Pathfinder
Editor, Senior Moderator
[h=1]Public Health Notice - Zika Virus[/h] March 11, 2016
Information is reviewed on a regular basis and updated as required.
[h=2]Why you should take note[/h] The Public Health Agency of Canada has confirmed travel-related cases of Zika virus from Central and South America, and from the Caribbean. Currently there is ongoing local transmission in many countries of South Asia, Western Pacific Islands, and South and Central America, including the Caribbean, and Mexico. Pregnant women and those planning a pregnancy should avoid travel to areas with ongoing Zika virus outbreaks. Zika virus is spread through mosquito bites. If travel cannot be avoided or postponed, strict mosquito bite prevention measures should be followed due to the association between Zika virus infection and increased risk of serious health effects on unborn babies.
Mosquitoes known to transmit the virus to humans are not present in Canada.
[h=3]Countries affected by Zika virus[/h] Zika virus has been reported in Africa and parts of Asia since the 1950s, and in the southwestern Pacific Ocean in 2007. In 2015, Zika virus emerged in South America with widespread outbreaks reported in Brazil and Colombia.
For the latest updates on countries affected by Zika virus, please visit the World Health Organization's website. For the latest map of confirmed cases in the Americas visit the Pan American Health Organization's website.
[h=2]Risk to Canadians[/h] Based on the Agency's Rapid Risk Assessment, the overall risk to Canadians, in Canada, is very low, as mosquitoes known to transmit the virus are not established in Canada and are not well-suited to our climate. The risk to travellers to affected countries is low; however, pregnant women and those planning a pregnancy should avoid travel to areas with ongoing Zika virus outbreaks. (See section below).
Current evidence suggests that Zika virus is likely to persist and spread in countries in tropical and subtropical regions. Although the risk of virus establishment in Canada is low, there is ongoing risk to Canadians travelling to outbreak regions.
[h=2]Advice to Canadians[/h] Canadian travellers visiting affected areas should protect themselves against Zika virus by taking individual protective measures to prevent mosquito bites, including using insect repellent, protective clothing, mosquito nets, screened doors and windows. There is no vaccine or medication that protects against Zika virus infection.
[h=2]Pregnant women and women planning a pregnancy[/h] It is recommended that pregnant women and those planning a pregnancy should avoid travel to areas with ongoing Zika virus outbreaks. If travel cannot be avoided or postponed, strict mosquito bite prevention measures should be followed due to the association between Zika virus infection and increased risk of serious health effects on unborn babies.
Women wishing to get pregnant should wait at least two months after their return from areas where Zika virus is circulating, and countries where the virus has the potential to circulate, before trying to conceive.
Men who have travelled to an area with an ongoing Zika virus outbreaks should use condoms with any partner who could become pregnant for two months after their return. It is recommended that men who have a pregnant partner should use condoms for the duration of the pregnancy.
[h=2]Symptoms and Treatment[/h] Twenty to twenty-five percent of people infected with Zika virus are believed to develop symptoms. These can include low-grade fever, headache, red eyes, rash along with joint and muscle pain.
The incubation period of Zika virus ranges from 3 to 12 days. The disease symptoms are usually mild and last for 2 to 7 days. Most people recover fully without severe complications and simple supportive care. Hospitalization rates are low. Zika virus infection may go unrecognized or be misdiagnosed as dengue, chikungunya or other viral infections causing fever and rash.
Currently, there is no prophylaxis, vaccine or treatment for Zika virus. Treatment is generally limited to symptom relief.
If you are pregnant, or you have underlying medical conditions and you develop symptoms that could be consistent with Zika virus infection, you should see a health care provider and tell them where you have been travelling or living.
[h=2]Testing[/h] Testing should be considered for travelers who are pregnant, those with underlying medical conditions or those who develop symptoms that could be consistent with Zika virus infection, during or within two weeks of travel to countries where Zika transmission is ongoing or widespread. For those travellers whose symptoms began more than 10 days ago, the best test is a test for antibodies, however this testing approach may take weeks to complete. It is important that patients and physicians discuss the limitations of Zika virus testing.
