Even if you live far from an infection zone, chances are Zika virus still comes up in your life. Your pregnant coworker is thinking of canceling her Caribbean vacation and your mother-in-law doesn’t understand why you won’t visit her in Miami this year.
You, meanwhile, don’t know what to think. And there may be a good reason for that: A Harvard T.H. Chan School of Public Health poll points to a few key Zika misconceptions in circulation. For example, 20 percent of Americans incorrectly believed that we already have a Zika vaccine. The poll also found that nearly half of Americans didn’t know that Zika could be sexually transmitted. And a full quarter of respondents thought that people infected with Zika were “very likely” to show symptoms, which isn’t necessarily the case.
Even if public understanding of the virus has improved since the poll was taken in March, it’s clear that Americans are woefully under-informed about Zika. Let’s change that: Here are expert answers to some of the most common questions people have about travel, testing and childbearing in the age of Zika.
(One important caveat: As always, consult your doctor if you or your partner are pregnant, trying to conceive or if you have individual Zika concerns.)
Where you’ll find Zika virus
Brazil declared Zika a public health emergency in 2015, and since then the virus has spread rapidly through Latin America, Central America, the Caribbean and Miami, Florida.
The U.S. Centers for Disease Control and Prevention recommends that pregnant women do not travel to these areas, because of the risk that Zika infection could cause microcephaly, a birth defect in their unborn child.
The guidelines got murkier last week when the CDC expanded its travel recommendations to include 11 countries in Southeast Asia. This advisory was less urgent, since a significant portion of Southeast Asia residents likely have Zika immunity from past exposure. Practically speaking, however, for pregnant women, the advice for traveling to Southeast Asia is similar to traveling to Latin America. Pregnant women should consider postponing nonessential travel to those countries and get tested for Zika if they’ve been exposed to the virus.
See the CDC’s map below (last updated in October), and check back regularly for the agency’s latest travel updates:
Getting tested for Zika
Because Zika virus can cause birth defects, identifying Zika infection in pregnant women is health departments’ top priority.
Non-pregnant people who traveled to a Zika outbreak area within the last two to 12 weeks and experienced symptoms can also get tested for the virus.
There are two types of tests: You’ll get a urine test if it’s been less than two weeks since you were exposed, and a blood test for Zika antibodies between three and 12 weeks after exposure.
To determine to whether or not you’re eligible for a Zika test, see the flowchart below:
What to consider about Zika if you are…
…Trying to conceive and wondering if your male partner can get tested:
If he hasn’t experienced Zika symptoms, the short answer is probably not.
Doctors aren’t being stingy ― the Zika test just isn’t as reliable for men as it is for women because the virus lives in semen longer than it is detectable through blood testing.
“There are cases of pregnant women who have been infected by their male sexual partners in the latter part of pregnancy [who go on to have] affected newborns,” Dr. Neil Silverman, an obstetric infectious disease specialist at the University of California, Los Angeles, told The Huffington Post. “These are men who have or have not had symptoms and transmitted after the virus was out of their bloodstream,”
“The prostate is the bad actor here,” he added.
Even though you could skirt the CDC’s guidelines by getting a Zika test from a commercial lab if you’re an asymptotic male or if it’s been longer than 12 weeks since you were exposed, Silverman wouldn’t recommend it.
“The test is not that reliable after 12 weeks,” he said.
… A pregnant woman and neither you, nor your sexual partner, have traveled to a Zika outbreak area:
You’re fine. You don’t need to be tested for Zika virus.
“I still get calls from people in Southern California who say that they were bitten by a mosquito in their backyard,” Silverman said. “And I say, ‘Okay, but there’s no transmission.’”
… A person who traveled to a Zika outbreak area ― or has a partner who did so ― and learned you were pregnant soon after returning:
If you or your partner traveled to a Zika outbreak area while you were pregnant, or learned you were pregnant soon after returning, you should get tested for Zika ASAP.
The window for reliable Zika testing is between two and 12 weeks after you’ve been exposed, according to the CDC. (Pregnant women can get a Zika test at any point post exposure, but again, it’s not reliable after 12 weeks.) If you live in an area with ongoing Zika transmissions, such as parts of Miami, Florida, or Puerto Rico, you should take extra precautions to avoid mosquito bites and get tested regularly for Zika.
“If they’re living in an area that has transmission, they get a test at least once a trimester regardless of symptoms or known bites,” Silverman said. “You’re trying to capture that 12-week window repeatedly to know if there’s been infection.”
… In your second trimester and want to go on a babymoon:
The recommendations are pretty clear on this one. Pregnant women should avoid traveling to areas with active Zika outbreaks and should postpone travel to Southeast Asia. In other words, Southern California and Nova Scotia are safer bets for your babymoon.
As for the advice that Aedes aegypti mosquito that transmits the virus doesn’t live above 6,500 feet? Well, technically that’s true, but it doesn’t help you if you fly into a lower-elevation airport. According to the CDC, even traveling through or stopping briefly in a low-elevation area on the way to a higher-elevation area increases your risk of contracting Zika from a mosquito bite.
And Zika aside, it’s a good idea to check with your doctor before traveling to a high-elevation area while pregnant anyway. SoCal it is.
… Attending a bachelorette party in the Virgin Islands, but you’re thinking of getting pregnant in the next few years:
This one is trickier. “If someone is in a relationship and they’re thinking of getting pregnant in the next year, then it may not be prudent to go to these places,” Silverman said.
If, on the other hand, you’re not planning a pregnancy, just imagining the possibility of having a child eventually, being exposed to Zika shouldn’t be a problem. In fact, Silverman explained, there could be an unexpected benefit if you do contract the virus while traveling ― developing Zika antibodies that could make you immune to the virus in the future.
Silverman’s biggest piece of advice, should you choose to travel to a Zika outbreak area: Use contraception. “Keep in mind,” he cautioned. “In the United States, almost half of all pregnancies are unplanned.”
… Getting married in Puerto Rico and your sister says she can’t come because of Zika:
If she’s pregnant or trying to conceive, she should follow the CDC’s guidelines and avoid traveling to areas with ongoing Zika transmissions.
If she’s in the gray area ― thinking of getting pregnant in the next year or so ― it might prudent of her and her partner to skip the wedding, but she’s not at immediate risk. Either way, that decision is ultimately up to her.
… A single, sexually active male who recently traveled to an affected area:
Wear a condom ― for vagina, oral and anal sex ― every single time you have sex for the next six months, no exceptions.
On September 30, the CDC changed its guidelines for men who have recently visited Zika outbreak areas. Men should now use condoms for at least six months following their last possible Zika exposure, regardless of whether they’ve experienced Zika symptoms, to ensure they don’t pass the virus to their sexual partners.
… Someone who met a hot guy at a bar who recently traveled to an affected area:
Make sure he wears a condom and don’t share sex toys. And remember that Zika isn’t just a problem for straight people: The the first case of sexually transmitted Zika involving two male partners was reported in Dallas in February.
… A granny who lives in Miami:
While granny probably doesn’t have to worry about Zika-related birth defects, microcephaly isn’t the only health complication linked to the virus. Guillain-Barré syndrome is strongly linked to Zika virus, and can cause gradual weakness in the limbs, temporary paralysis and in few cases, death. Still, Guillain-Barré is rare, according to the CDC, and much less of a concern than the risk Zika virus posses to pregnant women.
“If we use West Nile virus as an example, older folks or folks with chronic illnesses are at a little bit increased risk of Guillain-Barré as a complication,” Silverman said. “But I’m not sure that the entire retired population of Florida needs to move out of Miami.”