The Zika outbreak is growing at an alarming rate.

Here’s the critical information for travelers.

In the wake of serious CDC warnings, travelers are on alert about traveling to Mexico, the Caribbean, and South America.
World Health Organization will consider declaring a public health emergency.

So far, 25 countries are on the advisory list—which means pregnant women at any stage of their pregnancy should seriously consult their doctors before traveling.

While the situation continues to evolve on a day-by-day basis, here’s everything you need to know before booking your next vacation—or getting on the plane.

Which countries are affected?
Currently, the Center for Disease Control has listed
24 countries where the disease has been transmitted—the most updated list can be found right here. You’re looking at a lot of the Caribbean and South America (Brazil, Colombia, Ecuador, and Mexico are on the list, along with the U.S. Virgin Islands and Puerto Rico).

What symptoms are associated with Zika virus?
“Only one in five people infected with Zika will get sick, and for people who get sick, the illness is usually mild,” says Dr. Mark S. DeFranseco, president of the American Congress of Obstetricians and Gynecologists. According to the CDC, people who experience symptoms complain about rashes, fevers, or joint pain. Though the virus itself is mild compared to other mosquito-borne illnesses like dengue fever and malaria, doctors have noted an association of Zika cases with a neurological paralytic disease called Guillian-Barre syndrome. Dr. Daniel Caplivski, Associate Professor of Infectious Diseases and Director of Travel Medicine at Mount Sinai’s Icahn School of Medicine says that Guillian-Barre “typically develops within 7-14 days of the symptomatic infection with Zika virus.” Even still, he says it’s a “rare complication, albeit one that can affect pregnant and non-pregnant travelers alike.”

Who is at risk of contracting Zika?
Anyone can get Zika virus—but most people who do won’t even know it. (See the mild symptoms, above.) The risks are highest for pregnant women in their first trimester; the virus has been correlated with microcephaly, a pre-natal disorder that prevents the baby’s head from growing to its full size. At first the CDC’s warning was specific to women in their first trimester for that very reason, but because so much is still unknown about Zika, many doctors (and the CDC) are extending their travel warnings to all pregnant woman out of an abundance of caution.

How do you get Zika virus, anyway?
The illness is mosquito-borne, though as researchers continue to study it, they are exploring the possibility of sexual transmission as well. It’s unclear how the virus transmits from mother to baby in utero, so there’s much left to learn.

Should I cancel my babymoon?
Talk to your doctor before doing anything. Most of the physicians we’ve spoken to are recommending that pregnant travelers reconsider their plans to visit affected counties. Many questions remain about Zika and its effects on infants; some health officials have started to recommend eye screenings for newborns and infants who may have come in contact with the virus in utero.

At this point, little is known about the complications that can ensure after contact with the virus, so doctors are leaning towards an abundance of caution. Says Mount Sinai’s Dr. Caplivski, “Children and adults have shown the same symptoms with regard to Zika virus, as far as we know now.”

Do couples need to worry about conceiving on a vacation in the affected countries?
According to the CDC, “Women trying to become pregnant who are thinking about becoming pregnant should consult with their healthcare provider before traveling to these areas and strictly follow steps to prevent mosquito bites during the trip.” Dr. Caplivski adds that couples should feel comfortable conceiving (or trying to conceive) one or two cycles after visiting a country with Zika incidence.

Can Zika affect the growth of young children?
Microcephaly, or stunted growth of the brain, is associated with Zika virus in still-developing fetuses; no other growth disorders have been reported thus far.

How does Zika spread?
Zika is a mosquito-borne illness, but not all mosquitoes are carriers. There are some theories that Zika could be sexually transmitted, but only two cases have raised that suspicion.

Can you get Zika in the United States? So far, no cases have been contracted in the United States. But the disease could potentially spread here if enough cases are imported. There are real concerns that this could lead to an epidemic, which the World Health Organization is currently taking steps to evaluate.

What’s the history of Zika, and why have I never heard of it before?
Zika isn’t a new disease—it’s long existed in Asia and Africa, where locals in affected communities have developed immunity. Until recently, the disease had never presented in the Western Hemisphere, though, and prevailing theories say that it was to brought to Brazil during a major world event, such as the World Cup. Now that it’s manifested in the Americas, where no immunity exists, it has spread quickly.

Should I worry about traveling if I’m not expecting?
The major concern for non-pregnant travelers is bringing the disease back to the U.S. (or any other country where it doesn’t yet exist).

If you do travel to a country with Zika incidence, Dr. Caplivski and the CDC both recommend taking preventative measures, such as using DEET-based repellents, prometherine (an alternative to DEET), or prometherine-coated clothing (like what you’d purchase before heading on safari).

What are airlines doing to help worried travelers?
All three major domestic carriers have made provisions for travelers heading to Zika-affected countries.
United is allowing any concerned travelers heading to countries on the CDC list to rebook their trips at a later date at no cost.
Delta is allowing qualified passengers to make changes—with no fees—before February 29 (see here for details). American, meanwhile, has just expanded their waived cancellation fees to cover travel to 15 countries in total, including Puerto Rico and Martinique—though the carrier is requiring doctor’s notes.

What about cruise lines and hotels?
Royal Caribbean, Norwegian, Carnival, and Disney cruise lines have all invited concerned passengers to reach out about rescheduling; hotels are handling the situation differently across individual properties. In some cases, hotels in non-affected countries (such as St. Lucia) are still offering flexible cancellation policies, so reach out to your resort for further details.

CDC. Centers for Disease Control and Prevention. CDC 24/7: Saving Lives. Protecting People.™

Zika Virus
Zika-affected Areas

Where has Zika virus been found?
Prior to 2015, Zika virus outbreaks have occurred in areas of Africa, Southeast Asia, and the Pacific Islands.
In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infections in Brazil.
Currently, outbreaks are occurring in many countries.
Zika virus will continue to spread and it will be difficult to determine how the virus will spread over time.

For the latest Travel Notice Information.

Zika in the United States and its territories:

No locally transmitted Zika cases have been reported in the continental United States, but cases have been reported in returning travelers.
Locally transmitted Zika virus has been reported in the Commonwealth of Puerto Rico.
With the recent outbreaks, the number of Zika cases among travelers visiting or returning to the United States will likely increase.
These imported cases could result in local spread of the virus in some areas of the United States.

Countries and territories with active Zika virus transmission
World map showing countries and territories with reported active transmission of Zika virus (as of January 22, 2016). Countries are listed in the table below.


Dominican Republic
El Salvador
French Guiana

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