Zika Virus & other Mosquito Borne Diseases

Zika is a virus that is closely related to dengue. It is spread by mosquitoes but can also spread through sexual activity.

Zika virus was first reported outside Africa and Asia in 2007 where it caused an outbreak in Yap State (Federated States of Micronesia). Between 2013 and 2015 there were large outbreaks of Zika virus in the Pacific Islands, and in 2015, Zika virus emerged in South America, with spread to many countries in South and Central America and the Caribbean. Zika virus outbreaks are ongoing in the Americas. There is evidence of cases of Zika virus in Southeast Asian countries such as Thailand and Indonesia where the virus may have been present at low levels for many years.  I

Symptoms:     Most people experience a very mild flu-like infection without any complications. However, it is now known that Zika virus may be passed from a woman to her unborn baby. This can cause potentially serious consequences for the baby, in particular a condition called microcephaly (a small head and brain). Microcephaly is just one of the signs and symptoms of congenital Zika virus syndrome (CZVS) that can be present at birth or appear later in infancy such as seizures (fits), irritability, swallowing problems, hearing and sight abnormalities.

There is no vaccine currently available for Zika virus.

While the majority of people who get infected with Zika virus do not become sick, it is especially a concern for women who are pregnant or planning a pregnancy because of the risk of serious birth defects.  The following information is from the Department of Health: “Women who are planning pregnancy or at risk of pregnancy should consider deferring travel or avoid pregnancy during travel to a Zika affected country. They should also avoid unprotected sex and pregnancy for at least 8 weeks following return. Advice relating to a partner who has travelled also applies.

For men with a partner who is planning or at risk of pregnancy and the man has travelled to a Zika affected country or has a diagnosed Zika infection, pregnancy should be deferred for least 6 months after return, or 6 months after the date that Zika virus infection was diagnosed.” http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-zika-factsheet-basics.htm

The best prevention for Zika virus, and other mosquito-borne diseases for which there is no vaccine available, such as Chikungunya and Dengue viruses, is avoidance of mosquito bites.  The Department of Health makes the following recommendations:

• Cover up as much as possible, eg. Wear light coloured long-sleeved shirts and long pants.
• Use insect repellents as frequently as recommended on the label. The most effective mosquito repellents contain Diethyl Toluamide (DEET) or Picaridin, but those containing oil of lemon eucalyptus (OLE) (also known as Extract of Lemon Eucalyptus) or para menthane diol (PMD) also provide adequate protection.  Repellents containing DEET or picaridin, are safe for pregnant and breastfeeding women and children older than 2 months when used according to the product label.
• When using both sunscreen and insect repellent, apply the sunscreen first and then the repellent.
• Use insecticide-treated (such as permethrin) clothing and gear (such as boots, pants, socks, and tents).
• Stay and sleep in screened-in or air-conditioned rooms, and use bed nets if you cannot keep mosquitoes outside.

Risk regions for Zika (Source: healthwa.wa.gov.au)

Zika infection during pregnancy can cause serious birth defects. Therefore, pregnant women should not travel to countries where it is endemic. Partners of pregnant women and couples planning pregnancy should know the possible risks to pregnancy and take preventive steps.¹ You can get the disease from being bitten by a mosquito carrying the disease or through unprotected sex with an infected person.

The Centre for Disease Control in Atlanta keeps a constantly updated list of countries with Zika Virus:

https://www.cdc.gov/zika/

Due to the global risk of Zika to unborn babies, we recommend that those fertile women travelling through countries with Zika Virus, do not fall pregnant while there. Whilst Condoms are always a great idea, you may consider long or intermediate acting contraception such as Depot Injection (3 months), Implanon (3 years or Mirena (5 years). The advantage of these methods over an oral pill is that vomiting or diarrhoea do not cause them to fail.  If trying a new option, we suggest you try it 2-3 months before travelling to ensure it works well for you.  All options are available at Manly Village Medical.

People travelling to Africa, the Caribbean and Central or South America are at risk of contracting Yellow Fever, a virus carried by the Aedes and Haemagogus mosquito species.

There is no known cure, and if left untreated the virus can be fatal.  It is important to understand the risks and precautions to protect yourself.   Yellow Fever is hard to recognise in its early stages and often is misdiagnosed as other illnesses.  The name is derived from the discolouration of the skin in serious cases, causing jaundice.  Symptoms include fever, chills, headache, backache, and muscle aches (stage 1).  About 15% of people who get yellow fever develop serious illness (stage 2) which includes bleeding, jaundice, kidney and liver failure.

YELLOW FEVER IS PREVENTABLE!

• Yellow Fever Vaccine is the best protection against yellow fever disease.   You should receive this vaccine AT LEAST 10 DAYS BEFORE YOUR TRIP.  After  receiving the vaccine, you will be given a signed and stamped International Certificate of Vaccination or Prophylaxis (Yellow Card), which you must take on your trip.  The vaccine lasts for life but a booster is recommended for certain people after 10 years.
• Protect from Mosquito Bites.  Travellers to areas with risk of yellow fever should also prevent mosquito bites by using insect repellent, wearing long-sleeved shirts and pants when outdoors, and sleeping in air-conditioned or under and insecticide-treated bed net.

For more information, visit :

Centres for Disease Control and Prevention, Yellow Fever 

CDC Frequently Asked Questions about Yellow Fever

Risk regions for Yellow Fever (source HWA)

Malaria is a disease spread through mosquito bites. Symptoms usually appear within in 7-30 days but can take up to one year to develop. Symptoms include high fevers, shaking chills, and flu-like illness. Without treatment, malaria can cause severe illness and even death.

There is no vaccine currently available for Malaria.  However, prevention of infection or “prophylaxis” is available, in the form of anti-parasitic medications that are taken throughout the trip, and usually for a short while after returning home.  Your doctor will be able to discuss these with you and help you decide which ones might be best-suited.

For further information: https://wwwnc.cdc.gov/travel/diseases/malaria

Risk areas : Malaria (Source HWA)