Zika virus infection travel notice

Zika virus infection travel notice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]

Overview

The CDC has issued level 2 alert (practice enhanced precautions) for travelers to Cape Verde, the Carribean, Central America, Mexico, Pacific Islands, and South America. As of August 1, 2016, for the first time in history, the CDC has issued a travel warning within the United States. The warning applies to travelers within South Florida in the Miami-Dade County, Wynwood Area and Miami Beach area.

Travel Notice

Travel to South Florida

CDC ALERT - LEVEL 2 - Practice Enhanced Precautions

Updated guidance for Miami-Dade county:

Travel

• Pregnant women should consider postponing travel to all parts of Miami-Dade County.

Testing and Diagnosis

• Pregnant women who lived in, traveled to, or had sex without a condom with someone who lived in or traveled to Miami-Dade County after August 1, 2016, should be tested for Zika virus.
  • Pregnant women with symptoms of Zika should be tested for Zika virus.
  • Pregnant women without symptoms who have ongoing exposure (live in or frequently travel [daily, weekly]) to Miami-Dade County should consult with their healthcare provider to obtain testing for Zika in the first and second trimesters of pregnancy.
  • Pregnant women who have had limited travel to Miami-Dade County or who had sex without a condom with a partner who lived in or traveled to Miami-Dade County should be tested for Zika virus infection.

Pregnancy planning

• Women who traveled (limited travel) to Miami-Dade County or had sex without a condom with a person who lives in or traveled to Miami-Dade County may consider waiting at least 8 weeks after symptoms started or last possible exposure before trying to get pregnant. Although the level of risk in yellow areas is unknown, pregnant women are still at risk.
• Men who traveled (limited travel) to Miami-Dade County or had sex without a condom with a person who lives in or traveled to Miami-Dade County may consider waiting at least 6 months after symptoms started or last possible exposure before trying to get their partner pregnant.
• People living in Miami-Dade County who do not have symptoms and are interested in trying to become pregnant should talk to their healthcare provider about pregnancy plans.
• Women who live in or frequently travel to Miami-Dade County who are diagnosed with Zika should wait at least 8 weeks after symptoms started before trying to get pregnant.
• Men who live in or frequently travel to Miami-Dade County who are diagnosed with Zika should wait at least 6 months after symptoms started before trying to get their partner pregnant.
• Given the limited data available about the persistence of Zika in body fluids and the chances of harm to a pregnancy when the woman is infected with Zika around the time of conception, some couples with a partner with possible Zika virus exposure may choose to wait longer or shorter than the recommended period to try to get pregnant.

Prevention

• Pregnant couples and couples trying to get pregnant who live in or travel to Miami-Dade County should be aware of active Zika virus transmission and should strictly follow steps to prevent mosquito bites.
• Women and men who live in or traveled to Miami-Dade County should be aware of active Zika virus transmission, and those who are pregnant or who have a pregnant sex partner should use condoms during sex or not have sex during the pregnancy.

Guidance for Wynwood, North Miami Beach, South Miami Beach, and Little River, FL

The guidance for zika cautionary areas now applies to the identified areas in Wynwood, North Miami Beach, South Miami Beach, and Little River, FL, where the risk of Zika remains but is no longer greater than that in the rest of Miami-Dade County.Women and men living in or who traveled to these areas should be aware that these locations were considered to have intense Zika virus spread previously, but low risk of local spread may still exist. Partners of pregnant women in these areas should use condoms consistently and correctly to prevent passing Zika during sex, or they should not have sex during the pregnancy.

