Zika virus epidemic prompts Latin America travel warning

The US Centers for Disease Control and Prevention (CDC) has issued new guidelines warning pregnant women to avoid 14 countries and territories in the Americas.

Britain’s National Travel Health Network and Centre (NaTHNaC) says expectant mothers should “reconsider travel to areas where Zika virus (ZIKV) outbreaks are currently reported”.

The public health authorities in El Salvador are advising women in the country to put off pregnancies for the next two years to avoid the risk of giving borth to malformed babies.

Microcephaly

NaTHNaC – whose advice for travellers is endorsed by the Foreign Office – says the warning comes after thousands of babies were born in Brazil with microcephaly, a rare condition where the infant’s head is smaller than normal and the brain does not develop properly.

There were more than 3,500 cases of microcephaly and 46 infant deaths in Brazil between 22 October last year and 9 January 2016, all potentially related to the Zika virus, also known by the acronym ZIKV.

Scientists are still investigating a possible link between exposure to the disease in pregnancy and congenital birth defects.

The health authorities in Brazil have confirmed that two miscarriages and two infants who died within 24 hours of birth tested positive for the virus. Their mothers had fallen ill with a rash and fever during pregnancy.

Zika is similar to dengue fever and is transmitted by the Aedes mosquito, the same insect that carries the dengue and chikungunya viruses.

About 80 per cent of people infected with Zika show no symptoms, and those that do normally only experience a mild fever and rash. There is no known vaccine or treatment for Zika.

Experts do not know why the virus, which was first detected in Africa in 1947 but was unknown in the Americas until last year, is spreading so rapidly in Brazil and neighbouring countries.

There are 96 suspected cases of pregnant women with the virus in El Salvador, where the authorities have been fumigating houses in affected areas in order to kill mosquitoes.

Advice for pregnant women

The advice from NaTHNaC states: “If you are pregnant you should consider avoiding travel to areas where ZIKV outbreaks are currently reported.

“If travel is unavoidable, or you live in areas where ZIKV is reported, you should take scrupulous insect bite avoidance measures, both during daytime and night time hours.

“Remember to inform your obstetrician or midwife if you have recently travelled to a country where ZIKV is known to occur.”

It adds that Zika has been shown to be present in semen up to two weeks after men recover from the illness, raising the possibility of sexual transmission.

The US authorities say pregant women should avoid going to Puerto Rico, Martinique, Haiti, El Salvador, Guatemala, Honduras, Panama, Brazil, Colombia, French Guiana, Paraguay, Suriname, Venezuela and Mexico.

Dr Beth Bell of the CDC said: “We are quite concerned about the potential complications to the foetus of a Zika virus infection of pregnant women and so we really are advising that pregnant women seriously consider postponing travel to these areas if possible.”

She recommended that pregnant women in affected areas should put screens over doors and windows and use insect repellents.

“Mosquitoes bite not just at night but also during the day. And so the measures that people need to take to prevent mosquito bites they have to use all the time not just at night.”

The CDC is urging doctors to ask pregant women about their travel history and test those who have travelled to regions where Zika is active who report symptoms within two weeks of travel.

Those who test positive for Zika should be offered an ultrasound to check the baby’s development and look for signs of microcephaly.

El Salvador’s vice minister of public health, Eduardo Espinoza, said women who are already pregnant should stay covered up while outdoors to reduce the risk of mosquito bites.