Aedes mosquito (Shutterstock)
Article 02 February

Zika virus: How worried should you be?

It's spreading through South and Central America, and an international public health emergency has just been declared. Here's what travellers need to know about the Zika virus

The Zika virus is spreading every day – affecting countries in South and Central America, including the Caribbean. According to the World Health Organisation (WHO), it is an international public health emergency. So how worried should you be?

According to most sources, if you're not pregnant there's no need to panic – it is a relatively minor virus. However, if you are pregnant you need to take precautions: Zika has been linked to microcephaly – abnormal brain development – in babies.

“We strongly advise pregnant women to consider avoiding travel to areas reporting active Zika transmission”, says Dr Dipti Patel, director at the UK's National Travel Health Network and Centre. “If travel to these areas is unavoidable, they should take scrupulous insect bite avoidance measures both during daytime and nighttime hours.”

We quizzed Dr Jane Wilson-Howarth, travel health expert and practising GP, about the real risks of Zika – and how travellers can protect themselves against it.

Have you consulted with many people who are worried about travelling to Zika-affected places?

I had a long, complicated consultation with a pregnant lady last week. She was booked to go to a Zika-free Caribbean island that is close to one which does have Zika – but the insurers wouldn't let her cancel on the grounds of being worried about the virus. The problem is that the mosquito that transmits the virus is such a good 'hitchhiker' – it spreads very easily. She could go, and end up being the first case. In the end, she was able to cancel the trip with a letter from me – her GP – because of another medical problem. It really is worth checking out where you stand with your insurer. Ensure that pregnancy isn’t excluded.

Should all travellers to South and Central America be worried?
If I was pregnant, I would avoid going anywhere that's close to Zika-affected zones. Microcephalic babies never have a normal life – it is a disaster. It's not just a cosmetic thing – they basically have a poorly developed brain and will be severely intellectually compromised their whole life. Some don’t survive; there is also an increased risk of miscarriage and still birth. I would discourage anyone who is pregnant from travelling to affected areas. We don’t yet know enough about Zika to understand the necessary risks and precautions.

If I wasn't pregnant, I wouldn't worry. The big risk is to pregnant women.

So for people who aren't pregnant, there's no need to cancel travel plans?
The disease that people experience is generally trivial. They might have mild conjunctivitis, red eyes. They might feel a bit achey, feel a bit off. After a week they'll feel fine again. In a couple of cases, Zika has been linked to Guillain-Barré syndrome; this is rare but causes a paralysis albeit a paralysis that almost always completely resolves.

What about women who are hoping to get pregnant in the future – should they be worried?
No. If you get the virus now and you're planning on having a child in a year or so, it is unlikely to be an issue. The virus has been known in Africa for many decades and it is likely that locals experience the virus in childhood and are then immune so that when they do become pregnant they are not at risk. This is a common pattern in several illnesses: the foetus is unlikely to be at risk if the mother is immune – either naturally or through active immunisation.

What type of mosquito carries Zika?
Zika is spread by the Aedes mosquito – the same one that spreads dengue, chikungunya and the yellow fever virus. It is a day-biter also known as the tiger mosquito because of its stripy legs. Most people think of bed nets when they take precautions to avoid mosquito bites, but in this case you need to prevent bites from dawn til dusk.

What precautions should people take?
Of course, any form of bite prevention is a good idea, whether there's a risk of Zika or not. I'd advise proofing your clothes with EX4 spray [a contact insecticide for fabrics] too.

Most mosquitoes hunt at ankle level. Aedes mosquitoes tend to browse around, and hunt from your ankles upwards – if you have repellent on your feet and ankles, they will travel up and bite through your shirt. They are quite aggressive. Whereas other types of mosquitoes will be deterred by repellent and then go elsewhere.

Is there anything else we should know?
It's early days, but some research has indicated that Zika could be sexually transmitted. If you could be at risk, use a condom.

It's not yet known whether the virus affects all pregnant women and at what stage of pregnancy is it most dangerous – more research is needed. We don't know yet. My advice is to play it safe – very safe – if you're pregnant. Some insurers actually exclude everything to do with pregnancy from their travel policies. So it really is essential to check what's covered as soon as you get pregnant. There are a lot of exclusions. Pregnant women must make sure they have travel insurance that covers every potential issue or complication of pregnancy including care for a newborn if labour comes early.

Main image: Aedes mosquito (Shutterstock)

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