Travel Guard Health Advisory Zika

The head of the World Health Organization has indicated that the Zika virus is now a global emergency. The virus is moving rapidly and can be found throughout the Americas - from Argentina to the Southern U.S.

On January 15, 2016, The Center for Disease Control and Prevention (CDC) issued a travel alert for Mexico, Central America, South America, the Caribbean and the Pacific Islands as a result of an outbreak of the Zika virus. On January 16, 2016, health officials in Hawaii confirmed the first known instance of a Zika virus infection within the U.S. Since, then, cases have been confirmed in Florida, Illinois and Texas. The Zika virus is spread by a mosquito, tick, or a flea. Given their proximity and the monthly flow of people across these countries’ borders, it seems very likely that the means of introduction was infected travelers.

Zika is a mosquito-borne virus with symptoms that could include rashes, fever, headaches, pain behind the eyes, and joint pain. The illness and its symptoms are "usually mild," according to the CDC, and about one in five people infected will develop symptoms. As a result, Zika often goes undiagnosed and people infected may not seek medical care. Also, as of February 2, 2016, the CDC has confirmed test results that show Zika could be sexually transmitted. The CDC is doing more research to provide guidance; especially for the "male sexual partners of women who are or may be pregnant."

The urgency of this outbreak is not entirely from the severity of symptoms, but from the fact that Zika can be spread from a pregnant woman to her unborn baby and has been linked to birth defects, such as, microcephaly—smaller-than-normal head size—in infants.

The virus had never before been detected in the Americas – until now it had only been identified in Africa, Asia, and, most recently, the Pacific islands and Cape Verde. Currently, the two Pacific Islands where Zika virus infections are occurring in Samoa and Tonga, prompting the Australian Department of Foreign Affairs and Trade to advise travelers, and particularly pregnant women, consider postponing travel to both Tonga and Samoa.

Brazil is seen as the epicenter of outbreak with over 1.5 million infections. As a result, athletes and tourists planning to travel to Brazil for the upcoming Olympics in Rio de Janeiro are being told to continue to monitor the situation.

There is also evidence that Zika virus infections may be followed by a neurological disorder called Guillain-Barre syndrome, which is characterized by ascending paralysis, starting in the feet and legs and rising upwards. In severe cases, the muscles used for breathing become weak and the person has to be placed on a ventilator for respiratory support. In most cases, the person gradually recovers his or her strength over a period of weeks to months, but the recovery may not be complete.

The evidence linking Zika to Guillain-Barre syndrome is not as definitive as that for microcephaly, and the number of cases is not as large, so the CDC has not issued a warning against travel to these countries for those who are not pregnant. However, this is still a cause for concern.

There is no vaccine to prevent Zika. Therefore, the CDC advises travelers to protect themselves from mosquito bites by taking the following precautions:

• Wearing long-sleeved shirts and long pants.
• Use EPA-registered insect repellents as directed.
• Pregnant and breastfeeding women can use all EPA-registered insect repellents, including DEET, according to the product label.
• Most repellents, including DEET, can be used on children aged >2 months.
• Use permethrin-treated clothing and gear, such as boots, pants, socks and tents. (Clothing, shoes, bed nets and camping gear can be treated with a pesticide called permethrin to kill or repel insects such as mosquitoes and ticks) You can buy pre-treated clothing and gear or treat them yourself.
• Stay and sleep in screened-in or air-conditioned rooms.

• Please note, there is no specific medical treatment for Zika.
• Talk to your doctor or nurse if you develop a fever with a rash, joint pain or red eyes. Tell him/her about your recent travel.
• Your doctor or healthcare professional may recommend taking medicine, such as acetaminophen or paracetamol, to relieve fever and pain. Do not take aspirin, products containing aspirin, or other nonsteroidal anti­-inflammatory drugs such as ibuprofen.
• Your doctor or healthcare professional may likely recommend getting plenty of rest and drinking of liquids.

Consider postponing travel to any area where Zika virus transmission is ongoing: American Samoa, Barbados, Brazil, Bolivia, Cape Verde, Colombia, Costa Rica, Curacao, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Nicaragua, Panama, Paraguay, Puerto Rico, Saint Martin, Samoa, Suriname, U.S. Virgin Islands and Venezuela.