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Zika Virus Advisory

Tuesday, January 19, 2016

The Epidemiology and Surveillance Unit of the Ministry of Health, Seniors and Environment would like to update the public on guidance recommended by the World Health Organization (WHO), The Pan American Health Organization (PAHO) and The Centers for Disease Control (CDC) on the prevention of Zika Virus, a mosquito-borne illness that results in fever, rash and joint pains, among other symptoms.   

Media reports from various international sources are readily available but may not necessarily reflect official, evidence-based advice. To assure that information is scientifically supported and official, we direct the public to the above international authorities and to the Bermuda Government health website: The ESU is monitoring the regional situation closely. The website and Department of Health Facebook pages will be updated regularly as new developments occur.

There have been no cases thus far of Zika Virus infection reported in Bermuda. The Epidemiology and Surveillance Unit (ESU) in the Ministry conducts ongoing surveillance for rash and fever, with the collaboration of health care providers.  Individuals experiencing such symptoms, and who have a recent history of travel to affected regions, should inform their health care professional.  Physicians should report any suspected cases of Zika virus, or related vector-borne infections such as Dengue fever or Chikungunya, to the ESU (278-6503).  The ESU will investigate such reports and put control measures into place.

The public are advised, as always, to avoid mosquito bites when travelling to regions where mosquito-borne diseases are common.  Particularly, at this time pregnant travelers, or women who may become pregnant, are cautioned to consider the risks with their health care providers, and consider limiting travel to such regions.


How is Zika virus (Zika) transmitted?

Zika is primarily transmitted through the bite of infected Aedes mosquitoes.  Research is currently under way on possible mother-to-child transmission of the virus and its effects on babies

Who is at risk of being infected?

Anyone who is living in or traveling to an area where Zika virus is found, who has not already been infected with Zika virus, is at risk for infection.

What are the symptoms of Zika virus infection (Zika)?

About one in five people infected with Zika will get sick. Many people might not realize that they have been infected. For people who get sick, the illness is usually mild. The most common symptoms of Zika virus disease are fever, rash, joint pain, or conjunctivitis (red eyes). Symptoms typically begin 2 to 7 days after being bitten by an infected mosquito.

What countries are presently noted to have ongoing transmission of Zika virus?

Prior to 2015, Zika virus outbreaks had been identified in countries in Africa, Southeast Asia, and the Pacific Islands. In May 2015, the first confirmed Zika virus infection occurred in Brazil. Currently, outbreaks are occurring in many countries in the Americas including:

•  Barbados

•  Bolivia

•  Brazil

•  Colombia

•  Ecuador

•  El Salvador 

•  French Guiana

•  Guyana

•  Guatemala

•  Haiti

•  Honduras

•  Martinique

•  Mexico

•  Panama

•  Puerto Rico

•  Paraguay

•  Saint Martin

•  Suriname

•  Venezuela

The United States has reported cases of Zika virus in returning travelers, but no ongoing transmission.

There have been no cases of Zika Virus confirmed in Bermuda

Please check the CDC website for the most up to date report on countries affected.

I am pregnant or planning to become pregnant. How will Zika virus affect me or my unborn baby?

Should I travel to a country where cases of Zika have been reported?

  1. Research is currently under way on possible mother-to-child transmission of the virus and its effects on babies. This alert follows reports in Brazil of a serious birth defect of the brain called microcephaly  (abnormal smallness of the head) and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant. More studies are planned to learn more about the risks of Zika virus infection during pregnancy.

Out of an abundance of caution, CDC recommends special precautions for pregnant women and women trying to become pregnant:

  • Pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing. Pregnant women who do travel to one of these areas should talk to their doctor or other healthcare provider first and strictly follow steps to avoid mosquito bites during the trip.
  • Women trying to become pregnant should consult with their healthcare provider before traveling to these areas and strictly follow steps to prevent mosquito bites during the trip
  • Pregnant women who travel to areas where Zika virus is circulating should mention this during their prenatal check-ups.

What does PAHO recommend to women of childbearing age with respect to becoming pregnant in areas where Zika virus is circulating?

PAHO/WHO recommends they take preventive measures to avoid mosquito bites. Women who are pregnant or planning to become pregnant should seek prenatal care to receive information and monitoring of their pregnancy and to follow their doctors’ recommendations

Pregnant women and women of reproductive age should follow the same recommendations as all travellers.

What can travelers do to prevent Zika?

There is no vaccine to prevent or medicine to treat Zika. Travelers can protect themselves by preventing mosquito bites:

  • Cover exposed skin by wearing long-sleeved shirts and long pants.
  • Use EPA-registered insect repellents containing DEET, picaridin, oil of lemon eucalyptus (OLE), or IR3535. Always use as directed.
    • Pregnant and breastfeeding women can use all EPA-registered insect repellents, including DEET, according to the product label.
    • Most repellents, including DEET, can be used on children aged >2 months.
  • Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents). You can buy pre-treated clothing and gear or treat them yourself.
  • Stay and sleep in screened-in or air-conditioned rooms.

What should I do if I have Zika?

Seek medical advice. Treat the symptoms:

  • Get plenty of rest
  • Drink fluids to prevent dehydration
  • Take medicines as directed by your healthcare provider, such as acetaminophen or paracetamol to reduce fever and pain
  • Do not take aspirin or other non-steroidal anti-inflammatory drugs

Protect others. Zika virus can be found in the blood and passed from an infected person to another mosquito through mosquito bites. An infected mosquito can then spread the virus to other people. To help prevent others from getting sick, avoid mosquito bites during the first week of illness.

See your healthcare provider if you are pregnant and develop a fever, rash, joint pain, or red eyes within 2 weeks after traveling to a country where Zika virus cases have been reported. Be sure to tell your health care provider where you traveled.

What is Bermuda doing to prevent transmission of Zika Virus?

Suspected and confirmed cases of Zika are reportable to the Epidemiology and Surveillance Unit, who will investigate and put control measures in place to prevent ongoing transmission.

Bermuda maintains its Syndromic Surveillance of Fever and Rash, and Undifferentiated Fever through a pool of 41 reporting sources, including select physician’s offices, Department of Health clinics and the infection control practitioners of the Bermuda Hospitals Board.

The Epidemiology and Surveillance Unit, within the Ministry of Health, routinely monitors for increases in reported syndromes such as Undifferentiated Fever, as an indicator for mosquito-borne diseases such as Zika. Any increase in the incidence of symptoms suggestive of Zika would be investigated to determine the cause. The Vector Control Section of the Environmental Health Department works diligently to monitor mosquito distribution and eliminate mosquito breeding sites.

Ongoing monitoring for ill travellers continues at the LF Wade International Airport in collaboration with the Department of Customs.