UNC Health Talk

Traveling Soon? What You Need to Know About Zika

It seems that lately we haven’t heard much about Zika, the scary virus that was all over the news a couple of years ago. Does that mean the threat is gone?

The short answer: No. Although news of the virus has slowed down since the outbreak in 2015—which later became a worldwide epidemic, or a global occurrence, in 2016—the threat of catching Zika is still real. Women who are pregnant or planning to become pregnant and their partners should remain cautious.

“The CDC has not changed its Zika-related travel restrictions. They are still advising pregnant women to avoid areas where Zika is endemic,” says Elizabeth M. Stringer, MD, MSc, associate professor of maternal-fetal medicine at the UNC School of Medicine, who also works and researches with doctors in Nicaragua on Zika.

What is Zika?

Zika is spread through infected mosquitoes and sex. People who contract the virus might not experience any symptoms or only have mild symptoms, including:

  • Fever
  • Rash
  • Headache
  • Joint pain
  • Red eyes
  • Muscle pain

Although Zika symptoms might not make you particularly ill, for pregnant women or couples trying to get pregnant, the virus can be especially dangerous. Zika can produce severe brain defects in fetuses, most notably microcephaly, a defect in which a baby’s head is undersized because the brain has not developed properly.

Congenital Zika syndrome, or a unique pattern of birth defects in babies infected with the virus during pregnancy, can also occur. This condition is marked by:

  • Severe microcephaly, where the skull has partially collapsed
  • Decreased brain tissue with a specific pattern of brain damage
  • Damage to the back of the eye, including scarring and pigment changes
  • Joints with a limited range of motion, such as clubfoot
  • Too much muscle tone, restricting body movement soon after birth

Additionally, babies who contracted the virus before birth might also experience visual impairment due to damage in their eyes or the part of their brain responsible for vision.

How prevalent is Zika?

Areas most at risk of the virus include most of South America and parts of Africa and Asia, though people traveling to South Florida and Brownsville, Texas, where Zika has previously been reported, should also exercise caution.

“We do know that the epidemic has waned. For example, during the peak of the epidemic in Nicaragua, about half of pregnant women entering prenatal care were infected. Now the cases have dramatically fallen,” Dr. Stringer says. In the United States, 5,230 cases were reported during 2015 and 2016, the vast majority in travelers returning from affected areas. From 2017 to April 4 of this year, only 446 instances of Zika have been reported.

That dip is typical with these types of infections, Dr. Stringer says. “There will be a burst of transmission where lots of individuals become infected, and then ongoing lower levels of transmission after the acute epidemic is over.” Of course, for pregnant women who become infected, the virus remains a major problem.

How can I prevent Zika?

Although it’s still possible to catch Zika, there aren’t any Zika-specific health precautions that can be taken prior to travel. That said, because the virus is spread through mosquitoes, proper insect repellent is key. “When you travel to these areas, just like when you’re traveling to Africa and there’s the risk of malaria, you need to take precautions against mosquitoes,” Dr. Stringer says.

For women who are pregnant or wanting to become pregnant, traveling should be done with caution. “What’s devastating about the Zika virus is that it can cause fetal infection in utero, and so if you are early pregnant or trying to conceive, I still think you should follow the CDC recommendations and avoid areas where Zika is circulating,” Dr. Stringer says. “I often tell my patients, ‘The transmission is really low right now, but why would you risk it until we are certain there is no more risk of Zika, and you can travel there freely?’”

If you or your partner traveled to an area with Zika transmission, the CDC also recommends not having sex during pregnancy or using condoms, as the infection can stay in the body months after contracting the virus.

For women who travel to an area of Zika transmission, the CDC recommends waiting eight weeks before trying to conceive. For men, the wait time needs to be at least six months, as the virus appears to stay in semen longer than other body fluids. In the meantime, use condoms to avoid passing Zika to an uninfected partner.

If you have recently traveled to a country with Zika risk, it’s important to remember that just because you don’t feel sick doesn’t mean you don’t have the virus. The CDC suggests takings steps to prevent mosquito bites for three weeks after your return so as not to spread Zika to uninfected mosquitoes, which can then infect other people.

If you are concerned about Zika risk while traveling, talk with your doctor before you go. Find a doctor near you.