Zica virus is a flavivirus transmitted by mosquitoes. Cases of Zika virus have been reported in Africa, Southeast Asia, the Indian subcontinent, and the Pacific Islands. Since 2014, Zika virus epidemic has occurred throughout the tropical and sub-tropical regions of the western hemisphere, such as Mexico and Puerto Rico. Since Zika, dengue, and chikungunya viruses are transmitted by mosquitoes during the daytime, it is important that all travelers visiting infected areas take protective measures to avoid mosquito bites throughout the day.
The most common symptoms of Zika virus infection include low-grade fever, myalgia, conjunctivitis, joint pain, arthralgia, headache, skin rash, and post-infection asthenia. More rarely observed symptoms can be pruritus, mucous membrane ulcerations (aphthae), and digestive problems (diarrhea, constipation, abdominal pain). Diagnosis is based on the patient’s symptoms and recent history (e.g. mosquito bites, travel to an area where Zika virus is present, etc.) Blood tests can be taken to confirm the diagnosis.
So far, there is no specific cure for Zika virus infection. Therefore, the best way to prevent the disease is to avoid being bitten.
- Use mosquito coils and insect sprays.
- Use screens on doors and windows.
- Use a mosquito net over your bed. You can spray pesticide if you wish.
- Turn on air conditioning if available – this is a very effective way to keep mosquitoes out of a room.
- Use zip-up screens on tents.
- Wear light-colored clothing.
- Wear protective clothing such as hats, socks, long pants, and long-sleeved shirts.
- Avoid places where mosquitoes are breeding, such as swampy areas.
- Get rid of water containers to eliminate mosquitoes’ breeding sites.
- Wear a repellent cream, preferably containing DEET (diethyltoluamide). Repellent can be applied to clothing and cannot be treated with wounds or irritated skin.
If you are pregnant now but were not when you visited an affected country, then the risk is very low. The virus does not seem to linger in the body, and patients who recover from the infection are lifetime immune. Does it matter if I am infected with Zika virus in my pregnancy? Unfortunately, the answer is yes. The most dangerous period is during the first trimester when most women do not realize they are pregnant. Scientists still do not know how the Zika virus breaks into the placenta and damages the developing brain of the fetus. Closely related viruses (dengue, yellow fever, and West Nile) do not usually do so. However, viruses from other families (e.g. rubella and cytomegalovirus) sometimes do.
Newborns should be tested for infection with Zika virus if their mothers have lived in or visited any affected country, regardless of the mothers’ tests are positive or negative. The reason is that infection with Zika could be leading to defects in vision and hearing, along with other abnormalities, even if the baby does not suffer microcephaly. The other defects may require further assessments and testing.
Up to this time, there is no vaccine or any particular antiviral medication for people positive with Zika virus. The symptoms are mild and usually demand only rest, nourishment, and healthcare support. Since it is impossible to prevent mosquito bites entirely, WHO has advised pregnant women to avoid visiting areas where Zika is being transmitted. Women who are planning to become pregnant should consult doctors before departure. Travelers to these countries need to avoid or minimize mosquito bites by sleeping under mosquito nets, staying in screened or air-conditioned rooms, using insect repellent at all times, and wearing shoes, hats, long pants, long sleeves, etc.
El Niño and Zika
The Aedes aegypti mosquitoes grow and breed in standing water. Drought, flooding, and temperature rises are all effects of El Niño. An increase in mosquito population can be traced back to the expanse of favorable breeding sites. Steps should be taken to prevent the health effects of El Niño, at first by reducing the population of Aedes aegypti mosquito – the primary vector of Zika virus. WHO and partners are cooperating to provide support authorities to:
- develop preparedness and response to El Niño;
- strengthen vector surveillance (e.g. percentage of breeding sites in an area reduced);
- monitor the actions to control mosquito population; and
- reinforce any action that helps reduce mosquito population such as source reduction aimed at mosquito breeding spots, utilization of larvicide to treat water sites that cannot be dealt with in other ways (covering, cleaning, emptying), etc.
Individual households can also effect on the mosquito population. Containers that can accumulate even small amounts of water such as bottles, buckets, flower pots or old tires should be cleaned, covered or emptied so that mosquitoes cannot use them to breed.
Microcephaly is a rare condition wherein an infant has an unusually small head. This is owing to abnormal brain development when the baby is in the womb or during infancy. Children with microcephaly often have difficulties with their brain development when they grow older. Microcephaly can be triggered by a variety of genetic and environmental factors such as Downs syndrome; rubella infection during pregnancy; and exposure to alcohol, drugs or other toxins in the womb.
As a precautionary measure, some governments have made public health and travel recommendations to their citizens, based on their assessments of the existing evidence and local risk factors. Travelers should continuously update information about Zika virus and other mosquito-transmitted diseases. Consult the local health or travel authorities if you have any above-mentioned symptoms. Take the measures described above to avoid being bitten by mosquitoes. Women who are pregnant or thinking of becoming pregnant should follow this advice, and also consult their healthcare providers if traveling to an area with Zica virus outbreak.
Should I postpone or cancel my travel plans to any country on the CDC’s travel advisories list? It is up to you and your doctor. Though the risk of contracting Zika and suffering a severe complication are quite low, the actual risks are still unknown. In a word, try to avoid the infected regions if possible. Available evidence leads to many instances of microcephaly and Guillain-Barré Syndrome, which will affect not only yourself but also your next generation.
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