• Pregnant women who lived in, traveled to, or had sex without a condom with a person who lived in or traveled to the identified area of Little River after August 1, 2016, should be tested for Zika.
• Women who traveled to the identified area of Little River after August 1, 2016, regardless of whether they had symptoms, should wait at least 8 weeks before trying to get pregnant.
• Men who traveled to the Little River area after August 1, 2016, regardless of whether they had symptoms, should wait at least 6 months before trying to get their partner pregnant.
• Pregnant women who lived in, traveled to, or had sex without a condom with a person who lived in or traveled to the identified areas of North Miami Beach or South Miami Beach after July 14, 2016, should be tested for Zika.
• Women who traveled to the identified areas of North Miami Beach or South Miami Beach after July 14, 2016, regardless of whether they had symptoms, should wait at least 8 weeks before trying to get pregnant.
• Men who traveled to the identified areas of North Miami Beach or South Miami Beach after July 14, 2016, regardless of whether they had symptoms, should wait at least 6 months before trying to get their partner pregnant.
• Pregnant women who lived in, traveled to, or had sex without a condom with a person who lived in or traveled to the Wynwood area after June 15, 2016, should be tested for Zika.
• Women who traveled to the Wynwood area after June 15, 2016, regardless of whether they had symptoms, should wait at least 8 weeks before trying to get pregnant.
• Men who traveled to the Wynwood area after June 15, 2016, regardless of whether they had symptoms, should wait at least 6 months before trying to get their partner pregnant.
• Given the limited data available about the persistence of Zika virus in body fluids and the chances of harm to a pregnancy when the woman is infected with Zika around the time of conception some couples with a partner with possible Zika virus exposure may choose to wait longer or shorter than the recommended period.

Travel to Brownsville Texas

On December 14, 2016, CDC issued guidance related to Zika for people living in or traveling to Brownsville, Cameron County, TX. On November 28, the Texas Department of State Health Services reported the state’s first case of local mosquito-borne Zika virus infection in Brownsville. Additional cases of mosquito-borne Zika have been identified in the area, suggesting that there is a risk of continued spread of Zika virus in Brownsville. As a result, CDC has designated Brownsville as a Zika cautionary area.

Travel

• Pregnant women who live in other areas should consider postponing travel to Brownsville,TX.

Prevention

• Pregnant women,women trying to get pregnant,and their partners who live in or travel to Brownsville should be aware of local Zika virus transmission and should strictly follow steps to prevent mosquito bites.
• Pregnant women and their partners who live in or travel to Brownsville should use condoms every time they have sex or not have sex during the pregnancy.

Testing and Diagnosis

• Pregnant women who live in,travelled to,or had sex without a condom with someone who lives in or traveled to Brownsville on or after October 29,2016,should be tested for Zika virus.
  • Pregnant women with symptoms of Zika should be tested for Zika virus.
  • Pregnant women without Zika symptoms with ongoing risks for exposure (they live in or frequently travel [daily or weekly]) to Brownsville should talk to their healthcare provider to obtain routine testing for Zika virus in both the first and second trimesters.
  • Pregnant women without Zika symptoms who had limited travel to Brownsville or who had sex without a condom with a person who lives in or traveled to Brownsville should be tested for Zika virus.

Pregnancy planning

• Women who had limited travel to Brownsville or had sex without a condom with a person who lives in or traveled to Brownsville may consider waiting at least 8 weeks after symptoms started or last possible exposure before trying to get pregnant.
• Men who had limited travel to Brownsville or had sex without a condom with a person who lives in or traveled to Brownsville may consider waiting at least 6 months after symptoms started or last possible exposure before trying to get their partner pregnant.
• People living in Brownsville should talk to their healthcare provider about the possible risk for Zika infection and about their pregnancy plans.
• Women who live in or frequently travel to Brownsville who are diagnosed with Zika should wait at least 8 weeks after symptoms started before trying to get pregnant.
• Men who live in or frequently travel to Brownsville who are diagnosed with Zika should wait at least 6 months after symptoms started before trying to get their partner pregnant.
• Given the limited data available about the persistence at the time of conception, some couples with a partner with possible Zika virus exposure may choose to wait longer or shorter than the recommended period to try to get pregnant.

Travel to Cape Verde

CDC ALERT - LEVEL 2 - Practice Enhanced Precautions

• According to the Centers for Disease Control and Prevention (CDC), Cape Verde reported the first local transmission of Zika virus infection (Zika) in October 2015.

