Back when Zika swept the western hemisphere, the travel recommendations for people who were pregnant or planning a pregnancy were clear: avoid any areas that had a risk of Zika infection. It was fairly easy to know where those areas were, as governments and public health organizations around the world worked tirelessly to identify and report cases. World maps showing areas of risk provided clear “yes/no” guidance. Was there any doubt about who shouldn’t travel where? Not really. Not back then.
But what about now? The number of reported Zika cases has fallen dramatically in recent years. However, the accuracy of reporting can vary widely from country to country, so the once-clear world map of Zika risk now appears much less well-defined.
One of the most common Zika-related questions we still get at MotherToBaby is, “How likely is it that I’ll get Zika if I travel to Country X?” (Or a variation of the same: “We went to Country X. Do we really need to wait 3 months before we try to get pregnant?”) One resource to help answer that question is the interactive world map maintained by the Centers for Disease Control and Prevention (CDC) to illustrate areas with Zika risk. Visit the map now and you’ll find four colors, each indicating a different level of Zika risk and the corresponding recommendations for pregnant people, their partners, and those who are planning pregnancy. Let’s take a look at what each color means :
- Red areas have active Zika transmission. Travelers to red areas are at risk of Zika infection.
- Pregnant people and their partners should avoid all unnecessary travel to red areas.
- Couples and individuals who travel to red areas should wait at least 2 months (women) or 3 months (men) before trying to get pregnant, and have only protected sex during that wait time.
- Purple areas have had active Zika transmission sometime in the past, and there could still be sporadic cases. Travelers to purple areas might be at risk of Zika infection.
Pregnant people, their partners, and those who are planning pregnancy are encouraged to talk with their healthcare providers to make decisions about travel to purple areas. Careful consideration should be given to the risks and consequences of Zika infection in pregnancy, the nature of their travel, how much potential risk they are willing to accept, how soon they want to get pregnant (if they are not already), and any other factors specific to that individual or couple at that time.
- If pregnant people or their partners decide to travel to purple areas, they should take steps to minimize risk, including using insect repellent and considering the use of condoms for the rest of the pregnancy.
- People planning pregnancy who travel to purple areas should also take steps to minimize risk, including using insect repellent and considering following recommended wait times before trying to get pregnant (2 months for women, 3 months for men).
There is a sub-category of light purple, which shows higher elevations above 6,500 feet where mosquitoes that can transmit Zika don’t usually live. The chance of getting Zika in light purple areas is very low. However, be sure to consider if your travel plans would take you through dark purple areas on the way to these lighter purple zones.
- Yellow areas have mosquitoes that can transmit Zika, but have not had reported cases of Zika transmission. Travelers to yellow areas are at low risk of Zika infection.
- All travelers to yellow areas should take precautions to prevent mosquito bites.
- Green areas do not have mosquitoes that can transmit Zika and have not had any reported cases of Zika transmission. Travelers to green areas are not at risk of Zika infection.
- There are no Zika-related travel recommendations for green areas.
Given that many countries are included in the purple category, how does this map help you know what your risk really is if you travel to a purple area? The answer is that it doesn’t. Purple only tells you there is some level of risk. Here’s why purple—and we at MotherToBaby—can’t be more specific:
- Reliable data for every country around the world simply does not exist.Since Zika virus is no longer considered a public health emergency, many resources that once helped support global data collection have moved on to other, more pressing issues.
- The level of risk within a purple country could change without us knowing right away.The ability of any country to quickly identify and report cases depends on resources, logistics and other factors. This means there could be delays in detecting and announcing any new outbreaks.
The bottom line is that our post-Zika-epidemic world requires that we take the health of current and future pregnancies into consideration when planning travel. Ask ourselves how much potential risk we are willing to accept when we book our vacations and business trips. Does that mean that couples and individuals who want to have children should never go to areas that ever had Zika? Not at all! But if they are currently pregnant, or are not willing or able to effectively prevent pregnancy for at least 3 months after traveling, they might prefer to visit one of the many areas where there is no known risk of Zika. (Think yellow! Think green!)
MotherToBaby is here to answer your questions about Zika or other exposures before or during pregnancy. Happy travels!