How to stay one step ahead of the Zika virus

By Philip Wagenaar, MD
This item appears on page 53 of the September 2017 issue.

When the ms Prinsendam entered the harbor of Sint Maarten in January 2015, I knew that the Zika virus was rampant on the island and that, unless I took precautions, there was a good chance that I would be bitten by one of the many Zika virus-carrying mosquitoes that were flying around the island day and night.

Should I disembark? I decided to stay on the ship.

So when I read in ITN a very nice article about Sint Maarten/Saint-Martin (May ’17, pg. 57) and saw a picture of the author at the Philipsburg waterfront wearing shorts, I was flabbergasted. I recalled that locals and visitors were supposed to wear protective clothing so they wouldn’t get bitten by mosquitoes. (Of course, it’s possible that mosquitoes were no longer active at the time the picture was taken.)

What is the current situation?

Mosquitoes in many places worldwide are now infected with the Zika virus. Mosquitoes become infected when they feed on a person already infected with the virus. Infected mosquitoes spread the virus to other people, including pregnant women’s unborn children.

In the latter case, the fetus may develop microcephaly, a condition in which the offspring’s brain does not develop normally, resulting in a baby having an unusually small skull and other birth defects.

There is no vaccine or treatment for Zika.

Symptoms of Zika infection

You can have a Zika infection without being symptomatic or you can have the following mild symptoms: fever, rash, headache, joint pain, red eyes and muscle pain. Any of these symptoms may last from several days to a week.

Some people, however, develop Guillain-BarrĂ© syndrome, in which the body’s immune system attacks part of the peripheral nervous system. This may manifest itself by weakness and tingling in the legs, which may spread to the upper body.

Taking precautions

Anyone who enters an area when Zika-infected mosquitoes are active can be infected with the Zika virus. Therefore, people traveling to these places should protect themselves from mosquito bites.

To learn about areas where Zika is present, go to Check this website frequently before you start your travels.

To help prevent your being bitten by a Zika-carrying mosquito, you can do the following.

• Cover exposed skin by wearing long-sleeved shirts and long pants. Tuck pants into socks.

• Use mosquito repellent. Pregnant and breast-feeding women can use any EPA-registered insect repellent, including DEET, according to the product label.

• Stay in places with air-conditioning and which have window and door screens to keep mosquitoes outside.

• If air-conditioned or screened rooms are not available or if you’re sleeping outdoors, sleep under mosquito netting.

• With babies, particularly those younger than two months old, cover their cribs, etc., with mosquito netting.

• Pregnant women should not travel to Zika-infested areas, and women who are trying to become pregnant should protect themselves from mosquito bites.

• For couples who wish to conceive, the CDC now recommends that men wait six months, and women wait eight weeks, after Zika exposure or symptom onset before attempting to do so.

• Since infected people can, even when asymptomatic, transmit Zika through sexual contact, one should abstain from sex with a partner who has visited or lived in a Zika-infested area within the last six months (unless both male and female condoms are used).

• Symptomatic pregnant women with possible Zika exposure should be tested for Zika virus infection. The testing proposals for asymptomatic pregnant women with possible Zika exposure differ depending on where they traveled.

More on the subject

To learn more about Zika, I suggest you read the 2018 CDC “Yellow Book,” which includes important travel medicine information. You can order it for $49.95 through Oxford University Press (800/451-7556, or from or Barnes & Noble. Alternatively, you can access the “Yellow Book” for free online at (Click on “Table of Contents.”)

 For complete information on ALL aspects of the Zika virus, go to the Centers for Disease Control & Prevention’s Zika website for travelers: