Over the past several months, the Zika virus has grown from a regional outbreak to a global health scare, one that is resulting in confusion among travelers and a flurry of canceled vacations, honeymoons and business trips.
The developments over just the past few weeks have been fast-paced and sometimes hard to keep abreast of when information about the mosquito-borne virus is coming from so many different sources around the world.
Christina Ernst, owner of Georgia-based travel agency VIP Southern Tours, says her phones have been ringing continually, with concerned clients trying to figure out what they need to know about Zika.
"A lot of people are confused because the details that are out there are not very clear, and I think that's because the answers aren't really clear," says Ernst.
"It's really frightening people, not knowing what the right answer is," she adds. "They're hearing it's anywhere tropical, it's spreading, it's getting people sick - so they're not getting the facts about it."
Amid such confusion, says Ernst, one couple canceled their honeymoon to St. Lucia, while others are working with Ernst to find alternative vacation destinations that avoid the Americas and the Caribbean. (Alaskan cruises are becoming a popular alternative, she notes.)
Among the latest developments travelers should be aware of:
-On February 1 the World Health Organization (WHO) declared a Public Health Emergency of International Concern because of the clusters of microcephaly and other neurological disorders emerging in some areas affected by Zika.
-About a week prior to the WHO announcement, the Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Center (EOC) to respond to Zika outbreaks in the Americas, and then on February 8, elevated its EOC activation to a Level 1, the highest level.
-There is no vaccine to prevent Zika virus disease, according to the CDC.
-The best way to prevent Zika is to avoid mosquito bites.
-Mosquitoes that spread Zika bite mostly during the daytime.
There are currently about 30 countries, primarily located throughout South and Central America and the Caribbean, that have reported active transmission of the virus. The World health Organization expects the Zika virus to spread to almost every country in the Americas.
No local, mosquito-borne Zika virus disease cases have been reported in the 50 U.S. states, but there have been travel-associated cases, according to the CDC. In terms of U.S. territories, local, mosquito-borne transmission of Zika virus has been reported in Puerto Rico, the U.S. Virgin Islands, and American Samoa.
The CDC is regularly updating its travel information page with notices about impacted countries and locations and recommends checking its site before traveling anywhere.
If you are traveling, there are some very simple precautions that will go a long way toward maintaining your safety, says Ronald St. John, a retired public health and infectious disease control physician whose 35-year career included working at the CDC and the WHO, Regional Office for the Americas.
"The best thing is to avoid mosquito bites," St. John explains. "Take some OFF or DEET with you, and try to cover up. And sleep in an air conditioned place or a place that has a screen."
Women of reproductive age, who are traveling to an affected country, should take precautions to avoid pregnancy, says St. John. And perhaps more importantly, if you are already pregnant and in your first trimester, St. John recommends postponing the trip entirely.
The Zika virus can be spread from a pregnant woman to her fetus, says the CDC. The Atlanta-based agency's website says there have been reports of a serious birth defect of the brain called microcephaly in babies of mothers who contracted the Zika virus.
Both the CDC and St. John point out that the knowledge regarding the link between Zika and birth defects is still evolving. But for the time being, pregnant women need to be more cautious then the general population.
For those who are headed abroad, St. John has created a handy app designed to keep international travelers healthy. Called Sitata, the free app provides real time notifications and updates regarding health and safety events wherever you happen to be, as long as you've registered your travels with Sitata.
"Travelers are so good at inadvertently spreading disease," St. John says. "A small amount of knowledge will really keep people healthy when they travel anywhere. Travelers can register their trip with us and get free trip info - safety precautions, things to watch out for. And while traveling, if something is going on where they are, such as an outbreak of disease, they get an instant alert, as well as advice on what to do."
Some additional advice worth noting comes from Dyan Summers, a nurse practitioner and author of the first scientific paper published about Zika being imported by an American recreational traveler. In 2013, one of Summers's patients, who had recently visited French Polynesia, became the first reported case of Zika in the United States linked to the French Polynesian outbreak.
Summers points out that there are no commercially available tests for Zika and no specific medications to treat it, so the overall strategy with regard to the virus is aimed at prevention.
Important tips she shares includes applying sunscreen before insect repellent when traveling in affected countries because you want the mosquitos to land on the repellent. Summers also suggests minimizing the amount of exposed skin.
It's also important to know the symptoms, which may be flu-like, including malaise, muscle and joint pains, rash and conjunctivitis or discharge from the eyes.
"If you've traveled to an affected country and experience these symptoms, contact your medical provider immediately," says Summers.
For those who may not want to risk traveling in light of all of this information, airlines are being very cooperative and issuing refunds for tickets, says Diana Ramos, an OB/GYN physician and co-chair of the National Preconception Health and Health Care Initiative (PCHHC), a public-private partnership of more than 70 national organizations working to advance preconception health and reproductive life planning.
Echoing many other public health professionals, Ramos stresses that those most at risk are pregnant women and women of reproductive age, who could become pregnant.
"The CDC is saying that reproductive age women should avoid travel to affected areas," she emphasizes. "And men who may have traveled to affected countries, if they have a wife who is pregnant, should use a condom."
It's not only medical professionals and travel agents who are witnessing an increased level of concern in light of the the Zika virus' spread. Stan Sandberg, co-founder of TravelInsurance.com, says he too has seen a significant increase in traffic this past week and has been fielding customer inquiries primarily about trip cancellation coverage.
According to Sandberg, most insurance plans are treating the Zika virus like any other illness in the plan's terms and conditions. In other words, if a traveler contracts the virus while abroad, most plans would cover emergency medical services, medical evacuation and trip interruption benefits. What's more, the CDC warnings are not impacting the availability of travel insurance. Translation - travelers can still purchase insurance plans for visits to countries listed in CDC warnings.
"It's still important to note that none of the travel insurance providers are considering the CDC warning a reason to cancel a trip to an affected country," says Sandberg. "For travelers going to an affected country who want an option to cancel, we recommend plans with a Cancel for Any Reason option."
The CDC says the Zika virus will continue to spread and it will be difficult to determine how and where the virus will spread over time.
St. John, the former CDC and WHO physician, says it's dangerous to try to predict how long it will take a virus to run its course, but estimates Zika could remain a significant concern for anywhere from two to three years.
"With Zika, over time enough people will have been infected and they will develop immunity and then the virus becomes a background noise -there will be a few cases here and there but no major outbreaks," says St. John. "In general, the whole thing subsides when you have a good immune response."