Do You Still Need to Worry About Zika?

Remember Zika? It may have been a few years since you heard news headlines warning of it, but in many parts of the world, some risk still remains — especially for people who are pregnant or want to become pregnant.

But it isn’t something you need to worry about contracting at home in the United States, says Ob/Gyn Oluwatosin Goje, MD, who specializes in infectious diseases. “Zika is not an epidemic in the U.S.,” she confirms. “In the continental U.S., the last cases of Zika transmission were reported in Florida and Texas in 2017.”

Since 2018, there have been no reports of Zika virus transmission by mosquitoes in the continental United States. And since 2019, there have been no confirmed Zika virus disease cases reported from United States territories.

But in other parts of the world, the Zika virus still looms. Dr. Goje explains what you need to know about it when you travel.

The Zika threat has significantly decreased, but it’s still there

In 2015 and 2016, a Zika outbreak had the world on edge, beginning in Brazil and soon traveling through South and North America. The U.S. saw transmission in Florida, Texas, Puerto Rico and the Virgin Islands.

Since then, cases have dramatically declined. As of the end of 2022, no countries are experiencing active Zika outbreaks — but that doesn’t mean the virus has disappeared.

“There’s been a massive decrease in reported Zika transmission, but some countries are still at risk,” Dr. Goje states. “There is currently no vaccine to prevent or medicine to treat Zika.”

Who’s at the highest risk for Zika?

The Zika virus is most commonly spread through Aedes aegypti mosquitoes (also known as yellow fever mosquitoes), which thrive in tropical climates.

It can also be transmitted through sex and pregnancy (from a pregnant parent to a fetus). Infection during pregnancy can cause other severe fetal birth defects.

“One of the main reasons not to travel to areas at risk of Zika is that it is known to cause birth defects in babies born to parents infected with the virus,” Dr. Goje notes.

Zika can cause serious birth defects, including brain damage and microcephaly, a condition that causes a baby to be born with a smaller head than expected. Zika also increases the risk of:

• Low birth weight.
• Miscarriage.
• Premature labor.
• Stillbirth.

If you’re pregnant or trying to conceive (whether you could become pregnant yourself or impregnate a partner), medical professionals recommend that you proceed with caution when traveling to places with Zika risks.

Should you cancel travel plans because of Zika?

To learn whether there’s a risk of Zika in your travel destination, Dr. Goje recommends first checking the U.S. Centers for Disease Control and Prevention’s (CDC) interactive Zika map, which lists threat levels by country. It’s divided into these categories:

• Areas with a current Zika outbreak. There are currently no active outbreaks anywhere in the world. When there are, experts say people who are trying to conceive should avoid traveling to these countries.
• Areas that have ever reported cases of Zika, whether now or in the past.
• Areas that are home to Aedes aegypti mosquitoes but have never reported cases of Zika. The CDC says, “Zika has the potential to be present, along with other mosquito-borne infections.”
• Areas that don’t have Aedes aegypti mosquitoes. This includes all of Canada, parts of Northern Africa, most of the U.K. and Scandinavia and much of the Middle East. But the CDC notes that other types of mosquitoes may carry Zika, and those mosquitoes could reside in these places.

If you’re debating traveling to a country where Zika is a risk, the decision to cancel or postpone your trip is personal and complex.

“You’ll have to consider your travel destination and protect yourself accordingly,” Dr. Goje says. “You’ll also need to share your decision with your partner and doctor and discuss what that means.”

What precautions should you take against Zika?

If you find yourself traveling to an area that has or has had Zika, try to avoid mosquito bites. During your trip, you should:

• Wear proper insect repellent.
• Cover exposed skin with long sleeves and pants.
• Sleep indoors or in areas enclosed by screens or nets.

If you could become pregnant or could get someone pregnant, you’ll have to take precautions when you get home, too.

“If a couple decides that they’re going to travel to a Zika destination, they will need to decide that they won’t try for pregnancy for the first three months that they’re back,” states Dr. Goje. “This can mean abstaining from sex altogether or using contraception, like birth control or condoms.”

If you’re not part of a couple but are sexually active, the amount of time that you should abstain or use contraception when you get home depends on which reproductive organs you have.

• If you were assigned female at birth: Zika can be transmitted from birth parent to fetus, so try not to become pregnant for two months after returning from your destination.
• If you were assigned male at birth: Zika can live longer in semen than in other bodily fluids, so avoid creating a pregnancy for at least three months.

Doctors can help treat the symptoms of Zika, but there still isn’t a cure. “People who travel globally should know how to prepare and what to do and look for upon their return,” Dr. Goje advises. “Prevention and awareness are your best defenses.”