Getting Past the Hype of Zika

Plus, how to prevent mosquito and tick bites.

The four-letter word of the summer just might be Zika

“I get asked about it every single day, multiple times,” says Dr. Stephen Gluckman, medical director of Penn Global Medicine and a professor at the Hospital of the University of Pennsylvania

The truth: Zika isn’t dangerous to most people. In fact, 80 percent of those who contract it are asymptomatic. At worst, says Gluckman, it’s five to seven days of mild illness that includes fever, rash, joint pain and red eyes. 

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But while Zika shouldn’t worry the general population, it’s a real problem for women who are pregnant or might become pregnant. It can cause a birth defect called microcephaly, plus other forms of severe, sometimes fatal, brain disorders. It can also be transmitted sexually, so the Centers for Disease Control and Prevention recommend that men who travel to Zika-infected countries use condoms for two to three months after they return. For those who travel back and forth from Florida, Texas, Puerto Rico and South America, Zika should be an ongoing concern. 

Zika isn’t the only disease that mosquitos can transmit. In certain parts of the world, they carry malaria, chikungunya, dengue, yellow fever and West Nile virus. Vaccines and other medications can help prevent and treat some of them. This summer, even those staying home or traveling to nearby mountains and beaches need to take precautions. “Decrease where mosquitos breed,” says Gluckman. “Make sure there are no puddles or old tires that have water in them. That’s a classic place for mosquitos to leave their larvae.” 

Mosquitos aren’t the only insect threat. Ticks transmit a variety of diseases, including tularemia, STARI, ehrlichiosis, Powassan virus and Lyme disease. Pennsylvania has the dubious distinction of being the Lyme capital of the United States. More cases have been reported here than in any other state, and there was a 25-percent increase from 2013 to 2014. 

Bug spray can go a long way toward preventing mosquito and tick bites, but only if it includes DEET. “It’s the one repellent that’s proven to be effective,” says Dr. Michelle Karten of Nemours duPont Pediatrics in Villanova

Karten doesn’t recommend repellent for infants under 2 months. For everyone else, it’s a spray or cream with at least 20 percent DEET. Parents should apply it thoroughly to their kids’ skin and consider spraying permethrin, another repellent, on clothes. And always check your kids and yourself—for ticks. “Inspect them head to toe, and check a few times—especially before they go to bed,” says Karten. “It takes at least 24 hours for ticks to attach and pass disease, so there’s a window to prevent people from getting Lyme.”

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There’s little in the way of prevention, however, for one of the most common travel-related illnesses. Highly contagious and difficult to eradicate, noroviruses sweep through cruise ships like hurricanes, sickening thousands at once. 

“A norovirus spreads when people eat together at buffets and touch doorknobs,” says Dr. Lawrence Livornese, an infectious-disease specialist and the chairman of the department of medicine for Main Line Health. “The only way to prevent it is through lots of good hand-washing.”

Livornese offers this tip: Check the CDC’s online registry of cruise ships’ inspection scores. A good track record says a lot about the commitment to the health of passengers.

Gastrointestinal ugliness can come from other foodborne and waterborne parasites—and resisting them isn’t as simple as not drinking the water. Don’t brush your teeth with it; don’t consume fruit rinsed in tap water; and don’t eat dishes made with it unless it’s been boiled. Avoid tap water in baby formula, and don’t forget about ice. “Freezing bacteria doesn’t kill it,” Livornese says. “That’s how we store it in our labs.”

Anything in a sealed bottle or can is OK, including water, fruit juices and alcohol. Brewed coffee and hot tea are also OK. Fruits and vegetables with peels are fine, as long as travelers remove the peels themselves. 

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Also beware of tepid food. The longer it sits in a restaurant kitchen, the more contaminated it can become. “Bacterial counts can increase quickly,” says Livornese. “If it’s too hot to put in your mouth, it’s good to eat. Let it cool in front of you.”

Regardless, pack the Pepto-Bismol, Tylenol and other over-the-counter medications, including their pediatric forms. “A pharmacy may not be local to where you’re staying,” says Karten. “And in many other countries, medications may well be labeled differently.”  



How to prevent mosquito and tick bites.

Source: Centers for Disease Control and Prevention

Do …

use insect repellents that contain at least 20 percent DEET. 

Don’t … 

use products that contain sunscreen and repellent.

Do …

apply sunscreen first. Let it dry before adding repellent.  

Don’t …

use repellents on infants younger than 2 months old.

Do …

tuck shirts into pants—and tuck pants into socks for maximum protection.

Don’t …

allow kids to touch repellent. 

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