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Questions and Answers: Zika Risk in Countries with Endemic Zika

What does it mean when you say that a country has “endemic Zika”?

In some countries, there is evidence that Zika has existed there for years, and the countries may report occasional new cases. A large number of local residents of these countries may be immune to Zika, so occasional cases may occur but generally do not become outbreaks. In these countries, the virus does not spread as quickly as in countries where it is newly introduced.

What is the risk of getting Zika in a country with endemic Zika?

We do not know the risk of getting Zika in a country with endemic Zika, but we think it is lower than in countries with epidemic Zika. Although the risk is likely to be low, it is not zero.

Why aren’t you posting travel notices for countries with endemic Zika?

CDC does not post travel notices for diseases that have existed in a place for years (endemic diseases), unless the number of cases rises to the level of an outbreak. Although we do not know the risk of getting Zika in a country with endemic Zika, we think it is lower than in countries with epidemic Zika. In countries with epidemic Zika, the outbreak spreads quickly, and the risk to travelers is higher.

When would you post a travel notice for a country with endemic Zika?

We would post a travel notice for a country with endemic Zika if there were a sudden increase in the number of cases. The Zika situation is evolving, and recommendations may change as we learn more about the risk to travelers.

Why does the outbreak spread quickly in a country with epidemic Zika?

In the Americas, where Zika was newly introduced, it spread quickly because the local population was not immune. A population only becomes immune after a substantial proportion of people have been infected with the virus.

Will countries with newly introduced Zika become countries with endemic Zika?

This is likely. We cannot say for sure how long it will take, but it is likely to be years. As the local population becomes immune, spread of Zika will slow, and these countries will move to the list of endemic countries. When this happens, the travel notices will be taken down. However, it is possible that a country could experience another outbreak, in which case a new travel notice will be posted.

Is it safe for pregnant women to travel to countries where Zika is endemic?

  • For women who are traveling to Southeast Asia:

    For a list of countries in Southeast Asia with special travel considerations: Zika Travel Information.

    Zika virus infection during pregnancy is a cause of microcephaly and other severe brain defects and has been linked to other problems in pregnancies and among fetuses and infants infected with Zika virus before birth, such as miscarriage, stillbirth, and birth defects, including absent or poorly developed brain structures, defects of the eye, hearing deficits, limb abnormalities, and impaired growth. Therefore, pregnant women should talk with their healthcare provider and consider postponing nonessential travel to Southeast Asia. If they choose to travel, they should strictly follow steps to prevent mosquito bites and to protect themselves against sexual transmission of Zika virus.

    Zika virus testing should be offered to people with symptoms of Zika virus disease, including pregnant women and others who develop symptoms during or following travel. Pregnant women who traveled to Southeast Asia but do not have symptoms should talk to a doctor or other healthcare provider after their trip.

  • For women traveling to countries where Zika is endemic outside of Southeast Asia:

    For a list of endemic countries outside of Southeast Asia: Zika Travel Information

    Although the risk of getting Zika in countries where Zika is endemic is likely lower than in countries where Zika is epidemic, it is not zero.  Therefore, there is still a risk that a pregnant woman could get Zika and pass it to her fetus.  Pregnant women or women who are planning to become pregnant should discuss their travel plans with their doctor.  If they choose to travel, they should strictly follow steps to prevent mosquito bites and to protect themselves against sexual transmission of Zika virus.

Is it safe for women who are not pregnant and men to travel to countries with epidemic Zika?

Many people infected with Zika will not have symptoms or will only have mild symptoms, such as fever, rash, joint pain, and conjunctivitis (red eyes). However, infection during pregnancy can cause severe birth defects in a developing fetus.

Women and men who are considering getting pregnant should discuss their plans with their doctor. If they choose to travel, they should strictly follow steps to prevent mosquito bites.

If I take precautions to prevent mosquito bites, is it safe for me to travel to a country with endemic Zika?

Because Zika is mainly spread by mosquito bites, preventing mosquito bites will help prevent Zika. Because Zika can also be spread through sex, you should also not have unprotected sex with anyone who lives in or has recently traveled to a country with endemic Zika.

Could Zika become epidemic or endemic in the United States?

There may be small outbreaks of Zika in parts of the United States, but we think it is very unlikely Zika will become epidemic or endemic. Visit the CDC site for the latest information on Zika in the United States. The mosquitoes that spread Zika are mainly found in the southern United States, and there are very few areas that stay warm enough all year for the mosquitoes to survive through the winter. In addition, air conditioning and window and door screens are commonly used, so people in the United States are not as exposed to mosquitoes as are people in many other areas.

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