[h=2]Travel information[/h] A Travel Health Notice has been posted to provide advice to Canadian travellers. We will continue to monitor this situation very closely and advise Canadians as appropriate.
[h=3]Microcephaly and Guillain-Barr? Syndrome[/h] In November 2015, a Brazilian investigation indicated an average twenty-fold increase in the incidence of microcephaly (abnormally small head) among newborns born in areas where Zika virus was known to be in circulation.
An association between Zika virus infection and Guillain-Barr? Syndrome (GBS) has been observed in a few countries where the Zika virus is actively circulating. Investigations to better understand the possible relationship between Zika virus infection and the increase in cases of GBS is ongoing.
On February 1, 2016 the World Health Organization declared that the recent cluster of microcephaly cases and other neurological disorders reported in Brazil, following a similar cluster of neurological disorders in French Polynesia in 2014, constitutes a Public Health Emergency of International Concern. The investigation is ongoing to confirm whether Zika virus may be the cause of these microcephaly cases and this announcement recommends that actions be taken to standardize and enhance surveillance, as well as to intensify research. No restrictions on travel or trade with countries, areas and/or territories with Zika virus transmission have been recommended.
[h=3]Blood, cell, tissue and organ donations[/h] Canadian Blood Services (CBS) and H?ma-Qu?bec (Quebec's blood operator) are carefully monitoring the Zika virus issue. They have revised their eligibility criteria for donors to mitigate the risk of the virus entering the Canadian blood supply. Anyone who has travelled outside of Canada, the continental United States and Europe will now be temporarily ineligible to give blood for three weeks. This new waiting period was implemented across the country on February 5, 2016.
This 21-day waiting period ensures enough time has passed for the virus to be eliminated from a person's bloodstream, and begins the day a person returns to Canada. The waiting period also applies to cord blood and stem cell donors who have travelled to affected areas.
The risk of Zika virus transmission from a Canadian donor to a blood recipient is very low. Canadians may consider donating blood before they travel.
Health Canada issued a notice on February 9, 2016 to provide information on the risks to cell, tissue, organ, and semen donation. In the notice, Health Canada is advising that the donation of cells, tissues, and organs from live donors who have travelled to a Zika affected area be postponed until a minimum of 21 days. In the case of a deceased donor, if it is in the best interest of the patient to go ahead with the transplant, the exceptional distribution provisions of the Safety of Human Cells, Tissues, and Organs for Transplantation Regulations should be used. Ultimately, it is the responsibility of the transplant program to weigh the risks and benefits of postponing any transplant procedures.
Men that have returned from Zika-affected areas should postpone semen donations for 28 days after their return. The deferral period for semen donation is longer than the 21-day deferral for blood, cells, tissues, and organs since the infectious virus has been detected in semen for longer periods. In addition, there is concern that donated semen may be the human donation with the highest risk of a potential serious adverse outcome due to the potential association between Zika virus and adverse pregnancy outcomes, such as microcephaly.
[h=2]What the Public Health Agency of Canada is doing[/h] The Public Health Agency of Canada works with its national and international partners, including the World Health Organization, to monitor and share information. The Agency tracks diseases in Canada and around the world.
The Agency continues to work with Canada's health care professionals to develop and update clinical guidelines for identifying and managing suspected Zika virus infections. The Agency will continue to assess the risk on an ongoing basis by working with our partners, and support enhanced awareness for the travelling public.
The Public Health Agency's National Microbiology Laboratory is able to test for the presence of the virus or antibodies to the virus, and is in a position to support Provinces and Territories to test specimens.
[h=2]Additional information[/h]
http://www.phac-aspc.gc.ca/phn-asp/2016/zika-eng.php
Information is reviewed on a regular basis and updated as required.
