Zika Virus

Health Alert for persons traveling to Central and South America, and the Caribbean

Please note that as this is an evolving crisis the latest and most accurate information can be found here: http://www.cdc.gov/zika/index.html

When preparing for international travel please be aware the Center for Disease Control has issued a Level 2 Travel Alert for the Zika Virus.  Individuals wishing to travel to an affected area will be required to complete additional paperwork. Faculty leading group trips to affected areas will need to collect and file an additional assumption of risk form for all student travelers.  This form is available from the Office of Study Abroad .

Travelers who think they may be pregnant should consider a pregnancy test before travel. If you are pregnant, the CDC recommends deferring travel. No employee/student shall be required to travel to a country for which any CDC Travel Notices listed has been issued.

Background Information

The Zika Virus is related to yellow fever, dengue, West Nile and Japanese Encephalitis, having originated in the Zika Forest of Uganda in 1947.  The disease has the potential to become a pandemic with outbreaks in the Americas, Africa, Southeast Asia, and the Pacific Islands. It has spread rapidly across much of Central America, South America and the Caribbean, since initial cases were first seen in Brazil in May 2015. Zika Virus is transmitted by the Aedes species mosquito that bites aggressively during the daytime hours.

Transmission

Zika Virus is transmitted by Aedes mosquitoes which are the same as the ones we have in Kentucky.  So, if you are infected when you return to Kentucky, you can transmit this virus if you are bitten by an Aedes mosquito that in turn bites an uninfected person, who then becomes infected.

Symptoms

The symptoms of Zika Virus disease are fever, rash, muscle/joint pain, and eye redness. Severe disease is uncommon. About 80% of people who are infected never have symptoms. However, researchers are just beginning to investigate severe outcomes of the disease that can include a neurological illness known as Guillain-Barre Syndrome. Of greatest concern, pregnant women who are infected with Zika Virus may deliver babies with severe physical and neurological defects. The CDC recommends that pregnant women postpone travel to countries with local transmission.

Prevention

Numerous UofL students, faculty, and staff will be traveling over the next several months to areas with local transmission of the Zika Virus.  No vaccines or medications are available to prevent Zika infections. If you are traveling to an affected area, you can protect yourself by practicing strict insect precautions, which include the use of insect repellent (picaridin, lemon eucalyptus oil, IR3535, DEET) during daytime hours, wearing long sleeves and pants, and staying inside buildings with screens, closed windows, and air conditioning. You can also treat your clothing with permethrin, an insect repellent that does not harm your clothing. Alternatively you can purchase insect repellent treated clothing.

If you become sick during travel with the symptoms of Zika, you are advised to seek medical care. These same symptoms could also indicate dengue fever or chikungunya infection as well.  If you have symptoms within 2 weeks of return, seek medical care. Be sure to tell your doctor about your recent international travel.

Before you travel:

  • See your doctor before travel to an affected area to determine if you are healthy enough for travel and to update any routine or travel immunizations.
  • If you think that you may be pregnant, consider a pregnancy test before travel.
  • If you are pregnant and considering travel to an area with local transmission, consult your obstetrician before travel.
  • Assemble or purchase a travel health kit with protective supplies that includes products for protection from mosquitoes.

During travel:

UPDATES: February 5, 2015:

  • Strict daytime insect precautions:
    • Use of effective insect repellent on all exposed skin throughout daylight hours. The most effective products are those containing picaridin (Natrapel, Sawyer), DEET containing products, and products containing lemon eucalyptus oil (Repel). Repellents containing IR-3535, the active ingredient in Avon Skin So Soft, DO NOT provide adequate protection.
    • Reapply insect repellent after swimming and as directed by the product
    • Wear long sleeves and pants.
    • Wear clothing that has been treated with insect repellent or treat clothes yourself with permethrin. There are lots of online videos with instructions.
    • Stay in hotels with screens at the window and air conditioning. Keep windows closed during the day to prevent mosquitos from getting into the room.
    • If you plan to sleep in your hotel room during the day, consider sleeping under a bed net.
    • If you are returning to warm weather, continue insect precautions for 2-4 weeks to prevent the spread of the virus from person to person in the US. Remember that you may be infected but have no symptoms, since 80% of people who are infected never have any symptoms.

  • Practice strict daytime insect precautions to protect yourself from mosquito bites. If you are traveling to an area that also has a risk of malaria, practice strict evening and nighttime insect precautions as well.
  • Monitor the local and national situation closely during travel.
  • Cooperate with public health efforts announced by local public health and government officials.
  • If you develop symptoms associated with Zika Virus during travel, see a local healthcare provider.
    • Treat your symptoms by getting rest, drinking plenty of fluids, and taking acetaminophen (Tylenol™) for fever or pain. Do not take aspirin or nonsteroidal anti-inflammatory drugs (Advil™, Aleve™) until dengue fever has been ruled out as a diagnosis in order to reduce the risk of bleeding.
    • If you are diagnosed with Zika, use strict insect precautions to protect yourself from more mosquito bites during the first week of infection. The virus is found in your blood and can be transmitted via a mosquito that becomes infected after biting you. By preventing transmission, you are protecting others, especially pregnant women.

After return from travel:

  • Symptoms of Zika Virus typically occur within 2-7 days following the bite of an infected mosquito.
  • Monitor yourself for symptoms for 2 weeks after return.
  • If you develop symptoms of Zika Infection, see your healthcare provider. Be sure to tell the doctor about your travel history.
  • If you are diagnosed with Zika, use strict insect precautions to protect yourself from more mosquito bites during the first week of infection. The virus is found in your blood and can be transmitted via a mosquito that becomes infected after biting you. By preventing transmission, you are protecting others, especially pregnant women.

If you are pregnant:

  • The CDC recommends that pregnant women in all trimesters defer travel to an area with local transmission of Zika Virus.
  • Contact your obstetrician before travel to discuss the risks to you and your child.
  • If you must travel to an affected area, the CDC recommends that you practice strict insect precautions to avoid mosquito bites.

UPDATED RECOMMENDATIONS:  February 5, 2016

Updated recommendations:

  • Consistently and correctly use a condom with sex during your time traveling in an affected country. There have been cases of sexual transmission through semen, but the rate of this transmission is unknown. (CDC, ACHA)
  • Upon return, continue to use condoms consistently and correctly, as you may still be contagious. The CDC has not yet determined for how long. However, Britain’s National Health Service is recommending use of condoms for 28 days after return from an area with local transmission, if the traveler has been asymptomatic. If the traveler had a fever, rash, and joint pain, they are recommending that condoms be used for 6 months. (ACHA, CDC)
  • For a returning traveler with a pregnant partner, the recommendation is to abstain from sex or consistently and correctly use a condom for the duration of the pregnancy. (CDC)
  • The Red Cross is asking that travelers returning from an area with local transmission not donate blood for 28 days. (Red Cross)

Resources: