How long will it take us to acclimatize to the altitude in Cusco before we can comfortably participate in hiking or other activities?
The altitude in Cusco is 3400M/11,200' above sea level. Flights from Lima, take about 1 hour and do not allow any time for adaptation to the altitude. It is recommended that visitors arriving in Cusco allow at least 2 days before starting hikes or other strenuous activities. Fitness does not appear to be a factor in altitude sickness and surprisingly, those over the age of 50, have a slightly lower rate of sickness. We offer walking tours and traditional sightseeing activities on the first two days after your arrival, with flexible schedules & additional time for activities.
Machu Picchu is located at a lower elevation, (8000') and by the time you arrive there, you will be adapted to the altitude.
Visitors to Cusco can expect to feel at least minor symptoms of altitude sickness. Headaches, slight nausea, breathlessness & lethargy are common. To alleviate discomfort, drink plenty of water, avoid alcohol and take OTC pain relievers as needed. Local remedies include coca leaf tea and supplemental oxygen. Many hotels have a tea bar in the lobby as well as an oxygen tank. It is best to have a flexible schedule the first day of your arrival. Traveling companions should discuss their symptoms with each other and by the second day, everyone should be feeling a little better. If symptoms become worse, you should tell your companions and guide. Adios guides are trained to seek medical attention in some circumstances. Hotel staff can contact local medical professionals who can assess anyone whose symptoms do not improve within 24 hours. Some travelers think it's better to go to the lower elevation (9000 ft) of Sacred Valley to reduce symtoms of altitude. We have not been able to prove there is an advantage. The trade off is longer travel time (1-2 hours) and limited infrastructure without public transportation. We recommend arriving in Cusco and going straight to your hotel.
Travelers may discuss the option of a prescription for Diamox with their physicians and carry it with them, just in case. Sometimes it works. Sometimes it doesn't.
For US travelers, find a medical travel clinic near you for up to date medical alerts and information about vaccinations.
How will we carry all our luggage on the train to Aguas Calientes on our way to visit Machu Picchu?
Visitors to Machu Picchu do not take all their luggage when they leave their hotel in Cusco or Sacred Valley. Your main luggage remains at your hotel where it will be stored in a locked room. All hotels in Cusco & Sacred Valley have secure storage rooms for luggage. You will pack enough for a weekend in your daypack or carryon to take to Machu Picchu. Because the train does not have baggage cars, each traveler must carry their bag on board with them and store behind or under their seats. For this reason, it is not practical, nor is it allowed by Perurail, to carry all your luggage on the train. Aguas Calientes does not have cars, taxis or pedicabs. All luggage must be hand carried to your hotel. Our guides will assist you with your carryons if needed. If you're hiking the 1-day Inca Trail, you will need to pack everything for the hike and the overnight in your backpack. If needed, we can arrange for a porter to transport 1 small carryon size bag per group by train and deliver to your hotel in Aguas Calientes for $80 USD. Belmond Sanctuary Lodge is $90 USD per group.
Do we need shots or visas to visit Ecuador, Bolivia or Peru?
No special vaccinations are needed to visit Machu Picchu, Lima, Cusco, Lake Titicaca or Arequipa in Peru. No special vaccinations are needed to visit Quito, Otavalo, Cotopaxi National Park, Mindo, Guayaquil or Galapagos Islands in Ecuador. And no special vaccinations are needed to visit Uyuni Salt Flats. However, it is recommended that you check in with your physician before you travel to discuss your individual needs. Zika virus is not an issue for travelers to elevations over 6500 feet, including Machu Picchu, Lake Titicaca and Bolivia Salt Flats.
Yellow Fever vaccination is recommended and even required to visit some places in the Amazon jungle. Iquitos, Manu Biosphere Reserve and Puerto Maldonado in Peru are places where the YF vax is recommended. And in Bolivia, it is required to have the YF vax to travel in the jungle/lower elevations. You should travel with the medical documents provided at the time you receive the vaccination service. The Center for Disease Control in the US maintains an up to date travelers website to answer common medical and health questions about travel anywhere in the world. For travelers who plan to continue to other countries including places like Brazil and Costa Rica, proof of YF vaccination may be required if you are coming from Peru regardless of where you visited while there. Some countries including Canada and Australia, require YF vaccination for travel to Peru, no matter what elevation you are visiting.
Canadian and US passport holders do not need visas to visit Peru or Ecuador. US citizens do need a visa to visit Bolivia. At the time of this writing, it was possible to get the visa at the border upon arrival. All others should check with their embassy. We provide this great link to the embassy of every country located in Peru.
Is it safe to drink the water and eat the food?
We recommend that everyone traveling to South America drink only bottled water. And we support Travelers Against Plastic, who advise all travelers to purify their own water while traveling. Water quality varies from city to city and although water coming from the tap may be clean, it could contain micro-organisms that you have never been exposed to. To be safe, drink & brush your teeth with purified water. Bottled water is cheap & available everywhere, but generates waste from single use plastic bottles. Please consider bringing a purification device to make your own drinking water.
All our tours are escorted by Adios guides who steer travelers to restaurants and food establishments that maintain good food-handling practices. Street vendor food may be safe to eat in some circumstances and guides will help you assess foods from sources other than restaurants. Tip: fresh fruits are served at most breakfast buffets. Fresh Papaya fruit & juice is known to have a laxative affect. A little goes a long way.
In the main tourist areas of Quito, Guayaquil, in Ecuador and Cusco & Aguas Calientes in Peru, it is not uncommon for restaurant employees to stand outside and offer special deals to attract customers. It is advisable to scrutinize any deal as you would in any country. Know what you're getting and how much it costs before you place your order. While most offers are legitimate, you may be getting what you pay for. A mediocre meal.