Do I need to take antimalarials if I am visiting Lima, Cusco and Machu Picchu in Peru?
No, you don’t need Malarials. Lima can get damp, and the sea mist looks good from the top of the cliffs at Miraflores, but it’s cool damp, not mossie country. Machu Picchu and Cusco are 11-12 000 feet up. The thousand foot difference makes an hour difference coming and going in the train time from Cusco to Aguas Callientes below Machu Picchu. It’s well above where mosquitoes fly, on the Andean Altiplano. A brilliant place to stay after Lima, to aclimatise before going to Cusco, is Arequipa, at around 75oo feet. It’s got the most beautiful town square I’ve ever seen (been to Venice, Rome, Trieste, Vienna, all that stuff), a fabulous monastry so big it’s got named streets inside, the huge volcano Misti, and the incredible Colca Canyon where Condors fly, a bus ride away. Fly from Lima, then fly from Arequipa to Cusco, which is the finest and most exhilirating flight I’ve ever done. Buy the tickets from a travel agent in Lima for less than half the cost of buying from UK or USA agents. It’
