Zika Virus: What It Is, Affected Countries, Symptoms, Treatment and More [Guide]

The Zika virus dominated headlines in 2016 when some infected women had babies with significant birth defects. At the time, the threat of the mosquito-borne virus caused major concern, leading many travelers to change their travel plans.

Since Zika is no longer front-page news, people might think the virus is no longer a threat. However, there are still hot spots, particularly in tropical climates, that travelers should be aware of.

As you plan your travels for this summer and beyond, you might wonder how to prepare for travel to Zika-prone countries and what has become of the virus in the past few years. Here is a guide on everything you need to know about the Zika virus when traveling.

What is the Zika Virus?

Zika is a flavivirus. There is currently no vaccine for Zika, but it is not usually a life-threatening condition. In fact, the vast majority of people with Zika have no symptoms at all.

However, there are 2 uncommon, but severe, complications that are important to note. If you have contracted Zika, you have a significantly increased chance of having these issues:

• Infected pregnant women may transmit Zika to their babies, resulting in a number of serious birth defects that are directly linked to Zika.
• The infected person has an increased risk of having Guillain-Barre syndrome.

Because of this, it is important to be knowledgeable about how and where you are most likely to contract it.

How is Zika Transmitted?

A flavivirus is transmitted primarily by ticks and mosquitoes. It can be passed along to humans in the following ways:

• Zika is spread mostly by the bite of an infected mosquito.
• Zika can be passed from a pregnant woman to her fetus. Infection during pregnancy can cause certain birth defects. Make sure to check out the section dedicated to Zika-related pregnancy concerns below.
• Zika can be sexually transmitted from an infected man or woman. This can happen months after the initial transmission.
• Though a blood transfusion (though unconfirmed in the U.S.).

Bottom Line: According to the Center for Disease Control (or CDC), there is no evidence that Zika can be transmitted through saliva [1]. There is also no evidence that Zika is transmitted through animals other than mosquitoes [2].

Zika is a concern in many parts of the world, however, since the virus is primarily transmitted through mosquitoes, this means that the greatest risk for contraction is in climates that are most favorable to mosquitoes.

Specifically, though, Zika is transmitted by the Aedes species of mosquito. These are the same mosquitoes that spread dengue and chikungunya viruses. These thrive in the Caribbean, Central and South America, Southeast Asia, and parts of Central Africa.

A Brief History of Zika

The Zika virus was first discovered in 1947 and is named after the Zika Forest in Uganda. In 1952, the first human cases of Zika were detected.

Before 2007, 14 cases of Zika had been documented, although other cases were likely to have occurred and were not reported. Because the symptoms of Zika are generally mild and similar to those of many other diseases, cases may not have been recognized at the time.

The first large outbreak of Zika was reported in 2007 from the Island of Yap, which is located in the Federated States of Micronesia. Since then, outbreaks of Zika have been reported in tropical Africa, Southeast Asia, and the Pacific Islands.

Zika became international news in the summer of 2016 when a massive outbreak struck South and Central America and the Caribbean. causing more than half a million suspected cases and more than 3,700 congenital birth defects, according to the World Health Organization, (or WHO) [3].

In February 2016, WHO declared that the number of cases of the Zika infection constituted a “Public Health Emergency of International Concern.”

Declining Cases

It should be noted that in most countries, cases of Zika are significantly down from the peak in 2016. In fact, in November 2016, WHO declared the end of this emergency. Ultimately, the exact decline is hard to measure since many people with no symptoms were never tested for Zika.

Most experts say the decline in Zika cases is due, at least in part, to herd immunity. This means that when enough people become immune to a virus, that disease can’t easily travel from person to person. This is especially true for individuals living in areas with a high concentration of mosquito-based infections.

There is also suspected “cross-protection” because Zika virus shares antibodies with dengue virus and other flaviviruses, but this has not been proven.

Countries with Zika in 2020

According to WHO, the Zika virus is present in more than 87 countries. As of 2020, virus activity continues in the Caribbean, most of Latin America, Central Africa, India, Indonesia, Malaysia, Cambodia, and Papua New Guinea, among other places.

