Rio Camuy Cave Puerto Rico

Dr. Lang gives travel guidelines for areas with the Zika Virus

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An interview with Dr. Lang, WorldStrides Medical Director and Assistant Professor at the George Washington University Department of Emergency Medicine, on travel guidelines in areas with the Zika virus:

WorldStrides: Zika is getting extensive media coverage, with more and more countries added to the CDC list of impacted destinations. The underlying question from schools is, “Is it safe to travel?”

Dr. Lang: Yes. It is very safe to travel if you are not pregnant. The virus itself can show no symptoms in up to 80% of the population. The people who do express symptoms are experiencing your typical viral-type syndrome—fever, body aches, congestion, and conjunctivitis. There are no current anti-viral therapies, so the recommended self-care is what you would typically do for a virus: Tylenol, fluids, and rest. The virus typically resolves itself with no further complications.

WorldStrides: We know that pregnant women or those who may be pregnant are being advised to reconsider their travel plans to Zika-impacted countries. Are there other types of travelers who should reconsider travel?

Dr. Lang: No. We always caution people who have medical conditions or medications that weaken their immune system to be cautious in travel. These people should talk to their health care provider prior to travel. The rest of the population should have no worries.

WorldStrides: If a healthy non-pregnant adult or teen contracts Zika, what are the typical symptoms and duration?

Dr. Lang: Fever, body aches, congestion, and conjunctivitis are the most common symptoms, and typically they last from a couple days to a week. In general, these symptoms are less severe than with other mosquito-borne viruses.

WorldStrides: Are there more serious side effects? How frequently do these occur and how severe are these?

Dr. Lang: This virus is considered fairly weak, so the overwhelming majority who contract it should have the typical viral symptoms and then get better. With any virus, there is always a risk that you can get a secondary infection and thus complicate your recovery. This is very rare. There has been some discussion about whether there is any increased prevalence of Guillain-Barré syndrome if infected with Zika. Please see below the comments from the Centers for Disease Control and Prevention (CDC):

“Guillain-Barré syndrome (GBS) is a rare disorder where a person’s own immune system damages the nerve cells, causing muscle weakness and sometimes, paralysis. These symptoms can last a few weeks or several months. While most people fully recover from GBS, some people have permanent damage and in rare cases, people have died.

GBS is very likely triggered by Zika in a small proportion of infections, much as it is after a variety of other infections. CDC is investigating the link between Zika and GBS.”

There is not a definitive link between Zika and GBS, however increased rates of GBS are now being investigated. There are many viruses that can cause GBS. Zika is being investigated as yet another that can be a trigger.

WorldStrides: Can I catch Zika from an infected co-traveler, or only from mosquitoes?

Dr. Lang: Until recently, there was no other known method of transmission outside of a mosquito. There have been a small number of cases that have been investigated and concluded high probability of transmission via sexual contact. Still, it appears that human-to-human transmission is very rare.

WorldStrides: I understand that Zika presents outward symptoms in only 20% of cases. Does this mean I can travel, get Zika from an infected mosquito, and not even know it?

Dr. Lang: Yes. The majority of people will never know they are infected and will never exhibit any signs or symptoms of infection.

WorldStrides: How long does Zika stay in the bloodstream? Could I return to the U.S. with a Zika infection that I don’t know about and carry the disease around for weeks or months?

Dr. Lang: Typically, Zika stays in the body for 7-10 days (similar to other viruses), and as noted above, does not always show symptoms. However, there is still ongoing research on potential of the virus remaining in system (either blood or bodily fluids) for longer duration.

WorldStrides: What precautions should I take upon return from travel, with or without Zika symptoms? Should I get tested for Zika when I return?

Dr. Lang: Currently there are no precautions necessary upon return, although if you live in an area with a mosquito population you should continue to use insect repellent for 7-10 days upon your return. This is to prevent spread in the small chance you were exposed. The CDC is recommending that travelers should not be tested unless they are high risk. This is because the symptoms are generally mild and clear the system quite quickly.

WorldStrides: I am a female chaperone and am not pregnant. Am I at risk of infecting my partner after I return? Relatedly, how long should I wait after the return of the trip before it is okay to try to conceive?

Dr. Lang: Most human-to-human transmission to date has been from male to female, though in July the first case of female to make transmission was documented. The current guidance is that you wait at least 62 days before trying to conceive, or six months if you display any Zika symptoms (rash, fever, red eyes, painful joints) during or shortly after the return from your trip. It is highly recommended that you discuss with your medical provider when you decide to conceive.

WorldStrides: I am male chaperone and my non-traveling partner is not pregnant.  Am I at risk of infecting my partner after I return? Relatedly, how long should we wait after the return of the trip before it is okay to try to conceive?

Dr. Lang: Currently, it is believed that the virus can last several weeks in males.  Therefore the recommendation would be to talk to discuss with your medical provider with both of those questions.

WorldStrides: The best approach, I’m sure, is to avoid mosquito bites in the first place. What are the best recommendations for this?

Dr. Lang: We recommend long-sleeved shirts, long pants, socks, and mosquito repellents with DEET.

WorldStrides: Where can I obtain more information on the progression of Zika?

Dr. Lang: There are several helpful pages on the CDC website you can reference.  All are regularly updated.

In addition to Dr. Lang’s information above, WorldStrides’ Risk Management partners at iJet maintain extensive Zika information.

We hope you find this information helpful and we will update our blog as new facts emerge.

Learn more about WorldStrides’ medical director Dr. Christopher Lang.

Last Update:  7/19/16.


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