[Mark]

You're doing great so far. I'll go over the main topics one by one.

Manu
Dos Manos looks like a wonderful agency to explore Manu. Do let us know how it went if you travel with them.


Machu Picchu
Try to go as early as possible. The train will stop in Aguas Calientes. From there you can either hike up the hill or take a bus to Machu Picchu. Tickets to enter Machu Picchu can no longer be bought at the entrance to Machu Picchu itself. You now have to buy the entrance tickets at the Machu Picchu Cultural Centre in Aguas Calientes (10m from the main Plaza, opens at 5:15am) or in Cusco at the Instituto Nacional de Cultura (INC) offices which can be found at Calle San Bernado a few blocks from the main Plaza de Armas). You can find excellent information about getting to Machu Picchu here.


Lake Titicaca
Local, national, and international travel agencies can arrange trips to the floating islands on Lake Titicaca. It seems like you got this covered with Dos Manos.


Pantanal
It is a very long way from Puno (Lake Titicaca) to Cuiaba (Pantanal). The itinerary you're thinking about makes much sense but even so, it's going to take you a week busing the distance.


Vaccinations and Malaria Pills
The vaccinations recommended by your nurse are excellent and you should have them all before you leave, yes.. the anti-diarrhea pills too (better be safe than sorry). Yellow fever is required for Brazil and although I have never been asked for my vaccination card when I entered the country it is a must have vaccination. About malaria pills, I have heard many unpleasant stories about the side effects of malaria pills and I personally chose not to take them on my trip. If you see lots of mosquitoes consider wearing long-sleeved shirts or t-shirts, long trousers and socks, i.e. cover as much skin as possible. Always use insect repellent to avoid mosquito bites. You'll be just fine.

Avoid insect bites
Some serious infectious diseases such as malaria, yellow fever and dengue fever, are transmitted by insect bites. While there are vaccines and drugs available to help protect against some of these diseases, travelers are advised to always protect against mosquito bites. Some tips include:

• Wear mosquito repellent that contains at least 30 per cent DEET.
• Apply repellent, such as permethrin, to your clothes and bedding.
• Wear socks, long pants, and long-sleeve shirts when outdoors.
• Use a bed net.

Eat and drink wisely
The most common travel related illnesses are gastrointestinal diseases usually picked up from poorly prepared foods or untreated water. To avoid the diarrhea, stomach pains, nausea and vomiting associated with these illnesses:

• Use boiled or bottled water, or water purifiers or tablets.
• Avoid ice in drinks.
• Avoid unpasteurized milk and dairy products.
• Avoid fruit and vegetables that have been washed in local water.
• Eat thick-skinned fruit and vegetables that you can peel yourself, such as bananas, oranges and mandarins.
• Make sure food is cooked thoroughly and eat it while it’s hot

Travel Insurance
Play it safe and get travel insurance before you leave. I have partnered with World Nomads. Underwritten by Allianz, World Nomads offers low cost travel insurance in over 44 countries. You can get a free travel quote here.


Cell Phone
You will need an international SIM card. I have partnered with OneSimCard. You can get a 5% discount on your 1st purchase:
Your PROMO Code: MARKVOV100
Price and SIM Card details


Camera
Bring multiple SD cards with you. You can upload your pics in internet café's. Maybe it's not a bad idea to also burn them on a re-writable DVD. You'll then have a back-up copy of all your photos. When I traveled for 18 months I was shooting slides (I still do), when I had about 4 full rolls I would send them to a friend of mine back home. I remember mailing 3-4 rolls from some tiny mountain village in Peru thinking they would never make it. When I came back home I had almost 2000 slides waiting for me.