[h=2]Why you should take note[/h] The Public Health Agency of Canada has confirmed travel-related cases of Zika virus from Central and South America, and from the Caribbean. Currently there is ongoing local transmission in many countries of South Asia, Western Pacific Islands, and South and Central America, including the Caribbean, and Mexico. Pregnant women and those planning a pregnancy should avoid travel to areas with ongoing Zika virus outbreaks. Zika virus is spread through mosquito bites. If travel cannot be avoided or postponed, strict mosquito bite prevention measures should be followed due to the association between Zika virus infection and increased risk of serious health effects on unborn babies.
Mosquitoes known to transmit the virus to humans are not present in Canada.
[h=3]Countries affected by Zika virus[/h] Zika virus has been reported in Africa and parts of Asia since the 1950s, and in the southwestern Pacific Ocean in 2007. In 2015, Zika virus emerged in South America with widespread outbreaks reported in Brazil and Colombia.
For the latest updates on countries affected by Zika virus, please visit the World Health Organization's website. For the latest map of confirmed cases in the Americas visit the Pan American Health Organization's website.
[h=2]Risk to Canadians[/h] Based on the Agency's Rapid Risk Assessment, the overall risk to Canadians, in Canada, is very low, as mosquitoes known to transmit the virus are not established in Canada and are not well-suited to our climate. The risk to travellers to affected countries is low; however, pregnant women and those planning a pregnancy should avoid travel to areas with ongoing Zika virus outbreaks. (See section below).
Current evidence suggests that Zika virus is likely to persist and spread in countries in tropical and subtropical regions. Although the risk of virus establishment in Canada is low, there is ongoing risk to Canadians travelling to outbreak regions.
[h=2]Advice to Canadians[/h] Canadian travellers visiting affected areas should protect themselves against Zika virus by taking individual protective measures to prevent mosquito bites, including using insect repellent, protective clothing, mosquito nets, screened doors and windows. There is no vaccine or medication that protects against Zika virus infection.
[h=2]Pregnant women and women planning a pregnancy[/h] It is recommended that pregnant women and those planning a pregnancy should avoid travel to areas with ongoing Zika virus outbreaks. If travel cannot be avoided or postponed, strict mosquito bite prevention measures should be followed due to the association between Zika virus infection and increased risk of serious health effects on unborn babies.
Women wishing to get pregnant should wait at least two months after their return from areas where Zika virus is circulating, and countries where the virus has the potential to circulate, before trying to conceive.
Men who have travelled to an area with an ongoing Zika virus outbreaks should use condoms with any partner who could become pregnant for two months after their return. It is recommended that men who have a pregnant partner should use condoms for the duration of the pregnancy.
[h=2]Symptoms and Treatment[/h] Twenty to twenty-five percent of people infected with Zika virus are believed to develop symptoms. These can include low-grade fever, headache, red eyes, rash along with joint and muscle pain.
The incubation period of Zika virus ranges from 3 to 12 days. The disease symptoms are usually mild and last for 2 to 7 days. Most people recover fully without severe complications and simple supportive care. Hospitalization rates are low. Zika virus infection may go unrecognized or be misdiagnosed as dengue, chikungunya or other viral infections causing fever and rash.
Currently, there is no prophylaxis, vaccine or treatment for Zika virus. Treatment is generally limited to symptom relief.
If you are pregnant, or you have underlying medical conditions and you develop symptoms that could be consistent with Zika virus infection, you should see a health care provider and tell them where you have been travelling or living.
[h=2]Testing[/h] Testing should be considered for travelers who are pregnant, those with underlying medical conditions or those who develop symptoms that could be consistent with Zika virus infection, during or within two weeks of travel to countries where Zika transmission is ongoing or widespread. For those travellers whose symptoms began more than 10 days ago, the best test is a test for antibodies, however this testing approach may take weeks to complete. It is important that patients and physicians discuss the limitations of Zika virus testing.
