Zika virus infection: Global Update

Updated: December 15, 2016

Travel Health Notice

The Public Health Agency of Canada recommends that pregnant women and those planning a pregnancy avoid travel to countries or areas in the United States with reported mosquito-borne Zika virus. 

The World Health Organization Zika situation report lists countries where there is reported mosquito-borne Zika virus transmission (countries listed under category 1 and 2 of Table 1[pdf, 396 kb).

The United States have reported cases of Zika virus infection transmitted locally by mosquitoes in the states of Florida and Texas.

• Pregnant women and those planning a pregnancy should avoid travel to the affected areas of Florida (see CDC map), and Texas (see CDC map)
• There is potential transmission of Zika virus in and around areas with reported locally transmitted cases, even if cases are not yet reported.
• Pregnant women and those planning a pregnancy should consider postponing travel to other areas in Florida.

All travellers should protect themselves from mosquito bites.  For additional recommendations please see the section below.

Zika virus infection is caused by a virus which is primarily spread by the bite of an infected mosquito. It can also be transmitted from an infected pregnant woman to her developing fetus. In addition, Zika virus can be sexually transmitted, and the virus can persist for an extended period of time in the semen of infected males.  Cases of sexual transmission from an infected male to his partner have been reported. Only one case of sexual transmission has been reported from an infected female to her partner.

Symptoms of Zika virus can include fever, headache, conjunctivitis (pink eye) and skin rash, along with joint and muscle pain. The illness is typically mild and lasts only a few days and the majority of those infected do not have symptoms. There is no vaccine or medication that protects against Zika virus infection.

Experts agree that Zika virus infection causes microcephaly (abnormally small head) in a developing fetus during pregnancy and Guillain-Barré Syndrome (a neurological disorder).  Several countries have reported cases of microcephaly and Guillian-Barré Syndrome.  Brazil, in particular, has reported a significant increase in the number of newborns with microcephaly.

Zika virus is occurring in many regions of the world although local transmission of Zika virus was first reported in the Americas in 2015.  There have been travel-related cases of Zika virus reported in Canada in returned travellers from countries with ongoing Zika virus outbreaks.

On November 18, 2016, the World Health Organization announced that the Zika virus, microcephaly and other neurological disorders still pose a significant public health challenge, however, no longer meet the criteria of a Public Health Emergency of International Concern.   For Canadian women of childbearing age and their sexual partners, the risks associated with travel to countries reporting local mosquito-borne transmission, remain the same. 

This travel health notice will be updated as more information becomes available.

Recommendations

Consult a health care provider or visit a travel health clinic preferably six weeks before you travel.

• Pregnant women and those planning a pregnancy should avoid travel to countries or areas in the United States with reported mosquito-borne Zika virus.
  • If travel cannot be avoided or postponed strict mosquito bite prevention measures should be followed due to the association between Zika virus infection and increased risk of serious health effects on their developing fetus.
• Travellers returning from countries and areas in the United States with reported mosquito-borne Zika virus:
  • For pregnant women, if you develop symptoms that could be consistent with Zika virus infection, you should consult a health care provider. 
  • For women planning a pregnancy, it is strongly recommended that you wait at least 2 months before trying to conceive to ensure that any possible Zika virus infection has cleared your body.
  • For male travellers, Zika virus can persist for an extended period of time in the semen of infected males, therefore:
    • It is strongly recommended that, if you have a pregnant partner, you should use condoms or avoid having sex for the duration of the pregnancy.
    • It is strongly recommended that you and your partner wait to conceive for 6 months by using a condom or by avoiding having sex.
    • It is recommended that you should consider using condoms or avoid having sex with any partner for 6 months.

• Travellers should protect themselves from mosquito bites at all times, as the Zika virus is transmitted by a mosquito that can bite in daylight and evening hours. These mosquitoes generally do not live or transmit disease at elevations above 2,000 meters. A list of how to prevent insect bites is available on the Government of Canada's website.

• Most people who have Zika virus illness will have mild symptoms that resolve with simple supportive care. If you are pregnant, or you have underlying medical conditions, or you develop more serious symptoms that could be consistent with Zika virus infection, you should see a health care provider and tell them where you have been travelling or living.