Is the Zika virus risk still a serious concern for travelers!
Little has been heard about the Zika virus this past year, but according to the Centers for Disease Control (CDC), there is still a serious Zika virus risk for travelers and residents alike in Mexico, Central America, South America, Africa, Southern Asia, some Pacific islands and the Caribbean.
With summer coming to countries south of the equator, mosquitoes in those countries will tend to peak starting in January 2019. In tropical countries such as those in the Caribbean, the problems of mosquitoes are year round. My Zika Virus post from 2016 still is important.
CDC — 95 countries and territories where visitors face a Zika virus risk.
Currently, the CDC lists a total of 95 countries and territories across the globe where the local population and visitors face Zika virus risk. While Europe, the U.S. (not including territories) and much of Asia have no reported cases of Zika virus through presumed local mosquito-borne infection in 2018, some residents of those areas have contracted Zika while traveling. In the U.S., for example, 41 Zika cases are confirmed, all contracted while the patients were traveling in countries that are at risk for Zika.
It’s been known for some time that the Zika virus was transmitted by the Aedes aegypti and Aedes albopictus mosquitos. In 2016, Brazilian researchers found that the Culex quinquefasciatus mosquito can also carry the Zika virus. That has been confirmed by other researchers. Culex mosquitos are found in tropical and subtropical regions across the globe, as well as in temperate zones.
While Zika is mostly spread by the bite of an infected mosquito, Zika can also be transmitted sexually to partners. Of particular importance to pregnant women and couples attempting to become pregnant, Zika can be passed from a pregnant woman to her fetus. Even the unborn can face Zika virus risk.
No vaccine exists to prevent Zika.
Current CDC research suggests that Guillain-Barré syndrome (GBS) is strongly associated with Zika, however, only a small percentage of those infected with Zika contract GBS. Of particular concern for travelers who are pregnant or who become pregnant while traveling is that Zika infections during pregnancy can cause serious birth defects and is associated with other pregnancy problems. Among the serious birth defects caused by Zika infections during pregnancy are microcephaly, and Congenital Zika Syndrome (CZS). CZS includes damage such as scarring and pigment changes to the back of the eye, and joints with limited range of motion, such as clubfoot.
The CDC states, “It is important to note that babies affected by Zika virus will continue to require specialized care from many types of healthcare providers and caregivers as they age.”
Last year, in a small study presented at the American College of Cardiology Annual Scientific Session, it was reported that eight of the nine Zika infected adults in the study developed dangerous heart rhythm problems and six had evidence of heart failure. Just one of the adults studied had any prior cardiovascular problems.
The study was conducted at the Institute of Tropical Medicine in Caracas, Venezuela. The study’s lead author is Karina Gonzalez Carta, MD, a cardiologist and research fellow at the Mayo Clinic in Rochester, Minnesota. As the study was extremely small, considerable additional research in this area is needed to know if these cases are an aberration or demonstrate that Zika can cause severe heart problems in infected adults.
Take these precautions when planning visits to countries with Zika virus risk.
For travelers planning business or leisure journeys to countries at risk for Zika, there are a number of precautions that can be taken.
• Pregnant travelers or those trying to become pregnant should consider postponing travel to Zika affected areas.
• Male partners of women attempting to become pregnant should also consider postponing travel to Zika affected areas.
If you’re in an area at risk for Zika virus:
• Wear long-sleeved shirts and long pants whenever outdoors. If you pull your socks over your pants legs, it will prevent mosquitoes from going under them.
• Use EPA-registered insect repellents proven safe and effective. The CDC recommends DEET based insect repellents for mosquitoes. Use a repellent with a DEET concentration of 20 percent or more. Concentrations above 50 percent last longer.
Always follow the product’s use instructions and reapply as directed. If using sunscreen, apply the sunscreen before applying the repellent.
• Treat clothing and gear with permethrin-based insect repellents. Don’t use permethrin-based repellents directly on your skin, as they’re only intended to treat clothing.
• When camping, sleep under mosquito netting. Use mosquito netting for sleeping indoors if windows and/or doors without screening are open for ventilation.
At this time, the CDC is updating its warnings and instructions for the prevention of sexually transmitted Zika infection; however, here are the CDC’s current suggestions for sexually active travelers in Zika affected areas:
• Both male and female condoms can reduce the chance of transmitting Zika through sexual contact and should be used during sexual activity. The CDC specifically states, “To be effective, condoms should be used from start to finish, every time during vaginal, anal, and oral sex and the sharing of sex toys.” The CDC also suggests, “Dental dams (latex or polyurethane sheets) may also be used for certain types of oral sex (mouth to vagina or mouth to anus).”
It’s essential that travelers take precautions to prevent infection from mosquito bites, and if sexually active, use proper precautions meant for any sexually transmitted disease.