Zika travel advisory hits Asia tourism

Health authorities have extended to 6 months a warning to men about the risky time period for sexually spreading Zika virus, which often carries no symptoms but can cause devastating birth defects.

Men who live in or have traveled to an area of active Zika transmission are now urged to wait half a year before attempting conception, regardless of whether they have been diagnosed with Zika or showed any symptoms, the US Centers for Disease Control and Prevention said.

The federal agency also issued a warning to pregnant women, recommending they postpone non-essential travel to 11 Southeast Asian countries due to "the uncertain risk of Zika virus infection."

The countries are Brunei, East Timor, Cambodia, Indonesia, Laos, Malaysia, Maldives, Myanmar, Philippines, Thailand and Vietnam.

"Based on new though limited data, CDC now recommends that all men with possible Zika virus exposure who are considering attempting conception with their partner, regardless of symptom status, wait to conceive until at least 6 months after symptom onset (if symptomatic) or last possible Zika virus exposure (if asymptomatic)," it said in a statement.

Before, the CDC advised men with possible but unconfirmed Zika exposure – and no symptoms of the virus – to wait 8 weeks from the last possible exposure before having unprotected sex.

But in August, officials in Rome reported that Zika could persist in semen for as long as 6 months, based on the case of an Italian man who was infected with Zika while in Haiti.

Therefore, to reduce the likelihood of a woman being exposed to Zika around the same time as she is impregnated, the CDC updated its recommendations to urge men to take precautions for a full 6 months if they have possible Zika exposure.

The CDC defines possible Zika virus exposure as "travel to or residence in an area of active Zika virus transmission, or sex without a condom with a partner who traveled to or lived in an area of active transmission."

As of September 26, Zika was active in 59 countries and US territories, the CDC said.

"Zika virus is considered endemic in some of these countries, and many people who live there are likely immune," said the CDC.

"But travelers to areas where Zika is endemic may not be immune to the virus and infections have occurred in travelers to Southeast Asia."

In general, women who want to become pregnant and who have tested positive for recent Zika virus or unspecified flavivirus infection "should wait at least 8 weeks from symptom onset to attempt conception," the CDC said.

If pregnant women are infected with Zika, either by mosquito bite or sexual contact, they face a higher risk of bearing a child with a range of birth defects including microcephaly, in which the child's skull and brain are small and deformed.

Questions About Zika

Q: What is Zika?

A: Zika virus disease is caused by the Zika virus, which is spread to people primarily through the bite of an infected mosquito (Aedes aegypti and Aedes albopictus). The illness is usually mild with symptoms lasting up to a week, and many people do not have symptoms or will have only mild symptoms. However, Zika virus infection during pregnancy can cause a serious birth defect called microcephaly and other severe brain defects.

Q: How do people get infected with Zika?

A: Zika is spread to people primarily through the bite of an infected Aedes species mosquito (Aedes aegypti and Aedes albopictus). A pregnant woman can pass Zika to her fetus during pregnancy or around the time of birth. Also, a person with Zika can pass it to his or her sex partners. We encourage people who have traveled to or live in places with Zika to protect themselves by preventing mosquito bites and sexual transmission of Zika.

Q: What health problems can result from getting Zika?

A: Many people infected with Zika will have no symptoms or mild symptoms that last several days to a week. However, Zika infection during pregnancy can cause a serious birth defect called microcephaly and other severe fetal brain defects. Current research suggests that Guillain-Barre syndrome (GBS), an uncommon sickness of the nervous system, is strongly associated with Zika; however, only a small proportion of people with recent Zika virus infection get GBS. Once someone has been infected with Zika, it’s very likely they’ll be protected from future infections. There is no evidence that past Zika infection poses an increased risk of birth defects in future pregnancies.

Q: Should pregnant women travel to areas where Zika has been confirmed?

A: No. Pregnant women should not travel to any area with Zika. Travelers who go to places with outbreaks of Zika can be infected with Zika, and Zika infection during pregnancy can cause microcephaly and other severe fetal brain defects.

Q: If I am traveling to an area with Zika, should I be concerned about Zika?

A: Travelers who go to places with Zika can be infected with Zika, and CDC has issued travel notices for people traveling to those areas. Many people will have mild or no symptoms. However, Zika can cause microcephaly and other severe birth defects. For this reason, pregnant women should not travel to any area with Zika, and women trying to get pregnant should talk to their doctors before traveling or before their sex partners travel. It is especially important that women who wish to delay or avoid pregnancy consistently use the most effective method of birth control that they are able to use. Those traveling to areas with Zika should take steps during and after they travel to prevent mosquito bites and sexual transmission of Zika.

Q: What can people do to prevent Zika?

A: The best way to prevent Zika is to protect yourself and your family from mosquito bites:

Wear long-sleeved shirts and long pants

Sleep under a mosquito bed net if air conditioned or screened rooms are not available or if sleeping outdoors.

Zika can be spread by a person infected with Zika to his or her sex partners. Condoms can reduce the chance of getting Zika from sex. Condoms include male and female condoms.  To be effective, condoms should be used from start to finish, every time during vaginal, anal, and oral sex and the sharing of sex toys. Not having sex eliminates the risk of getting Zika from sex. Pregnant couples with a partner who traveled to or lives in an area with Zika should use condoms every time they have sex or not have sex during the pregnancy.

Q: What are the symptoms of Zika virus disease?

A: The most common symptoms of Zika virus disease are fever, rash, joint pain, and red eyes. Other symptoms include muscle pain and headache. Many people infected with Zika won’t have symptoms or will have mild symptoms, which can last for several days to a week.

Q: How is Zika diagnosed?

A: To diagnose Zika, your doctor will ask you about recent travel and symptoms you may have, and collect blood or urine to test for Zika or similar viruses.

Q: Can someone who returned from an area with Zika get tested for the virus?

A: Zika virus testing is performed at CDC and some state and territorial health departments. See your doctor if you have Zika symptoms and have recently been in an area with Zika. Your doctor may order tests to look for Zika or similar viruses like dengue and chikungunya.

Q:What should pregnant women who have recently traveled to an area with Zika do?

A: Pregnant women who have recently traveled to an area with Zika should talk to their doctor about their travel, even if they don’t feel sick. Pregnant women should see a doctor if they have any Zika symptoms during their trip or within 2 weeks after traveling. All pregnant women can protect themselves by avoiding travel to an area with Zika, preventing mosquito bites, and following recommended precautions against getting Zika through sex.