Ask the Pharmacist

Q: All right, it’s mid-January and I’m already sick of this weather with two (possibly three or four?) more months to go. I would love to get away to a warm destination and am wondering if I still need to consider the Zika Virus in my planning?

A: With the arrival of a particularly virulent strain of flu (and perhaps a similarly disposed president-elect), the media’s attention has shifted away from coverage of the Zika Virus to fresher topics.

This, however, does not by any means signify that Zika is no longer a threat in certain areas to at least some of us. Instead, it is simply a reflection of the reality that the presence of Zika is the “new norm” and is, therefore, no longer considered newsworthy.

The consensus opinion of our experts seems to be that Zika is here to stay and should play a role in your vacation planning, depending on your age and health status. All that being said, for the vast majority of people who do get infected, this is a relatively benign virus. In fact, in 80 per cent of infections, there are virtually no symptoms felt whatsoever.

When people do feel ill, what they experience is quite similar to the usual viruses we have dealt with for decades. These include such indicators as fever, headache, pink eye, muscle and/or joint pain, and a rash that rarely lasts longer than a week.

However, for a select few, this virus can be devastating. In very rare cases, some people infected go on to develop an auto-immune disease known as Guillain-Barrè Syndrome (GBS) which is characterized by a form of temporary muscle paralysis that can be life-threatening and can leave affected individuals with long-term consequences.

While the syndrome is rare, the incidence of GBS has skyrocketed in those countries dealing with Zika to levels that are two- to 9.8-times higher than normal. While experts are unsure as to who is more likely to develop GBS, post-Zika infection studies seem to indicate that risk factors include being older than 50, and common sense dictates that those among us who are already dealing with other medical conditions might be more prone as well.

The other complication from Zika occurs when a pregnant woman gets infected. The virus can interfere with the normal development of the fetus, resulting in birth defects that leave the infant’s head and brain as abnormally small, a condition known as microcephaly. Babies with microcephaly can have a range of other problems associated with their brains, including a risk of seizures, developmental delays, intellectual disabilities, problems with motor skills and balance, vision problems, hearing loss and a host of other issues no parent wants to see in a newborn.

While the risk of developing microcephaly appears to be highest when a mother is infected in the first trimester (i.e. within the first three months) of pregnancy, an infection at any point throughout the pregnancy may lead to complications affecting the infant’s sight, hearing or cognitive abilities. It is still not known how often Zika causes these birth defects when a pregnant women is infected but when the consequences are so severe and long-lasting, we're not sure any vacation is worth that kind of risk in this niche group of individuals.

So, the key questions are: what regions of the world are affected and just who needs to consider this infection at all in their vacation plans?

Unfortunately, areas that need to be avoided if you are pregnant, are many of our most common hot-weather travel destinations, including Mexico (except for regions at the highest altitude which aren’t particularly known for their awesome beaches), all of the Caribbean, all of Central America, all of South America (with the exception of Chili and Uruguay), a number of the Pacific Islands (but not New Zealand or Australia), and Singapore as the sole country within Asia that is battling this disease.

Who should not go to these regions is a little more complicated. Obviously, those who are currently pregnant should go enjoy California or Florida (or Vancouver which has simply spectacular clouds this time of year!) rather than any of the destinations listed above.

For those couples planning to start a family in the near future, the advice is a little more nuanced. The problem is that the virus can remain within the body for months without any symptoms indicating that you have been infected. If you were to become pregnant months after your vacation and you had been infected, there is a chance your fetus will become infected as well.

Studies indicate that the virus can persist for a longer period of time in a man’s semen as compared to a female’s vaginal secretions but the exact length of time is unknown at this point. As such, caution is the order of the day. Therefore, it is recommended that men should refrain from sex or use a condom for six months after returning from an area where Zika is present, and women should avoid getting pregnant for at least two months.

During the trip, both sexes should do their best to avoid getting bitten by mosquitoes by using all the usual tips (as have been addressed here in previous columns) especially since Zika is far from the only disease that may be spread by mosquitoes (think dengue fever, malaria and chikungunya, to name a few).

Long story short, if you are pregnant, stay away from these areas. If you’d like to start a family soon, plan ahead and be mindful of the adequate precautions and go enjoy the sun.

For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/?fref=ts