Below is some information regarding the number of Zika cases over recent years in specific countries. This information is what has been reported to the European Center for Disease Prevention and Control [4] as of October 2019 and risk information from gov.uk as of July 2019 [5].

U.S. & U.S. Territories

Zika does not easily spread in the continental U.S. because Aedes mosquitoes are relatively rare, however, U.S. territories have experienced a significant number of Zika cases.

In 2016, Puerto Rico, the U.S. Virgin Islands, and American Samoa saw more than 36,000 cases of locally-transmitted Zika virus [6]. Texas and Florida saw a little over 200 cases locally-transmitted.

Since the high point in 2016, Zika in the U.S. has declined sharply and has all but disappeared. During 2019, only 57 cases were acquired through local mosquito-borne transmission in U.S. territories, and 0 cases were noted locally in the continental U.S., including Florida and Texas that had experienced cases before [7]. Alaska and Hawaii also reported no cases.

This doesn’t mean that people living in the U.S. don’t have the Zika virus, but rather that it wasn’t transmitted locally. They would have contracted the virus during their international travels.

For the most current information, the CDC has a county by county breakdown of all mosquito-borne cases reported in the U.S. by year, including Zika virus.

Below are the U.S. States and Territories that have a current risk of Zika:

Mexico & Central America

In 2019, Mexico reported 50 confirmed cases of Zika compared to 39 for the same period in 2018. This is a significant decrease in cases compared to 2018 when 860 confirmed cases were reported.

In 2018, Guatemala was one of the countries in the region reporting the highest number of cases. The good news is that only 10 cases were reported in 2019!

Below are the countries in Central America that have a current risk of Zika:

Caribbean Islands

In 2018, according to the Pan American Health Organization (PAHO), Cuba reported 873 cases of Zika. The PAHO doesn’t have data for Cuba from 2019 as of the date of publication of this article. In addition, Puerto Rico reported 39 cases.

In other parts of the Caribbean, the disease has seen a decline. For example, the U.S. Virgin Islands reported their last confirmed cases in June 2018, Saint Lucia reported its last cases in 2016, and Grenada, Anguilla and Dominican Republic reported their last cases in 2017.

Below are the countries and territories in the Caribbean that have a current risk of Zika:

South America

In 2019, according to the PAHO, Brazil reported 3,323 cases of Zika. After Brazil, the countries in South America that reported the majority of cases were Peru (829) and Bolivia (27).

Below are the countries in South America that have a current risk of Zika:

Pacific Islands

In 2018, Australian health authorities reported 2 cases where the probable places of infection were Fiji and Vanuatu. Overall, while large outbreaks occurred in this area in 2014, new cases have been rare.

Below are the Pacific islands that have a current risk of Zika:

Asia

Currently, India is the area with the most cases being currently reported in Asia. As of November 2018, 159 confirmed cases were reported in 2018.

Thailand has also reported cases in recent years. In 2018, 568 cases were reported across the country and in 2019, 48 cases have been reported as of June.

Media outlets have also reported cases with probable infection in Vietnam, Malaysia, the Philippines, Singapore, Indonesia, and the Maldives.

Below are the countries in Asia that have a current risk of Zika:

Africa

Multiple countries in Africa are considered to have current or past Zika transmission. In recent years, Zika has been reported in Angola, Cabo Verde, and Guinea Bissau.

According to the WHO Eastern Mediterranean Regional Office, no cases have been recorded in the countries since August 2019. However, since not all areas report health information, it is difficult to truly gauge the current risks in Africa.

Below are the countries in Africa that have a current risk of Zika:

Bottom Line: Real-time data on Zika Virus outbreaks and transmission is often not available. This is because most people who become infected with Zika do not show signs or symptoms. In some countries, reliable reporting and monitoring systems that track virus transmission may not be available. 

Zika Prevention

There is currently no vaccine to prevent Zika. There is research in progress that may lead to a vaccine in the future, though.

