Zika Virus and the over-50 Traveler

Feeding mosquito - Aedes aegypti (Photo Credit: Muhammad Mahdi Karim GFDL 1.2)
Feeding mosquito - Aedes aegypti (Photo Credit: Muhammad Mahdi Karim GFDL 1.2)
Feeding mosquito – Aedes aegypti (Photo Credit: Muhammad Mahdi Karim
GFDL 1.2)

If you think Zika virus should only be a concern of travelers of childbearing age, you’re mistaken. 

Mosquito bites can be itchy, annoying, and unsightly but the aftereffects are usually short-term and inconsequential. Although far less common, mosquitoes also spread serious diseases like malaria, dengue, chikungunya, West Nile fever, and Zika virus disease.

What is Zika?

Zika is a mosquito-borne virus. The symptoms of Zika virus infections typically include fever, rash, joint pain, general malaise or red eyes (conjunctivitis) that resolves in a few days or a week. Some people who are infected have no symptoms at all.

Symptoms of Zika (from the CDC)
Symptoms of Zika (from the CDC)

However, the effects of the virus on an unborn fetus of a pregnant woman can be devastating. These may include microcephaly and other severe fetal brain abnormalities such as eye defects, hearing loss and impaired growth.

Even though Zika virus was discovered and named in 1947 and first detected in humans in 1952, there are still many gaps in our knowledge about the disease.

There is no existing vaccine to prevent Zika and no specific antiviral treatment. Current treatment is limited to addressing its symptoms (e.g. with rest, fluids, acetaminophen.)

As the number of confirmed Zika cases has escalated around the world since 2007, physicians, scientists and the public are slowly beginning to learn more about the disease. We now know that although most often spread by infected mosquitoes, Zika can also be transmitted through sexual contact. Additionally, the Food and Drug Administration (FDA) recommended last month that all blood donations be routinely tested for the virus to prevent transmission through blood transfusions.

How Zika Spreads (CDC graphic)
How Zika Spreads (CDC graphic)

In terms of travel, the Centers for Disease Control (CDC) in Atlanta has issued a Level 2 Travel Notice urging precautions for travelers headed to destinations where mosquitoes are known to spread Zika.

Older folks: Should we worry?

New evidence suggests that older people who contract the Zika virus may be at increased risk for Guillain-Barré syndrome (GBS).

Symptoms of GBS include weakness of the arms and legs and in some severe cases, paralysis, which can even affect muscles that control breathing. Most people recover after weeks or months but others are left with permanent muscle damage.

Doctors believe GBS occurs when the body’s immune system attacks part of the peripheral nervous system. According to the CDC, the disorder is rare (1-2 cases for every 100,000 people in the U.S.) and its causes unclear. True clusters of cases are very unusual.

The association between Zika and Guillian-Barré Syndrome

Several countries that recently experienced Zika outbreaks have reported corresponding increases in Guillian-Barré syndrome (GBS). The CDC website notes:

“Current CDC research suggests that GBS is strongly associated with Zika; however, only a small proportion of people with recent Zika virus infection get GBS.”

NBC News reported on a letter in the New England Journal of Medicine noting that rates of GBS have risen dramatically with the spread of Zika, and that even asymptomatic Zika infections can lead to GBS.

NBC News science writer Maggie Fox wrote: 

“From April 1, 2015, to March 31, 2016, a total of 164,237 confirmed and suspected cases of Zika virus disease and 1,474 cases of the Guillain-Barré syndrome were reported in Bahia, Brazil; Colombia; the Dominican Republic; El Salvador; Honduras; Suriname; and Venezuela.”

“The reported incidence of the Guillain-Barré syndrome was 28 percent higher among males than among females and consistently increased with age, findings that are in line with previous reports.” 

While there are still gaps in what we know: 

  • There appears to be an established link between Zika and GBS.
  • Although the incidence of GBS is rare, its prevalence is rapidly increasing in countries with reported Zika epidemics.
  • The incidence of GBS is greater in males than females, and increases with age.

The bottom line for over-50 travelers

In making travel decisions to Zika-prone areas, older individuals need to evaluate and weigh their own risks in consultation with their physician. Until more is known about the causes, treatment and prevention of Zika, it seems prudent for older travelers to:

  • Review the growing list of countries included in the CDC travel notice on the Center’s Zika Travel Information
  • Keep abreast of emerging Zika-related information and research in the media.
  • Use an Environmental Protection Agency (EPA)-registered insect repellent when traveling to areas prone to mosquito infestations. (The CDC website provides brand-name examples.)
  • Whenever possible, cover up with long sleeve shirts and pants and opt for stays in places with air-conditioning and window screens.

A review in the medical journal Lancet concludes:

“While clinical research and the funding debate continues, protection from the Zika virus will depend largely on avoiding the mosquitoes that carry it.”

Useful Information & Resources

Recently on Reuters: For one Zika patient, lingering symptoms and few answers

Links to additional information from the CDC 

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  1. Thank you, Irene, for this important information. I hate bug spray, and mostly elect to itch and bitch, but you definitely got my attention. We’ll be using plenty of that dreaded spray while in Panama.

  2. Ugh! Do we really want to know this? It’s bad enough worrying about malaria in African and other malaria-prone countries (hated taking Malarone!). Sometimes we think we should just stay home! (And then we’d get hit by a bus…)

  3. Great info, certainly need to be aware of the risks for all ages. I am not a fan of the sprays but may have to start using more – I have been using the citronella bands and they worked in DR. But not so much in PV. 🙁

  4. The CDC links here are useful, too. I really don’t want to plan around Zika, but then again, I don’t want to be stupid. Hoping to travel to S.A. again in 2017, but here’s how it would go: Tom would get Zika; it would be my fault.

  5. My family in Guatemala has been hit hard by both Zika and Chikungunya and of the two, Zika seems to have had the most devastating consequences , resulting in one still-born baby and muscle weakness that lasts months among the older people. I myself contract dengue fever and it is also quite serious. I did a blog post on tips on how to avoid mosquito bites and it’s helped me avoid bites.

  6. Had not heard about the connection between Zika and Guillian-Barré syndrome. Thanks for the info. Unfortunately, the way things are going it looks like it might not be too long before we won’t have to travel to have some danger from the virus.

  7. Very interesting and informative post, Irene.

    I live in an area where we have lots of mosquitoes and the risk is West Nile disease. There is also risk of Lyme disease. The key with visiting any area with mosquitoes is to cover up, use insect repellent and try not to be out at dusk or dawn when mosquitoes are most active. I agree that pregnant women have serious concern with the Zika virus, but I think that with anything, we need to be informed and be protected … but still GO!

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