The Zika virus is an unusual illness in that, for most people, it represents a very low risk – after all the hype, not one visitor or athlete got Zika at the summer Olympics in Brazil. However, it also has many disturbing characteristics that are cause for concern, particularly for expectant mothers, given that children born to a person with Zika can suffer from microcephaly and other severe brain defects.
The Chair of the UN’s Emergency Committee on Zika, David L. Heymann, believes that “the situation continues to constitute a public health emergency of international concern.” With that in mind, and to help the business traveler in the Americas, Nearshore Americas has compiled this breakdown of the things you should know about Zika, and how best to avoid catching the virus.
Not all countries are created equal
“Latin America all too often gets bucketed into one category, but not all countries are affected equally,” says Luke Bujarski, Research Director at Skift, which provides travel industry intelligence. “Peru and Chile, for example, have not seen substantial Zika outbreaks.” Neither have Argentina and Uruguay.
Brazil, as the Olympics proved, is fairly well equipped to handle Zika, as is Colombia. However, according to the Pan American Health Organization, Bolivia and Paraguay are ill-prepared to handle outbreaks, as are all the Caribbean countries, as well as the Central American countries El Salvador, Guatemala, Honduras, and Nicaragua. With this in mind, greater precautions should be taken when visiting these countries.
Know your mosquito prevention
Zika is primarily spread by bites from an infected Aedes mosquito. Knowing how to prevent those bites, and employing a multi-pronged approach, is the best defense. That means covering up, using a repellent with DEET, and, if necessary, staying indoors.
Mosquitos are more likely to bite you if you are sweating, and they bite more aggressively during the day. They are also more attracted to dark clothing. Washing with bacterial soap might be a good idea, as the insects are drawn to the diverse mix of bacteria on your skin.
Pick the right neighborhood
Latin America and the Caribbean have seen a surge of growth in metropolitan areas since WWII. It is estimated that about 80% of the population now lives in cities, many in densely populated slums. Poor sanitation and plumbing result in localized standing water – a perfect breeding ground for mosquitos.
“In these areas the factor is more socio-economic,” says Dr. Stephen J. Gluckman, Medical Director, Penn Global Medicine, and Professor of Medicine at the Hospital of the University of Pennsylvania. “Mosquitos don’t fly that far, so when people are packed close together where there are a lot of mosquitos, that’s a set-up for an epidemic.”
If you are in a neighborhood with decent sanitation, and screened or air-conditioned accommodation, the risk of infection is greatly reduced.
There are two dominant factors affecting local temperature and mosquito prevalence in Latin America: altitude and latitude. One reason why Peru, Chile, Argentina, and Uruguay have low Zika levels is that they have winter – which is of course when there are few mosquitos.
Similarly, a reason why the “summer” games proved not to be much of a threat was because they were held in Brazil’s winter. With regard to altitude, a high city like Mexico City is at lower risk than a low-lying tropical region like Bahia, Brazil.
Know your risk profile
Zika does not affect children, the elderly, or people with other illnesses any more than able-bodied adults. If you are following the precautions and want to bring your son or daughter on a business trip, that’s fine.
“There is no mortality with Zika, and it is perhaps less dangerous than dengue or chikungunya,” says Dr. Gluckman. “But when women are pregnant there really is a worry.” As such, it is only pregnant women who should consider restricting travel.
Consider a mosquito net
It is not true that mosquitos are only outdoors; they can breed indoors, too. If you are travelling, you may have little control over wet areas near your room. Mosquitos can also breed in plants, and get blown around by ventilation systems.
Though they are more active during the day, they also bite at night, and will be attracted to the C02 you release when sleeping. Mosquito nets are light and easy to deploy. It may seem like overkill, but a net is the ultimate precaution.
Zika is also an STD
That’s right, Zika is not only spread by mosquito bites – it is also a sexually transmitted disease. That means that all the standard precautions for avoiding mosquitos, such as covering up and using DEET, may not be sufficient.
“Of the 2,500 or so cases of Zika diagnosed in the US, 22 were sexually transmitted, so the risk is very small,” says Dr. Gluckman. “Of those, only one was female to male. A very cautious recommendation is for a man with a non-pregnant partner to use a condom for eight weeks after his return from a Zika-infected region. If he believes he is at risk of having the disease, extend it to six months. If the partner is pregnant, condoms should be used until she delivers.”
This cautious approach seems warranted, given that there is much we don’t know. David L. Heymann, who is also responsible for communicable diseases at the World Health Organization (WHO), has confirmed that more research is needed “on how long the risk is for sexual transmission of the Zika virus.”
The sum of all this information and advice is that, with the notable and important exception of expectant mothers, there isn’t a “no go” area for Zika. However, Zika is a virus capable of mutation, and there is more to learn.
Many infected people are asymptomatic; for others, the worse it gets is a fever for three to five days. However, in rare cases adults infected with Zika can develop Guillain-Barré syndrome, which causes severe paralysis, and takes weeks of recovery. Readers are advised to keep informed.
“There are a lot of unanswered questions about the full implications of the Zika threat to individuals,” says Bujarski from Skift. “Everyone knows about the link to microcephaly, but there is a broader psychological impact on travel, too. How this will shake out depends on many different factors, with prolonged impact.”