The National Institute of Allergy and Infectious Disease (NIAID) is currently in phase 2 of a Zika vaccine trial in Texas, Puerto Rico, and South and Central America [8]. Other vaccine trials exist, too, but may take years to finalize [9].

Beyond simply avoiding those countries, here are some strategies from the CDC to avoid Zika if you do travel to a country that has or is at risk of having Zika.

Mosquito Control

The single best way to prevent diseases spread by mosquitoes is to protect yourself and your family from mosquito bites.

According to the CDC, here are a few preventative measures to take:

• Wear Protective Clothing
  • When you go into mosquito-infested areas, wear a long-sleeved shirt and long pants
  • Treat your clothing and gear with permethrin or buy pre-treated items
  • Wear socks and shoes instead of sandals
• Use Insect Repellent
• UseEnvironmental Protection Agency (EPA)-registered insect repellents containing one of the following active ingredients:
  • DEET (note that a higher concentration of DEET doesn’t mean a product is stronger, only that it lasts longer)
  • Picaridin
  • IR3535
  • Oil of lemon eucalyptus (OLE)*
  • Para-menthane-diol (PMD)*
  • 2-undecanone

*The CDC recommends not using these products on children under 3 years old.

Apply insect repellent based on the instructions used on the container’s label. EPA-registered insect repellents are proven safe and effective for pregnant and breastfeeding women but are not approved for use on babies younger than 2 months old.

The CDC does not recommend natural insect repellents (such as those made with citronella, lemongrass, peppermint, and cedarwood).

Hot Tip: Parents should apply insect repellent to their children. It should be applied only to exposed skin. Avoid hands, eyes, cuts, or irritations. You might want to put it on your hands first, then rub it on your child so you don’t use too much. 

Make Yourself a Less-Attractive Target

Don’t use scented lotions or sprays that can attract bugs before going outside.

You may also have heard people say that they always get bit while others are left without a trace. There may be some truth to this! The main way mosquitoes search for their next victim is by carbon dioxide output.

Unfortunately, most of this directly relates to genetics but you do have some control. Drinking alcohol and exercising can both raise your resting metabolic rate and carbon dioxide output, making you more attractive to mosquitoes [10].

Stay in Air-Conditioned or Well-Screened Housing

The mosquitoes that carry the Zika virus are most active from dawn until dusk, but they can also bite at night. Stay in places with air conditioning and keep windows and doors closed.

If this is not possible, ensure that the doors and windows have screens to keep mosquitoes out.

Take Steps to Control Mosquitoes Outside Your Home

The goal is to reduce the breeding habitat to lower the overall mosquito population. The mosquitoes that carry the Zika virus typically breed in standing water that can collect in such things as animal dishes, flower pots, and used car tires.

Make sure to dump out water from smaller containers periodically, but especially after rainfall. Cover larger bodies of water like pools and hot tubs when not in use.

Sleep Under a Mosquito Bed Net

If air-conditioned or screened rooms are not available or if you are sleeping outdoors, but sure to sleep under a mosquito net. Mosquito netting can also be used to cover babies younger than 2 months old in their strollers or cribs as using an insect repellent is not safe for them.

Here are some guidelines for using a mosquito net:

• Tuck the net under the mattress to keep the mosquitoes out
• Tuck netting over a crib under the mattress or select a net long enough to touch the floor
• Pull the net tight to avoid choking hazards for young children
• Check for holes or tears in the net where mosquitoes can enter
• Do not sleep directly against the net, as mosquitoes can still bite through holes in the net

Hot Tip: Do not hang the mosquito net near open flames or candles as it can catch on fire.

Protected Sex

Prevent sexual transmission of Zika by using condoms or not having sex for either the rest of the pregnancy or for 3 months after return from a country with current or past known transmissions.

This advice applies to both men and women. Men can transmit Zika to their partner, who can then, in turn, transmit to a baby.

