News about the Zika virus is everywhere these days, and rightfully so—if a woman is infected during pregnancy, the virus can cause frightening birth defects in infants. The virus started in South America and has spread across the Caribbean. Most recently, a Zika outbreak in a neighborhood of Miami Beach has many experts considering whether to issue a travel warning to the area. Still, for most people, Zika has mild or negligible effects—as far as viruses go, it’s not much worse than the average case of pinkeye. We recently spoke with Dr. Michele Barry, director of Stanford University’s Center for Innovation in Global Health and former president of the American Society of Tropical Medicine and Hygiene (ASTMH), to get the scoop on Zika and what travelers can do to minimize risk of contracting Zika on the road.
If I’m traveling, what do I need to know about Zika?
Three things, really. One is to be aware of whether Zika is happening in the area that you’re traveling. Two is to make sure that you avail yourself of the best mosquito repellent out there, and in my estimation or opinion, that’s anything with diethyltoluamide, DEET. Three: Make sure you’re wearing permethrin-impregnated clothes, which are easily obtained in mountain goods stores like REI. These clothes have mosquito repellent built-in. If you have permethrin-impregnated clothing and a little bit of DEET on your exposed skin, that’s probably the best protection that you can have. The CDC also has some great tips about prevention.
You mentioned DEET. What kind of DEET is best?
I like to use a percentage between 35 and 50. The percentage of DEET doesn’t mean it's more effective; it just means it stays on your skin longer so you don’t have to keep reapplying. The higher the percentage, the longer it lasts, so if you’re using a low percentage like 10 to 20, everybody thinks that that’s less carcinogenic, but actually that means you have to reapply it every two hours, and in actuality, the studies on carcinogenicity in DEET are really lacking. There really are very few side effects, even in long-term use. Another mosquito repellent you can use that’s equally effective is Picaridin, although I have to say I tend more towards the DEET products. Picaridin only comes in one percentage, but there are some people who like that better and think it works as well.
So many Zika cases are in warm, tropical climates. Any tips for applying repellents with sunscreen?
Absolutely. Everybody should remember to apply the sunscreen first and then the mosquito repellent over the sunscreen so you don’t dilute out the mosquito repellent.
You’re a doctor at Stanford’s Travel Medicine Clinic [which is open to the public]. Are there any other precautions travelers can take?
Try to reduce your environmental exposure. If you’re renting a house in a tropical setting, make sure there’s no standing water around your house. If you’re able to rent a place with air-conditioning so that you can stay inside and not be exposed to mosquitoes most of the time, that’s also better. Then recognize that there are areas that mosquitoes like to hang out in, which is stagnant pools, ponds, swamps. Try to avoid those, or when you go near them, just be sure you’re wearing repellent.
The CDC has said Zika is most dangerous for pregnant women or women who might want to get pregnant. How can these specific travelers minimize risk?
If you’re a pregnant woman, you should not travel to a Zika area. If you have been exposed and you want to become pregnant, you really should wait eight weeks before conceiving. Men who want to conceive should wait six months after being in the area; if a man gets the disease, it can hang out in his testicles for a while.
What would you say is the biggest misconception about Zika out there today?
First, I think those images of babies with tiny heads have created mass hysteria. I also think we need to remind people Zika is not just a mosquito-borne illness, it’s also a sexually-transmitted disease. The majority of Zika cases to this point are asymptomatic—about 75 percent of all cases involve people who don’t even know they had it. It’s important to educate people on this point. This also is why the situation in Miami Beach is so concerning. That’s a very sexually active population there. That could create a mini-epidemic pretty fast.
How does the Zika saga end?
Viruses die down, and this one could. We also have a bill on the table in Congress to fund a vaccine. One vaccine candidate already has been approved for trials. I wrote about that in a recent op-ed for USA Today. Congress needs to get off their asses and move on it.
Until then, what can we learn from Zika?
The larger, more philosophical aspect of Zika is that this is another disease that's jumped from monkey to man, like the yellow fever outbreak that's going on in Angola, and potentially the Ebola outbreak that happened in Guinea. We as a society need to take care of our animals. If you look at the Ebola outbreak in 1976, they had a big die-off of gorillas six months before it even jumped into man. If we had known that, we might have been able to prevent many deaths. There is something called the One Health Initiative, and it focuses on keeping animals and humans healthy by doing better bio-surveillance. That will only become more important.
Matt Villano is a freelance writer and editor based in Healdsburg, California. In nearly 20 years as a full-time freelancer, he has covered travel for publications including TIME, the Wall Street Journal, the New York Times, Sunset, Backpacker, Entrepreneur, and more. He contributes to the Expedia Viewfinder blog and writes a monthly food column for Islands magazine. Villano also serves on the board of the Family Travel Association and blogs about family travel at Wandering Pod. Learn more about him at Whalehead.com