On a recent trip to Southeast Asia, I saw signs warning about Zika transmission and realized that it had been over a year since I had heard about the virus. And though a lot has changed since the Zika outbreak in 2015-16, Zika is still a concern for some travelers.
After interviewing medical professionals and researching Zika on the CDC’s website, I think this underreporting is the result of zero reported cases of mosquito-bite transmission of Zika in the continental U.S. in 2018. Even Puerto Rico, while it still has the Zika virus, has seen a drop in cases. Because of this decline, Zika has largely gone unreported in 2018 for North Americans.
What’s Changed with Zika Since 2015-16?
As of March 2019, the CDC has downgraded its travel restrictions and recommends that pregnant women (or those planning on getting pregnant) do not travel to areas where there is an active outbreak of Zika. Right now that is only one area, the state of Rajasthan in India. With the new labeling system by the CDC, you can tell if a country has a current Zika outbreak, has ever reported Zika cases (past or current), has a low likelihood of Zika infection because of high elevation, has a mosquito type that carries Zika but no Zika cases, or has no mosquitos that spread Zika.
Check out the map on the CDC’s website to see where the virus has been active or search for specific destinations.
“Based on research, the CDC has updated the recommendations for men [who] have traveled to Zika-infected areas and may have been exposed to the virus. This includes being [bitten] by an infected mosquito or having sexual relations with someone who is infected with Zika or lives in a high-risk area. It was previously recommended that these men wait six months before having unprotected sex or trying to conceive. That number has dropped down to three months. Research has shown that the virus does not live as long in semen as previously thought. However, if that man’s partner is pregnant, the recommendation is to still use protection for the entire pregnancy. For women the recommendation is still to wait two months before trying to conceive if you have traveled to a high-risk area,” says Nadeen White, M.D. Physician, and travel blogger.
According to Tulia Marcolongo, the Executive Director of IAMAT (International Association for Medical Assistance to Travellers), “The recent decline in cases is believed to be associated in part with increased mosquito control in countries at risk … Most people who become infected with Zika virus do not show signs or symptoms, so they do not know if they are carrying the virus. Reliable reporting and monitoring systems that track virus transmission also may not be available in some countries. As a result, the virus can still be a risk at your destination if there is no evidence that transmission of the virus has been interrupted.” This possibility of underdetection makes the overall risk and risk of travel to certain areas difficult to assess, especially for pregnant travelers.
I Have Travel Plans to an Area That Had/Has Reported Zika Cases …
If you’re healthy, then there is no reason for you to avoid travel to a destination that at one point in time reported local transmission of Zika. However, it’s recommended that you take certain precautions, like mosquito-bite prevention and having protected sex, both during and after your travels. There is currently no vaccine or medication for the virus, so mosquito-bite prevention is key. Using EPA-registered insect repellents, covering exposed skin, wearing light-colored clothing, sleeping inside or in screened-in rooms, and wearing pre-treated clothing and gear can help prevent bites. Read full information on traveling and Zika here.
If you are trying to get pregnant, or your partner is trying to get pregnant, then you may want to reconsider travel because of the virus’ link to birth defects and complications. The CDC says, “Pregnant women and couples planning a pregnancy within the next three months consult with a health care provider in making this decision.” On the pregnant traveler’s section of the website, it says, “We do not have accurate information on the current level of risk in specific areas. The large outbreak in the Americas is over, but Zika is and will continue to be a potential risk in many countries in the Americas and around the world.” Read full information on Zika and pregnancy here.
In a recent Washington Post article, Albert Ko, an infectious disease expert at the Yale School of Public Health who is studying Zika, says, “The virus is still circulating in Southeast Asia and South Asia, but large numbers of new infections and Zika-related birth defects are not being reported.”
You can purchase travel insurance with a “cancel for any reason” clause so you’re protected if more information comes to light or you change your mind about your trip.
If you’re thinking about becoming pregnant outside of the time frame suggested by the CDC (two to three months depending on your situation) after exposure to a Zika-carrying mosquito, then there is reassuring information from the CDC: “Current evidence suggests that Zika infection prior to pregnancy would not pose a risk of birth defects to a future pregnancy. From what we know about similar infections, once a person has been infected with Zika virus, he or she is likely to be protected from a future Zika infection. Currently, we do not have a test to tell if someone is protected against Zika virus.”
Where Can You Go If You Want to Avoid Zika in 2019?
There are still plenty of vacation-worthy destinations to visit if you’re looking to travel somewhere without any reported Zika cases. Tourist hot spots that don’t have the type of mosquito that carries Zika include Bermuda, Morocco, Canary Islands, Mauritius, New Zealand, Chile, Azores, Hawaii, Seychelles, and most of Europe.
Dr. Kacey Ernst, Associate Professor and Program Director at the University of Arizona’s Epidemiology and Biostatistics Department adds, “Think about the specific areas and times you want to travel to better assess your risk. Higher-altitude areas tend to have fewer mosquitoes. In addition, check out the season: Is it during or near the rainy season? That is often when the transmission of mosquito-borne viruses is highest. Try to get rooms on higher floors if possible, and check the screens on the windows or just keep them closed to avoid bringing the mosquitos in the room. It is important to note that Ae. aegypti likes being around people and is quite happy to live inside as well as outside. Even in areas where Zika is no longer being transmitted, the Ae. aegypti mosquito can also transmit dengue and chikungunya.”
For the most up-to-date information, prevention tips, or what to do post-travel to a Zika country, always check the CDC’s website.
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