Blood Transfusion

According to the CDC, there have been no confirmed transfusion-related transmission cases of Zika virus in the U.S. [11]. However, cases of Zika virus transmission through platelet transfusions have been documented in Brazil.

There isn’t anything in particular individuals can do to prevent transmission through blood transfusions. All blood donations are now screened for the Zika virus and the CDC notes that they ensure “the blood supply safe is by assisting state and local health departments and hospitals in investigating reports of potential infectious disease transmission.”

Bottom Line: The only way to protect yourself from the Zika virus is to take preventative measures regarding mosquitoes and having protected sex.

Symptoms of Zika

As many as 4 out of 5 people infected with the Zika virus have no signs or symptoms. When symptoms do occur, they usually begin 2 to 7 days after a person is bitten by an infected mosquito.

According to the Mayo Clinic, the symptoms include [12]:

• Mild fever
• Rash
• Joint or muscle pain
• Headache
• Red eyes (conjunctivitis)

People typically recover in about a week and death is rare.

What to Do If You Think You Have Zika

If you have traveled to an area with known Zika outbreaks and develop some of the common symptoms noted above, please go see your healthcare provider immediately. A blood or urine test can identify a Zika infection.

Be sure to tell them where you traveled and whether or not you may be pregnant. In addition, if you are taking medicine for another medical condition, talk to your doctor before taking additional medication.

Bottom Line: We are not medical professionals, so always discuss all of these items with your healthcare provider.

Zika Treatment

For most of those infected, with the exception of babies, the side effects of Zika are not usually severe. Common practice has been to treat symptoms as there is no “cure” for Zika.

After you see your doctor, they may tell to do some of the following items in order to treat the symptoms:

• Get plenty of rest
• Drink fluids to prevent dehydration
• Take medicine such as acetaminophen to reduce fever and pain
• Do not take aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs)

How Long is Zika Detectable in the Body?

According to a study [13], Zika was still detectable in 5% or more of participants up to:

• Vaginal fluids — 7 days
• Saliva — 7 days
• Urine — 39 days
• Blood — 54 days
• Semen — 3 months

The good news is that once a person has been infected with Zika, they are likely to be protected from future infections.

Guillain-Barre Syndrome

As briefly touched on earlier, there is also a 20 fold increased risk of Guillain-Barre syndrome. This is an autoimmune disease that results in widespread weakness and paralysis. While it only occurs in less than 1% of Zika infections, it can have severe complications.

Two-thirds of patients lose the ability to walk, and 25% need to be put on a mechanical ventilator because of the weakness of the respiratory muscles. Those with the syndrome usually experience their most significant weakness within 2 to 4 weeks after symptoms begin.

According to the Mayo Clinic [14], signs and symptoms of Guillain-Barre syndrome may include:

• Prickling, pins and needles sensations in your fingers, toes, ankles or wrists
• Weakness in your legs that spreads to your upper body
• Unsteady walking or inability to walk or climb stairs
• Difficulty with eye or facial movements, including speaking, chewing or swallowing
• Severe pain that may feel achy or cramp-like and may be worse at night
• Difficulty with bladder control or bowel function
• Rapid heart rate
• Low or high blood pressure
• Difficulty breathing

There’s no known cure for Guillain-Barre syndrome, but several treatments can ease symptoms and reduce the duration of the illness. Most people make a partial or full recovery.

Zika and Pregnancy

Studies have found that pregnant women have 2 disadvantages when it comes to mosquitoes [15]. Their body temperatures tend to be higher and they also exhale more carbon dioxide, both of which can lead to more mosquito bites.

If a pregnant woman gets bitten and contracts the Zika virus, she may transmit it to her baby. Babies are much more likely to be born with a birth defect in which a developing baby’s brain fails to grow to its usual size. Hearing and vision problems have also been reported in newborns exposed to Zika in the womb.

If you are considering getting pregnant, partners will need to take precautions as well.

Trying to Conceive

Women who have had symptoms of the virus or tested positive for it should wait at least 8 weeks after their symptoms first appeared before trying to get pregnant according to the CDC.

