A certificate is also required from travellers coming from endemic areas. Malaria risk, almost exclusively in the benign vivax form, is moderate in certain municipalities of Caaguaz , Amambay and Canendiy . In the other 13 departments there is a negligible risk.
Bottled water is available and is advised for the first few weeks of the stay.
Drinking water outside main cities and towns is likely to be contaminated and sterilisation is considered essential. Milk is unpasteurised and should be boiled. Powdered or tinned milk is available and is advised, but make sure that it is reconstituted with pure water. Avoid dairy products which are likely to have been made from unboiled milk. Only eat well-cooked meat and fish, preferably served hot.