Counseling Travelers on Zika Virus Risks

Download and print this page Cdc-pdf[PDF – 71 KB, HTML]

Women and Men of Reproductive Age Who are Considering Travel to Areas with Risk of Zika

This guide describes recommendations to providers for counseling women and men of reproductive age who are considering travel to any areas with risk of Zika (as indicated by red and purple areas on the Zika map). This material includes recommendations from CDC’s interim guidance and talking points to cover while discussing recommendations.

Recommendation: Assess risk of Zika exposure and prevention
Key Issues: Environment
Talking Points

  • Discuss whether the planned area of travel is an area with a Zika outbreak (as indicated by red on the Zika map) or other areas with risk of Zika (as indicated by purple on the Zika map)*.
  • Discuss environment in which patient will be staying: advise traveler to stay in hotel rooms or other accommodations that are air conditioned or have good window and door screens to keep mosquitoes outside.
  • Discuss mosquito bite prevention, including insect repellent, clothing (including permethrin-treated), and bed net use.
  • Advise patient that taking steps to protect themselves against mosquito bites could potentially protect them from other mosquito-borne diseases, including dengue and chikungunya.
  • Discuss how to prevent sexual transmission during and after the trip.

Recommendation: Discuss Zika infection
Key Issues:
1. Signs and symptoms of Zika virus disease
2. When to seek care
3. Treatment
4. Preventing transmission after returning home

Talking Points

  • Many people infected with Zika won’t have symptoms or will have only mild symptoms. The most common symptoms of Zika are fever, rash, arthralgias, and conjunctivitis; other common symptoms include myalgia and headache.
  • Illness usually lasts about a week.
  • Zika infection during pregnancy or around the time of becoming pregnant may cause poor pregnancy and infant outcomes, including birth defects. Guillain-Barré syndrome is possibly triggered by Zika in a small proportion of infections, as it is after a variety of other infections.
  • If travelers have recently been to an area with risk of Zika and develop symptoms consistent with Zika, they should see a healthcare provider and report their (or their sexual partner’s) recent travel.
  • Symptoms of Zika are similar to other mosquito-borne infections, like dengue and chikungunya.
  • If travelers develop symptoms of Zika, they should rest, stay hydrated, and take acetaminophen for fever or pain. To reduce the risk of hemorrhage, aspirin or other NSAIDs should not be taken until dengue can be ruled out.
  • To help prevent others from getting sick, people infected with Zika should prevent the spread of Zika through sex by using condoms or not having sex for 2 months (women) or 3 months (men). They should also strictly follow steps to prevent mosquito bites during the first week of illness. Even if they do not feel sick, travelers returning from an area with risk of Zika should take steps to prevent mosquito bites for 3 weeks. These steps will prevent them from passing Zika to mosquitoes that could spread the virus to other people.
  • Taking steps to protect themselves against mosquito bites could potentially protect them from other mosquito-borne diseases, including dengue and chikungunya.

Recommendation: Discuss Zika infection and pregnancy
Key Issues: Possible adverse outcomes of Zika infection during pregnancy
Talking Points

  • Zika can be passed to the fetus during pregnancy or at delivery if a woman is infected during pregnancy.
  • Zika infection during pregnancy can cause microcephaly and other severe fetal brain defects.
  • Children with microcephaly often have serious problems with development and can have other neurologic problems, such as seizures.
  • Zika has been linked to other problems in pregnancies and among fetuses and infants infected with Zika before birth, such as miscarriage, stillbirth, defects of the eye, hearing deficits, and impaired growth.
  • Current evidence suggests that Zika virus infection prior to pregnancy would not pose a risk of birth defects to a future pregnancy.

Recommendation: Access pregnancy plans related to timing of travel
Key Issues:
1. Timing of conception
2. Avoiding travel to areas with risk of Zika outbreak while pregnant

Talking Points

  • CDC recommends that pregnant women not travel to an area with a Zika outbreak (as indicated by red areas on the Zika map).
    • Before pregnant woman and couples considering pregnancy travel to other areas with risk of Zika (as indicated by purple areas on the Zika map), discuss their travel plans and carefully consider risks and possible consequences of Zika.
  • If a pregnant woman must travel to one of these areas, discuss potential risks and the steps she should take to prevent mosquito bites and sexual transmission of Zika during and after the trip.
  • CDC recommends that travelers returning from any area with risk of Zika (as indicated by red and purple areas on the Zika map) wait to conceive.
      1. If traveler is female: Use condoms or do not have sex for at least 2 months after travel to an area with risk of Zika (if she doesn’t have symptoms), or for at least 2 months from the start of her symptoms (or Zika diagnosis).
      2. If traveler is male: Use condoms or not have sex for at least 3 months after travel to an area with risk of Zika (if he doesn’t have symptoms), or for at least 3 months from the start of his symptoms (or Zika diagnosis).

NOTE: If traveling as a couple, both travelers should use condoms or not have sex for at least 3 months.


Recommendation: Discuss Zika – risk of sexual transmission and need for contraception
Key Issues:
  1. Preventing sexual transmission
  2. Contraception

Talking Points

  • Zika can be passed through sex from a person who has Zika to his or her sex partners.
  • Anyone who is not pregnant or trying to get pregnant who wants to avoid getting or passing Zika during sex can use condoms every time they have sex, or not have sex.
  1. If traveler is female: Consider using condoms or not having sex for at least 2 months after travel to an area with risk of Zika (if she doesn’t have symptoms), or for at least 2 months from the start of her symptoms (or Zika diagnosis) if she develops Zika.
  2. If traveler is male: Consider using condoms or not having sex for at least 3 months after travel to an area with risk of Zika (if he doesn’t have symptoms), or for at least 3 months from the start of his symptoms (or Zika diagnosis) if he develops Zika.