The Latest on Zika: Why Its Global Health Emergency Status Changed—And How It Affects Holiday Travel

Whole regions in the Southern Hemisphere have declared war on mosquitoes. Health warnings to pregnant women living and traveling throughout the Americas, and now Southeast Asia, have become commonplace. And yet, after a year of watching two species of mosquitoes spread the Zika virus—a frightening disease with dire and heartbreaking health consequences for babies in the womb—suddenly, the World Health Organization (WHO) has declared an end to its status as a global health emergency. What are we to make of last week’s announcement and what does it mean for women in Zika-filled regions and places the virus is just starting to reach? Here, UCLA clinical professor of medicine in infectious diseases Dr. Peter Katona explains the virus’s new status and the precautions we should continue to take.

What the Warning Meant
“The World Health Organization has only issued emergency warnings three or four times, ever,” says Katona, explaining that the WHO reserves such alerts for diseases that are “catching fire and getting worse.” Essentially, the initial declaration signified the dire threat Zika posed, and was issued as an alert to countries where the virus was spreading rapidly, as a call to action. Now that virus transmission has reached a more predictable rate, Zika joins other vector-borne illnesses like tuberculosis and malaria, Katona says.

“Zika is at a different level now; there’s been a reshuffling of concerns. With Zika, most people don’t get sick,” Katona explains. “There is the horrible complication of microcephaly [babies are born with a smaller head and potentially brain development complications] that affects pregnant women in 1 in every 100 cases, and Guillain-Barré syndrome [in which the immune system attacks the peripheral nervous system that can result from the virus].” But, tuberculosis, he points out, causes more than 1 million deaths a year, and malaria—another vector-borne disease—causes major long-term complications. Many affected by Zika are asymptomatic or get mild fever, rashes, and headaches.

Next Steps
Winter is coming to the Northern Hemisphere, and that’ll slow Zika’s spread, says Katona, explaining that mosquitoes aren’t likely to cause as much damage in the coming colder months. “What we do with the larvae that persist for seven to nine months and can thrive in something as small as a bottle cap of water will determine how things look in the spring,” he adds. While cases in South America aren’t spiking, those in Miami and Singapore are growing. “This is the very beginning of Zika,” says Katona. “We’ve had TB for centuries; we know how it spreads.” Much more research must be done to track the disease and prevent it, and the new WHO designation of Zika won’t change funding for those programs, says Katona, though he notes, “the new administration could change that.”

Where to Travel Now
“If you’re pregnant or going to get pregnant, be careful going to a Zika area,” says Katona. He favors the chemical repellent DEET as a good option to ward off bugs. “Use it at a 40 percent concentration; after that it’s more toxic but not more effective.” Now you can get tested for Zika, but results from the complicated series of blood tests still take a few weeks to arrive.

Meanwhile, mosquito spraying and other eradication methods are ongoing projects across the Americas. “Pay attention to what happens in the spring; we’ll get a better idea if the programs we’ve initiated have worked,” says Katona. He points out that the insects that carry the virus are everywhere in the U.S. “Draw a line across the middle of the U.S., and south of that are the states that are affected.” The Southeast and Southwest will certainly be places to watch as the weather heats up again.

Meanwhile, Katona says Zika is still a major concern for holiday travelers. “I’m planning a vacation for my family next year,” says Katona, “and the difference between the Caribbean and Hawaii is Zika.” As of today, the Centers for Disease Control and Prevention reports zero locally acquired cases in Hawaii, while its travel notice to the British Virgin Islands, Puerto Rico, and more of the Caribbean remains in effect.

 

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