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Coming to America... the Zika Virus

By Bret Nicks
MD, FACEP

Since 2015, the Zika virus has progressed across the Americas and heightened concern over expansion and impact of this mosquito-borne illness. The CDC and other U.S. governmental agencies have been working diligently with state and local partners on early detection and prevention as part of their preparation for the anticipated emergence of mosquito-borne transmission of the Zika virus in the continental U.S. in 2016.

Zika, a virus spread to people primarily through the bite of an infected Aedes species mosquito, the same mosquito that transmits dengue and chikungunya, has had markedly increased transmission in the Americas since May 2015 when the Pan American Health Organization issued an alert for Brazil. It can also be transmitted during sex and also from a pregnant woman to her developing baby. The most common symptoms are fever, rash, joint pain and conjunctivitis. Symptoms which typically begin 2-7 days after being bitten by an infected mosquito are usually mild, lasting several days to 1 week and most commonly managed without hospitalization with supportive care.

There is increasing evidence that Zika virus infection during early pregnancy is associated with miscarriage, microcephaly and other pregnancy-related problems.  Currently, the CDC recommends special precautions for pregnant women to avoid travel to areas with active Zika virus and to consistently use condoms during sex or abstain from sex for the duration of the pregnancy with male partners that have traveled to or reside in areas with active Zika transmission. In addition, it remains unclear whether there is a connection between Guillain-Barre syndrome, an autoimmune system response that damages the nervous system and causes progressive muscle weakness and sometimes paralysis, and the Zika virus.

When in areas with Zika and other mosquito-borne illnesses, prevention is essential and can include taking the following steps:

  • Wear protective clothing (long sleeve shirts and pants)
  • Ensure appropriate screens and windows when indoors
  • Sleep under a mosquito net when in at risk locations
  • Use appropriate approved insect repellent and reapply as directed
  • Treat clothing with permethrin or consider purchasing pre-treated clothing for travel
  • Avoid getting mosquito bites for up to 3 weeks once returning home from an area with Zika

To date, local vector-borne transmission of Zika virus has not been identified in the continental US. However, the US mainland does have the Aedes species mosquito that can become infected with and spread the Zika, as well as chikungunya and dengue, virus.  Updated information and additional resources on Zika can be found on the following reputable websites:


About the author: Bret Nicks, MD, FACEP, is an Associate Professor of Emergency Medicine and the Associate Dean of Global Health at Wake Forest School of Medicine in North Carolina. Dr. Nicks has experienced living, working and teaching globally with specific focus in East Africa and Central America. As such, he has developed a keen understanding of mosquito-based diseases such as malaria, dengue, West Nile and others. Dr. Nicks also served as the chair of ACEP’s Public Relations Committee.