In 2016, when the Zika virus first made headlines, people canceled vacations to Latin America and the Caribbean as the mosquito-borne virus spread through the region and into Texas and Florida. While the illness caused by Zika is mild, it can cause severe birth defects when pregnant women are exposed to it. But almost as quickly as it had taken over headlines, it seemed to disappear from the news.
But on Tuesday the World Health Organization, as part of a report on the virus, updated its guidance for travelers planning to visit areas where Zika is known. It has been identified in 87 countries, including Brazil, China, India and Egypt.
[Read more about why Zika is still a threat.]
“The good news is that we haven’t been hearing about Zika because transmission has been low,” said Dr. Eve Lackritz, who leads the Zika Task Force at W.H.O. “Transmission dropped dramatically through 2017 and 2018, but when we have an end of an epidemic we don’t stop our work.”
The W.H.O. update comes a few months after the Centers for Disease Control downgraded its Zika warning. The C. D. C and W.H.O. said that although the disease has for the moment receded around the world, it is still circulating at a lower level.
”The only way to avoid it is to not travel at all, but ultimately the risk will not be zero,” Dr. Lackritz said. “People have to make their personal choices accordingly, but we have a number of messages for how they can protect themselves.”
Here, answers to questions about Zika and travel.
Is travel to a country with Zika safe?
For most people, yes. Zika symptoms are relatively mild and only last a few days, but issues arise for women who are pregnant or couples thinking about getting pregnant. Zika is mostly spread through the bite of Aedes mosquitoes, but it can also spread through sex with an infected person, so couples should talk to their doctors about risks before traveling.
“If there’s a place that someone has to travel while pregnant then all the strategies for prevention are paramount after you’ve had a conversation about whether you absolutely must go,” said Dr. Emily Adhikari, assistant professor of maternal fetal medicine at University of Texas Southwestern Medical Center and the medical director of the obstetric infectious disease clinic at Parkland Hospital in Dallas.
Is there a better time to go?
The virus is still circulating in Brazil and other countries that were at the center of the epidemic, but it is less prevalent in colder months than in the summer. Travelers can take that into account when planning a trip.
“Summer in the north is winter in the south and vice versa so you have to consider that,” said Dr. Ernesto T.A. Marques Jr., associate professor at the Infectious Diseases Department at University of Pittsburgh Graduate School of Public Health. “The mosquito season is usually the summer in the southern hemisphere. In the winter the population of mosquitoes is much lower, so try to plan, if possible, to go in winter and stay in cities.”
How can I protect myself?
The W.H.O. suggests a number of ways to protect your skin while in an area with Zika transmission, including wearing light-colored clothing that covers as much of the body as possible and using mosquito repellent. If you use repellent and sunscreen, apply sunscreen first and then the repellent, the guidelines say.
“Avoid exposing the skin, the least skin you have exposed, the odds of being bitten reduce a lot,” Dr. Marques said.
Physical barriers go a long way in protecting against mosquito bites. While traveling in affected areas, keep doors and windows closed and sleep under mosquito nets. The guidelines also recommend using insecticide-treated netting materials on doors and windows.
To avoid risk of sexual transmission of Zika while traveling, men and women should practice safer sex, including the consistent use of condoms, or abstinence.
“It’s not just Zika to think about,” said Dr. Adhikari. “There are destinations that might have other diseases that are potentially a bigger deal like dengue, yellow fever, malaria chikungunya. That’s why it’s important to tell your doctor exactly where you intend to go.”
What about when I get back?
W. H. O. recommends that travelers who have returned from a trip and develop a rash, fever, painful joints or red eyes should contact their physicians, inform their provider of their travel history and get laboratory testing and clinical care as indicated.
That can help with the overall tracking of the spread of Zika, too, since many of the countries where it has been identified lack the public health infrastructure needed to identify new cases.