[h=2]Travel information[/h] A Travel Health Notice has been posted to provide advice to Canadian travellers. We will continue to monitor this situation very closely and advise Canadians as appropriate.
[h=3]Microcephaly and Guillain-Barr? Syndrome[/h] In November 2015, a Brazilian investigation indicated an average twenty-fold increase in the incidence of microcephaly (abnormally small head) among newborns born in areas where Zika virus was known to be in circulation.
An association between Zika virus infection and Guillain-Barr? Syndrome (GBS) has been observed in a few countries where the Zika virus is actively circulating. Investigations to better understand the possible relationship between Zika virus infection and the increase in cases of GBS is ongoing.
On February 1, 2016 the World Health Organization declared that the recent cluster of microcephaly cases and other neurological disorders reported in Brazil, following a similar cluster of neurological disorders in French Polynesia in 2014, constitutes a Public Health Emergency of International Concern. The investigation is ongoing to confirm whether Zika virus may be the cause of these microcephaly cases and this announcement recommends that actions be taken to standardize and enhance surveillance, as well as to intensify research. No restrictions on travel or trade with countries, areas and/or territories with Zika virus transmission have been recommended.
[h=3]Blood, cell, tissue and organ donations[/h] Canadian Blood Services (CBS) and H?ma-Qu?bec (Quebec's blood operator) are carefully monitoring the Zika virus issue. They have revised their eligibility criteria for donors to mitigate the risk of the virus entering the Canadian blood supply. Anyone who has travelled outside of Canada, the continental United States and Europe will now be temporarily ineligible to give blood for three weeks. This new waiting period was implemented across the country on February 5, 2016.
This 21-day waiting period ensures enough time has passed for the virus to be eliminated from a person's bloodstream, and begins the day a person returns to Canada. The waiting period also applies to cord blood and stem cell donors who have travelled to affected areas.
The risk of Zika virus transmission from a Canadian donor to a blood recipient is very low. Canadians may consider donating blood before they travel.
Health Canada issued a notice on February 9, 2016 to provide information on the risks to cell, tissue, organ, and semen donation. In the notice, Health Canada is advising that the donation of cells, tissues, and organs from live donors who have travelled to a Zika affected area be postponed until a minimum of 21 days. In the case of a deceased donor, if it is in the best interest of the patient to go ahead with the transplant, the exceptional distribution provisions of the Safety of Human Cells, Tissues, and Organs for Transplantation Regulations should be used. Ultimately, it is the responsibility of the transplant program to weigh the risks and benefits of postponing any transplant procedures.
Men that have returned from Zika-affected areas should postpone semen donations for 28 days after their return. The deferral period for semen donation is longer than the 21-day deferral for blood, cells, tissues, and organs since the infectious virus has been detected in semen for longer periods. In addition, there is concern that donated semen may be the human donation with the highest risk of a potential serious adverse outcome due to the potential association between Zika virus and adverse pregnancy outcomes, such as microcephaly.
[h=2]What the Public Health Agency of Canada is doing[/h] The Public Health Agency of Canada works with its national and international partners, including the World Health Organization, to monitor and share information. The Agency tracks diseases in Canada and around the world.
The Agency continues to work with Canada's health care professionals to develop and update clinical guidelines for identifying and managing suspected Zika virus infections. The Agency will continue to assess the risk on an ongoing basis by working with our partners, and support enhanced awareness for the travelling public.
The Public Health Agency's National Microbiology Laboratory is able to test for the presence of the virus or antibodies to the virus, and is in a position to support Provinces and Territories to test specimens.
[h=2]Additional information[/h]
- World Health Organization's website
- The Pan American Health Organization
- Zika virus
- Laboratory Testing Recommendations for Zika Virus
- Assistance - sickness or injury
- Returning to Canada - if you get sick
- Country travel advice and advisories
- WHO fact sheet - Zika virus
http://www.phac-aspc.gc.ca/phn-asp/2016/zika-eng.php