Posted & filed under Asterisk, Medical Travel Risk.

Zika_virus_vox
Source: Vox
Graphic Last Updated January 28, 2016

The mosquito-borne virus Zika has been dominating the news for some time now. Fears are spreading, suspicions are rising, and a vaccine still isn’t available. With so many people concerned about Zika, the Global Business Travel Association (GBTA) Risk Committee took the opportunity to discuss the explosive virus along with some of the other less talked about mosquito-related diseases.

On February 18, GBTA hosted the webinar “Zika, Chikungunya and Dengue: The Other Mosquito-Borne Illnesses” with Europ Assistance USA’s Chief Medical Officer, Dr. Eugene Delaune, as part of the expert panel. Dr. Delaune opened with an in-depth discussion about the virus we all want to know about – Zika. Until recently, most of us had never even heard about the virus. This quickly changed, however, when a strong link between Zika and a serious neonatal condition, microcephaly, surfaced. People have now come to realize that Zika is no small matter.

Even though Zika has been around for decades (primarily in Africa), the virus received little attention up until now, as the symptoms were mild and not unlike the usual mosquito-related viruses – fever, headache, a rash and occasionally muscle or joint pain. Furthermore, the majority of people infected with Zika do not show any symptoms at all; in fact, just 20% of Zika victims will be symptomatic. As a result, there hasn’t been much research or focus paid to the virus and no vaccine is available at this point.

Currently, the only form of prevention available is protection against mosquito bites. Zika is primarily carried by the Aedes aegypti and Aedes albopictus species, both day biters. Protection methods include using insect repellent (DEET, picaridin and IR3535 are safe, even during pregnancy), wearing light-colored clothing, keeping doors and windows screened or closed, sleeping under mosquito nets, and emptying/cleaning any containers that hold water (since these are attractive breeding grounds for mosquitos). Additionally, there have been some new developments in the fight against mosquitos since the resurfacing of Zika. Researchers have developed genetically-modified mosquitos that cause the offspring to die before adulthood (and therefore are unable to transmit the virus). In the meantime, Zika is still actively spreading – especially in Latin America.

Dr. Delaune cautioned: “Before people panic too much and blame microcephaly on the Zika virus, a lot more research needs to be done.” It could be that people in these same areas where Zika is spreading are also exposed to some other type of irritant or chemical that is causing microcephaly. Still, he concluded, “It’s better to be cautious and assume that Zika does cause all of these things and take all the precautions necessary.”

There are several other mosquito-related diseases that have been around for a while but haven’t received quite the attention that Zika has. These include dengue [deng-gee], chikungunya [chik-un-gun-ya], malaria and yellow fever. Dengue and chikungunya show symptoms similar to Zika; however, with dengue, people typically have severe muscle pain while chikungunya victims suffer joint pain. Like Zika, only about 20% of people infected with dengue show symptoms. With both diseases, fever comes on sharply a week after exposure and lasts a week. Scarily, the more times you are infected with dengue, the greater your risk of death.

Another panelist discussed malaria and yellow fever, which don’t necessarily follow the same patterns of risk and mitigation as the three previously discussed mosquito-related illnesses. Malaria, which has a much longer incubation period than the other viruses (at 7 to 30 days), shows similar symptoms like fever, headaches/body aches, nausea and weakness.  Some forms of malaria can remain dormant in the body, causing relapses months or years after recovery. Fortunately, malaria prevention is simple: many prescription medications can effectively prevent malaria infection – each with its own set of pros and cons.

In general, yellow fever is much rarer but outbreaks do occur. Currently Angola is experiencing an outbreak – one large enough that the CDC has issued an alert because of it. The initial symptoms of yellow fever resemble the other illnesses discussed, but some patients progress to stages that are much worse, which can include jaundice, hemorrhagic syndrome, shock and even organ failure.

The webinar concluded with some practical advice for companies in the midst of the present Zika outbreak. Not only is it important to consider what your company should be doing in times like this, but also what other companies are doing so that you too can implement best practices. In today’s corporate travel climate, there are four main priorities that have emerged: the first is communicating travel advice across the board to those traveling to and from affected areas. This is followed by educating staff about risks and recommendations, enhancing bite protection in-country, and updating company health threat plans.

The seemingly sudden explosion of Zika is concerning but we’re still learning new things about the virus every day. Zika is a moving target, so this means official recommendations and guidelines are constantly changing. This also means that companies’ communications need to follow suit. This may be seem like a daunting task for many businesses, but education is the best foundation and will result in better preparation for companies and their travelers.

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