In addition, the CDC recommends that men who had symptoms should wait between 3 to 6 months before having unprotected sex. The reason for the difference in time is because Zika can be found in semen longer than in other body fluids.

Already Pregnant

If your partner has Zika or has traveled in an area with an outbreak, continue to follow the same guidelines as above – no unprotected sex for 3-6 months. This will prevent transmission while the mother is carrying the child.

If Zika is transmitted, the infection during pregnancy can cause a birth defect of the brain called microcephaly. It is also linked to other problems, such as miscarriage, stillbirth, and other birth defects.

Estimates of the rate of birth defects related to Zika have ranged from 6% to 42%. Additionally, while studies are being done to determine more information about the effects of contracting the virus at different stages in pregnancy, what is known is that the earlier the infection occurred in pregnancy, the greater the risk.

If families would like to speak to someone about a possible Zika virus infection or diagnosis during pregnancy and risk to the baby, the CDC has a free and confidential service available called MotherToBaby. This service available Monday-Friday 8 a.m. – 5 p.m. (local time) at:

• Call 866-626-6847 or text 855-999-3525
• Chat live or send an email through the MotherToBaby website

Future Pregnancies

Based on the available evidence, the CDC believes that the Zika virus infection in a woman who is not pregnant would not pose a risk for birth defects in future pregnancies after the virus has cleared from her blood.

From what is known about similar infections (like West Nile and Yellow Fever), once a person has been infected with Zika virus, he or she is likely to be protected from a future Zika infection.

If you have been infected with Zika previously, it is always best to consult your doctor before trying to conceive again.

Zika Treatment for Babies

Babies who were infected with Zika before birth may have damage to their eyes and the part of their brain that is responsible for vision, affecting their visual development. Both babies with and without microcephaly can have eye problems.

If your baby was born with a congenital Zika infection, he or she should receive the CDC-recommended screenings and tests to check for eye and other health problems, even if your baby appears healthy.

Much is still unknown about how Zika affects those babies born with or without microcephaly. Even without the obvious birth defect or for mothers that never showed symptoms, there may still be other side effects.

Studies are being done which show that there might be detrimental effects on long-term memory, social interactions, and abstract reasoning as patients age [16].

Zika-Free Destinations

Many couples choose to take babymoons to relax and enjoy time together before the arrival of their new bundle of joy. While it may sound appealing to head to a tropical destination for some sun and sand, it is also important for expectant mothers to avoid countries with a high risk of Zika.

There are still plenty of vacation-worthy destinations to visit if you’re looking to travel somewhere without any reported Zika cases! Some great options include Bermuda, Morocco, Canary Islands, Mauritius, New Zealand, Chile, Azores, Hawaii, Seychelles, and most of Europe.

Other Factors to Consider

If you’re looking to go somewhere else, be sure to think about the specific areas and times you want to travel to better assess your risk of contracting Zika.

Higher-altitude areas tend to have fewer mosquitoes. In addition, look into what season you would be traveling during. Rainy season is often when the transmission of mosquito-borne viruses is at its highest.

Whenever you arrive at your destination, try to get rooms on higher floors and check the screens on the windows. If there aren’t any, be sure to keep them closed to avoid bringing the mosquitoes in the room.

Hot Tip: Travel insurance can go a long way toward providing peace of mind during any trip. If you get ill while traveling, you’ll find consolation in being financially covered. With our complete guide to travel insurance, you’ll find the best affordable travel coverage and get tips for finding travel coverage you might already have.

Final Thoughts

Overall, Zika is on the decline, but this doesn’t mean you can forget about the potential risks. It is always good to be informed and take the preventative measures we’ve laid out above.

Pregnant women and couples planning on having kids in the near future should be especially aware of the risks of Zika when choosing travel destinations. It may be good to postpone or change travel plans to prevent any serious complications.

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All information and content provided by Upgraded Points is intended as general information and for educational purposes only, and should not be interpreted as medical advice or legal advice. For more information, see our Medical & Legal Disclaimers.