Do I Still Need to Worry About Zika?

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We talked to an infectious disease expert about this pesky virus.
 

In short: yes, you do still need to worry about the Zika virus. In fact, some doctors feel that the virus isn’t getting the attention it should from the media. While there are plenty of ways to plan around it, to travel safely, and to avoid Zika altogether during your next vacation, travelers (especially those looking to conceive, or who are childbearing) should be aware of what––and where––the risks are.

In general, you should first consult the Zika page on the Centers for Disease Control and Prevention website. Here, you’ll find lots of useful information, including a world map that reflects where Zika is currently a threat, and where it has been a threat in the past.

With spring break approaching, and many travelers looking to book trips to warm-weather destinations, it’s important to be aware of the proper ways to prepare for traveling to a destination that has seen Zika. We spoke with Dr. Elizabeth Talbot, Associate Professor of Infectious Diseases at Dartmouth College Geisel School of Medicine, and travel medicine expert in the Section of Infectious Disease and International Health at Dartmouth Hitchcock Medical Center. She shares her important advice, below.


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Put simply, what should travelers know about Zika?

"Zika is still circulating in many parts of the tropical world. In some places it’s what we call endemic, meaning it’s circulating at a low level all the time, and in some areas the epidemic that had the attention of a lot of media and public health agencies has now turned, but it’s still at a higher level than in those areas where disease has become endemic."

How should travelers protect themselves from these types of diseases?

"First, to note that there are many diseases that are transmitted by insects. The mosquitos that transmit Malaria, for example, bite especially at dusk and dawn and overnight, but the mosquitos that transmit disease like Zika––also Dengue and Chikungunya and other diseases that travelers need to avoid––bite during the daytime. So prevention methods include 24/7 vigilance with regards to dressing smartly, using Deet on exposed skin, and also adopting a practice of using Permethrin to impregnate clothing before travel. This chemical has been widely used for a very long time, and is highly effective, binding to fibers of clothes––it doesn’t smell, it doesn’t hurt the clothes––and you can use it on things like shoelaces and bathing suits and headbands and hats, and it gives you a little bit of an extra edge over those insects. So that’s generic, vector-borne disease prevention."

And prevention tips for Zika, specifically?

"With regards to Zika there are a few things that are important to remember. First, that the disease itself is generally very mild. Most people who get Zika virus aren’t even aware of it. It’s what we call subclinical. But the real danger of Zika is in neurologic complications, called Guillain-Barré Syndrome. That happens in very few people who get Zika. But it’s catastrophic for pregnant women, or those becoming pregnant after having Zika. So, it’s the pregnant women, or women of childbearing age, or men who are planning to conceive, who we need to be careful about."


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Can you speak about the locations most severely threatened by Zika currently?

"Many endemic diseases, pandemics, epidemics––these are dynamic, and the country that bore the most morbidity and mortality recently has been Brazil. And their epidemic has turned, they are looking at lower numbers. But other countries in the Caribbean, such as Haiti, and countries in the Americas, have also experienced high levels of disease that are transitioning into endemic. We know that you can acquire ZIka across Africa and many countries in Asia, as well. So the best way to know if you’re destination is impacted is to check out the CDC website, they keep that very updated, and it’s a quick click away."

What precautions should female travelers take?

"There’s a clear, strong enduring recommendation at this point that women who are pregnant should postpone travel to Zika endemic or epidemic settings. This is a strong recommendation that needs to be heeded. For women who are planning pregnancy: they should delay their pregnancy for two months after leaving the setting that has the possibility of Zika."

And male travelers?

"If you’re a man traveling, and you intend to conceive with your partner, you should delay that for three months after return from a Zika endemic setting."

Other thoughts about the virus?

"For me, it’s funny that it has fallen off of media attention. I think it’s reflective of emergency fatigue. Definitely, in the countries that are impacted, this is not a choice. In a lot of places––Catholic Americas, where women don’t have reproductive choices and there are not opportunities for pregnancy monitoring or abortion or even care of impacted infants––this is really a global catastrophe, and remains so, even if it’s not making headlines in media these days."