The mosquito-spread Zika virus continues to cause increasingly worldwide alarm. Dr. Vanya Gant, PhD, FRCP FRCPath, a GeoBlue-contracted contracted provider specializing in Infectious Diseases and Microbiology, has provided 10 important facts about the current Zika virus outbreak and how it could impact you.
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Zika virus has now been reported in a very large number of countries, including Mexico, most tropical regions in the Far East and of course there continues to be a large outbreak in Brazil and other parts of the Americas. It's a virus carried by mosquitoes - especially those that can and do bite in the daytime as well as night. It's the mosquito bite that will get you infected with Zika - much as it does many other viruses, such as dengue and the malaria parasite.
Mosquito bites are essential. If you get fever and malaise a few days later in endemic areas, you may have contracted Zika. The infection may however be very mild, and often may go unnoticed. Some people will get symptoms not unlike having a mild version of the flu: a low fever, some headache, muscle and joint pains, as well as red eyes and a non-itchy flat rash. These symptoms are variable enough between people to make the diagnosis of Zika virus infection impossible without a specific blood test - as many other viruses can do the same thing as well as malaria, of course.
Zika virus has been around for many years in countries like Brazil. The real issue is that it is now acknowledged by the World's experts as being associated with damaging babies' development in the womb; some may be born with a condition called "microcephaly" - literally meaning "small brain". This has enormous consequences for those countries with Zika - and of course for the traveler.
Yes. Cases of Zika virus infection have been detected in travelers returning home from various South American countries and further afield. Newer reports suggest that this is a worldwide phenomenon, simply because of travel to and from an increasing number of countries around the globe now known to have the virus in circulation.
This, of course, is especially important for GeoBlue members who are residing in or near an affected country, or are thinking of attending the Olympic Games in Rio. People who get infected with Zika virus have a mild illness which resolves in a few days; many won't even know they've got the virus. The problem relates to people who are pregnant.
There is now a clear link between birth abnormalities and Zika virus infection in pregnancy. If you're pregnant then you should postpone non-essential travel to Zika affected areas. Furthermore, you should avoid becoming pregnant when there and for 8 weeks afterwards. If such travel is deemed absolutely essential, you should use scrupulous mosquito bite avoidance measures day and night and especially during mid-morning and late afternoon to dusk, when the mosquito is most active).
We now know that Zika can be sexually transmitted; and what's more, Zika virus can persist in male ejaculate for long periods of time - perhaps up to 6 months after recovery. Female to male transmission has also now been shown. You should always use condoms when having sex when away, and if you're a man, you should continue to do so for 8 weeks after you return home.
It's all about preventing mosquitoes from biting you. Wear loose fitting clothes and long trousers and sleeves, this includes in the daytime for Zika avoidance. Spray some permethrin insecticide on your clothes. DEET-based repellents are the most effective, the higher the concentration, the better: 20% is OK, and 50% is best. This is safe if you're pregnant. Sleep under an insecticide-treated bed net.
If you are well, you should discuss this with your Obstetrician. What will likely happen is that your doctor will wish to keep an extra close eye on you during pregnancy and advise you further about the risks, If you have recently come back from affected areas and had, or have, symptoms suggesting a viral illness within the last 2-3 weeks, you should actively seek medical advice and state that you wish to be tested for Zika (see below).
There are blood, urine and semen tests for finding the Zika virus itself. These are likely to remain positive for about 2-3 weeks after developing symptoms. In addition, an antibody test can detect both relatively recent (a few weeks), and older Zika infection, from which you will have fully recovered. There is understandably much demand for testing; whether or not you really need testing is something to discuss with your doctor.