What is the Zika virus?
Zika is an arbovirus that is spread by the bite of an infected Aedes aegypti of mosquito. The greatest risk is to fetuses, particularly when expectant mothers are infected during the first trimester. Zika has been linked to microcephaly (abnormally small head) in newborn children. Thousands of such cases have been reported to date, especially in Brazil, which is thought to be the epicentre of the current breakout. There is no vaccine or medicine for Zika.
Up to 80 per cent of Zika virus infections are free of symptoms and go undetected. According to the Public Health Agency Canada (PHAC), these symptoms can include fever, headache, conjunctivitis (pink eye) and skin rash, along with joint and muscle pain. The illness is typically mild and lasts only a few days.
Zika has also been linked to incidence of Guillain-Barre syndrome—a serious disorder of the body’s immune and neurological systems.
If you are a pregnant woman or might become pregnant, you are in the highest risk category and you should not travel to areas where active, local transmission of Zika has been officially reported.
If you have recently travelled to a region where local transmission is common or has occurred, the PHAC recommends that you wait at least two months after returning home before trying to conceive. This is the time your body needs to clear any possible Zika virus infection.
For male travellers, Zika virus can survive a long time in the semen of infected males. You are strongly advised to use condoms with a pregnant partner for the duration of the pregnancy, and for six months after travel. Regardless of pregnancy and conception, you should use condoms with any partner for six months after your return.
It’s important to distinguish between locally transmitted Zika (by mosquito), and transmission by sexual contact. The outbreak of locally transmitted Zika in a section of Miami was the first of its kind in the U.S. Up until that point, all of the approximately 1,700 reported cases of Zika infection in the U.S. occurred among sexual partners of travellers returning from countries with active Zika transmissions.
Canada has also reported cases of Zika infection transmitted by sexual contact. But the Aedes aegypti mosquito species does not exist in Canada, so local transmission is not expected.
Where are the highest risk areas for active Zika infection?
Active Zika virus infection has been reported throughout the entire Caribbean area (not including the Bahamas), Mexico, and every country in South America except Chile. The virus has also been detected in Papua New Guinea, and several island nations in the South Pacific (not Australia or New Zealand).
The PHAC, CDC and the World Health Organization have recommended that if you are pregnant, or are planning on becoming pregnant, you should avoid travelling to any of these areas. If you are unsure about Zika risk in any country or region you are planning to visit, check out the CDC website at http://www.cdc.gov/zika/, or the PHAC at http://www.healthycanadians.gc.ca/.
The CDC has also recommended that pregnant or potentially pregnant women not travel to Wynwood, the section of Miami where the recent outbreak of locally transmitted Zika occurred, but it has not recommended a limitation on travel to other areas of Florida, or elsewhere to the United States.
How should you protect yourself against Aedes aegypti?
Aedes aegypti are active biters during the day, indoors as well as outdoors, but are most active in the post-dawn and pre-dusk time periods. They prefer urban environments to the wide-open spaces, so you’re probably best off heading for the beach. But to protect against their bites, wear long sleeves or pants, (they like to sneak up on their victims and bite their ankles and elbows), and stay indoors in air conditioning or within well-screened areas, which is pretty unrealistic given that staying indoors is not why you go to Florida. So, the best remaining protection is the frequent use of repellents on all exposed skin: Deet, Picaridin (known as Icaridin in Canada), or oil of eucalyptus (less effective but still acceptable if you have nothing else). Some still like to rely on Skin so Soft, but it’s more expensive that DEET or Picaridin.
Also, if you are outdoors or on a patio, try to stay in breezy areas, as the Aedes mosquito is a poor flyer, and can’t navigate well in windy conditions.
If you feel you may have contracted Zika
The illness is typically mild and lasts only a few days. But if you feel you may have contracted Zika, notify your travel insurer’s assistance service and follow the advice of the representative you speak with. If you need treatment, you may go to an urgent care clinic or hospital emergency room to be tested. If you test positive, you may be stabilized and referred home for follow-up care with your family physician, or you may be given medication for your symptoms and told to rest and stay clear of mosquitoes as best you can. In any case, call your toll-free assistance service before you seek testing or treatment.
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