The Tennessee Department of Health cautions travelers headed to Mexico, Central and South America, Hawaii and Caribbean islands including Puerto Rico and other locations with year-round warm climates to have increased awareness about the threat of mosquito-borne illnesses and to take appropriate bite protection measures. The cautionary message follows a recommendation from the Centers for Disease Control and Prevention that all pregnant women consider postponing travel to areas where an emerging health threat, zika virus infection, is ongoing.
Updates on areas with ongoing zika virus transmission are available online at wwwnc.cdc.gov/travel/notices/ . The CDC has also issued guidelines for pregnant women during a zika virus outbreak; to see these visit www.cdc.gov/mmwr/volumes/65/
"Zika virus, dengue and chikungunya virus are among the most troubling of current mosquito-borne public health threats for travelers," said TDH Commissioner John Dreyzehner, MD, MPH. "Tennesseans planning travel to warmer climates should understand the threats each of these presents and plan to protect themselves from mosquito bites at all times. Pregnant women or women trying to become pregnant especially should consider postponing a trip to countries with ongoing zika virus transmission at this time."
Travelers should know about these mosquito-borne illnesses now causing health concerns for U.S. public health officials:
Zika virus: There is no vaccine to prevent infection and no specific antiviral treatment for zika virus infection. Its most common symptoms are fever, rash, joint pain and red eyes. Pregnant women can be infected with zika virus in any trimester and zika virus infections have been confirmed in infants with microcephaly, a condition where the head is smaller than normal and a child may experience a variety of other health challenges, including physical and speech functions, seizure, hyperactivity, coordination problems and other brain/neurological disorders.
Dengue: There is no vaccine to prevent infection and no specific antiviral treatment for dengue infection or dengue hemorrhagic fever. Symptoms may include high fever, severe headache, severe pain behind the eyes, bone and muscle pain. Dengue hemorrhagic fever is the more serious infection; it may cause severe circulatory system failures and shock, and can be fatal in some cases. To see a map of current locations with evidence of dengue, go to wwwnc.cdc.gov/travel/
Chikungunya virus: There is no vaccine to prevent infection and no specific antiviral treatment for chikungunya virus infection. Symptoms may include headache, severe muscle pain, joint swelling and rash, and may vary in severity from one individual to another. The most vulnerable are older persons, newborns infected at birth and those with other diseases including diabetes and chronic heart or kidney problems. Although it rarely results in death, chikungunya virus infection is known to cause severe pain in some people. To see a map of current locations with evidence of chikungunya, go towww.cdc.gov/chikungunya/geo/
"Travelers should understand mosquitoes can bite any time of the day or night and can bite both indoors and outdoors," said Abelardo Moncayo, PhD, director of the TDH Vector-Borne Disease program. "Bite prevention strategies should include the use of U.S. Environmental Protection Agency registered insect repellents. Repellents containing 20 to 30 percent DEET, picaridin and IR3535 are safe for pregnant women when used as directed on the product label. Other bite protection measures include staying in air conditioned places with window and door screens, wearing long, loose shirts and pants, not using perfumes or colognes that may attract insects and using permethrin-treated clothing."
Certain products containing permethrin are recommended for use on clothing, shoes, bed nets and camping gear. Permethrin-treated clothing repels and kills mosquitoes and other pests and retains this effect after repeated washing. Some clothing products are available pretreated with permethrin. It should not be used directly on skin.
TDH urges people who suspect they are infected with a mosquito-borne illness to seek medical help immediately. Medicines such as acetaminophen or paracetamol may be use to relieve pain. Aspirin, products containing aspirin and other nonsteroidal drugs such as ibuprofen should not be used if dengue virus infection is suspected. Patients should rest and drink lots of fluids. If symptoms develop following a trip, travelers should let their healthcare providers know when and where they traveled.