Travel to the Caribbean

CDC ALERT - LEVEL 2 - Practice Enhanced Precautions

• According to the Centers for Disease Control and Prevention (CDC), the first local transmission of Zika virus infection (Zika) was reported in the Caribbean in December 2015.
• Since then, the following Caribbean destinations have reported ongoing transmission of Zika:

• Anguilla
• Antigua and Barbuda
• Bahamas
• British Virgin Islands
• Cayman Island
• Cuba
• Domanica
• Aruba
• Barbados
• Bonaire
• Curaçao
• Dominican Republic
• Grenada
• Guadeloupe
• Haiti
• Jamaica
• Martinique
• The Commonwealth of Puerto Rico, a U.S. territory
• Saba
• Saint Barthelemy
• Saint Lucia
• Sint Eustatius
• Saint Martin
• Saint Vincent and the Grenadines
• Sint Maarten
• Trinidad and Tobago
• U.S. Virgin Islands
• Turks and Caicos Islands

Travel to Central America

CDC ALERT - LEVEL 2 - Practice Enhanced Precautions

• According to the Centers for Disease Control and Prevention (CDC), the first local transmission of Zika virus infection (Zika) was reported in Central America in November 2015.

• Belize
• Costa Rica
• El Salvador
• Guatemala
• Honduras
• Nicaragua
• Panama

Travel to Mexico

CDC ALERT - LEVEL 2 - Practice Enhanced Precautions

• According to the Centers for Disease Control and Prevention (CDC), the first local transmission of Zika virus infection (Zika) was reported in Mexico in November 2015.

Travel to Pacific Islands

CDC ALERT - LEVEL 2 - Practice Enhanced Precautions

• According to the Centers for Disease Control and Prevention (CDC), the first local transmission of Zika virus infection (Zika) was reported in Samoa in November 2015.
• The following destinations in the Pacific Islands have reported ongoing transmission of Zika:

• Fiji
• Kosrae,Federated states of Micronesia
• Papua New Guinea
• American Samoa
• Marshall Islands
• New Caledonia
• Palau
• Samoa
• Tonga

Travel to South America

CDC ALERT - LEVEL 2 - Practice Enhanced Precautions

• According to the Centers for Disease Control and Prevention (CDC), the first local transmission of Zika virus infection (Zika) was reported in South America in November 2015.

• Argentina
• Peru
• Bolivia
• Brazil
• Colombia
• Ecuador
• French Guiana
• Guyana
• Paraguay
• Suriname
• Venezuela

Travel to Singapore

CDC ALERT - LEVEL 2 - Practice Enhanced Precautions

• According to the Centers for Disease Control and Prevention (CDC), the first local transmission of Zika virus infection (Zika) was reported in Singapore in August 2016.

Areas to Avoid or Postpone Non-Essential Travel

While the CDC has not issued a travel warning in these regions, ZIKV is considered endemic and non-essential travel is not advised at this time to the following countries in Southeast Asia:

• Bangladesh
• Brunei
• Burma (Myanmar)
• Cambodia
• Indonesia
• Laos
• Malaysia
• Maldives
• Philippines
• Thailand
• Timor-Leste (East Timor)
• Vietnam

Travel Plan

Protection from mosquito bites

• Travelers should prevent mosquito bites during and after the trip.

• Travelers returning from Zika endemic area should take steps to prevent mosquito bites for 3 weeks (even if they do not feel sick), so they do not spread Zika to mosquitoes that could spread the virus to other people.

For more information regarding prevention of mosquito bites click here

Pregnant or trying to be pregnant

• If you are pregnant avoid travelling to Zika endemic areas.
• If you or your partner trying to get pregnant, consider avoiding nonessential travel to Zika endemic areas.
• Practice safe sex practices if the partner traveled to the Zika endemic areas.

For more information regarding prevention of Zika virus through sexual transmission click here

Consult doctor

Consult doctor or healthcare professional immediately, if you have signs and symptoms of ZIKV infection after travel from Zika endemic areas.