. Please be sure to confirm all rates and details directly with the companies in question before planning your trip.