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Update on Zika virus

​Zika virus is spread to people through mosquito bites. The virus is a fever disease lasting 4-7 days and can be accompanied by rash, muscle and joint pain, headaches and eye inflammation. There is currently no cure or vaccine against the illness, however, up to 80% of persons infected with Zika do not show any symptoms.


Since October 2015, an accumulation of congenital microcephaly (reduced development of head size) and other damages to the central nervous system in new-borns, as well as of Guillain-Barre syndrome (nerve paralysis of varying degrees), has been noted in countries where there is widespread Zika virus transmission. Therefore, it is strongly suspected, though not fully proven, that there is a link between these illnesses and Zika virus. Due to the above, there is a great attention to Zika virus from health authorities both globally and especially in the countries affected.

 
Affected areas
From February 2015, an increasing number of cases has been found in South America, first in Brazil (in May 2015) and later in 19 other South and Central American countries. According to the ECDC (European Centre for Disease Control), Zika virus is widespread in the following countries: American Samoa, Argentina, Aruba, Barbados, Belize, Bolivia, Bonaire, Brazil, Cape Verde, Colombia, Costa Rica, Curaçao, Dominica, Dominican Republic, Ecuador, El Salvador, Fiji, French Guiana, Guadaloupe, Guatemala, Haiti, Honduras, Jamaica, Martinique, Mexico, Micronesia, Nicaragua, Panama, Paraguay, Peru, Puerto Rico, Saint Lucia, Saint Martin, Saint Vincent and the Grenadines, Saint-Barthélemy, Samoa, Sint Maarten, Suriname, Thailand, Tonga, Trinidad and Tobago, US Virgin Islands, Venezuela and Florida (United States).

The Florida Department of Health has reported an area in Miami where Zika is being spread by mosquitoes. It is a specific and somewhat small area. Therefore pregnant women are recommended not to travel to that particular area – see more here. According to the CDC there has not been identified other areas in the US with infected mosquitoes (CDC).

Sporadic spread of the illness has been reported in: Antigua and Barbuda, Anguilla, Grenads, Guinea-Bissau, Indonesia, Philippines, Saba, Sint Eustatius and Turks and Caicos Islands.
 
Travel risk
Only a few cases of Zika have been reported in Europe. The risk of infection is dependent on the degree of exposure to mosquitoes, the destination as well as on the length of the journey. Particularly rural areas and slum areas are expected to be of greater risk compared to travelling in high altitude areas (>2,000 m). However, it is still difficult to assess the risk for travellers at the moment.

Routes of infection
Zika virus is primarily transmitted through the bite of the same kind of mosquitoes that spread dengue and chikungunya viruses (the Aedes species mosquitoes). Unlike the malaria mosquitoes, Aedes mosquitoes bite throughout the day.

 
In addition, the virus could possibly be passed from a mother to her baby during pregnancy. Furthermore, spread of the virus through blood transfusion and sexual contact have been reported.

 

Sexual transmission of the virus can occur, and all men and women returning from an area where Zika is circulating - especially pregnant women and their partners - should practice safer sex, including through the correct and consistent use of condoms, or abstining from sex for the duration of the pregnancy (source: www.who.int).

 

Symptoms of Zika infection
The disease usually develops 3-12 days after infection. Most people do not show symptoms nor get ill, while some may get a fever, rash, joint pain and red eyes for up to a week. The symptoms are similar to what can be experienced during a flu and are usually described as being mild. Due to this, the symptoms can also be difficult to separate from other mosquito-borne diseases such as dengue and Chikungunya.

 
Recommendations for travellers
As there is currently no cure or vaccine against Zika virus, it is recommended to protect oneself against mosquito bites when visiting affected areas:
  • Use mosquito repellent.
  • Wear long pants and long sleeves.
  • Sleep under mosquito nets, which optimally are impregnated especially if sleeping in rooms without air-conditioning and sufficient screening.
  • Pregnant women should carefully consider to avoid travelling in the affected areas. Women who intend to become pregnant are also advised to postpone non-essential journeys to affected areas. If pregnant women travel in these areas, they are recommended to be particularly attentive to protecting themselves against mosquito bites and seek medical contact upon return – even if there has been no sign of infection.
  • Business travellers staying in larger cities and in air-conditioned cars and hotels are assessed to have a very low risk of infection.

Get more information about Zika virus at:
http://www.who.int/mediacentre/factsheets/zika/en/
http://www.cdc.gov/zika/index.html

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