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Zika Virus, Other Mosquito-Borne Illnesses, and Mobile Populations

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Zika virus and mobile populationsWhen it comes to mosquito-borne illnesses like Zika, chikungunya, dengue, and West Nile, migrants may warrant greater attention from clinicians in the exam room. In 2016, Zika became a household name as the virus gained speed through Central and South America, Mexico, and parts of the Caribbean, including US territories. Zika is not the only concerning illness spread by mosquitoes. Please read our chikungunya, dengue, and West Nile sections at the bottom of this page for more information.

About Zika

The Migrant Clinician

Other mosquito-borne illnesses

Mosquitoes may transmit a number of viruses beyond Zika, including chikungunya, dengue, and West Nile virus. All of these viruses have recently been found to be locally transmitted in the mainland United States. 

Zika, chikungunya, West Nile, and dengue present similarly in the exam room, and clinicians are encouraged to take a closer look before diagnosis. The Aedes aegypti and Aedes albopictus mosquitoes are primary vectors for Zika, chikungunya, and dengue; consequently, the three viruses can be found in the same regions. Additionally, the symptoms of illness resulting from the three viruses are similar, with fever, rash, and joint pain. Differential diagnosis needs to be considered to quickly identify potential outbreaks and to initiate an early response. In the case of dengue, proper diagnosis is essential to avoid serious or fatal complications. Here, we provide a short summary of chikungunya, dengue, and West Nile.

Prevention of Mosquito Bites

To prevent the spread of Zika and other mosquito-borne illnesses, all people (including pregnant women) living or visiting an area experiencing an outbreak are encouraged to practice the following preventative measures:

 

  • Avoid areas of outbreak, if possible.
  • Know your mosquito. The Aedes mosquitoes who are primarily responsible for carrying Zika, chikungunya, and dengue feed mostly during the day.
  • Participate in community-based responses. Community involvement is critical to educate neighbors on the risks of illness. Residents are responsible for eliminating local mosquito breeding grounds, by draining bird baths, old tires, rainwater barrels, pet water bowls, vases, and other places where shallow stagnant water may pool to prevent the development of mosquito larvae, and cleaning the drained receptacles to remove eggs. Such personal and community efforts are effective and should be emphasized.
  • Wear protective clothing. Long-sleeved shirts and pants may decrease the likelihood of a bite.
  • Use insect repellant. The risk of Zika infection is far more serious than side effects from repellent chemicals, provided they are used as directed. The CDC recommends  products with the following active ingredients as they typically provide reasonably long-lasting protection:
    • DEET - Products containing DEET include: Off!, Cutter, Sawyer, and Ultrathon.
    • Picaridin - Products containing picaridin include: Cutter Advanced, Skin So Soft Bug Guard Plus, and Autan.
    • Oil of lemon eucalyptus (OLE), or PMD, the synthesized version of OLE - Products containing OLE and PMD include:  Repel and Off! Botanicals.
    • IR3535 - Products containing IR3535 include: Skin So Soft Bug Guard Plus Expedition and SkinSmart.

 

Read more about the CDC’s recommended active ingredients in repellents here. (Note: “pure” oil of lemon eucalyptus [essential oil not formulated as a repellent] is not recommended as it has not undergone validated testing for safety and efficacy and is not registered with EPA as an insect repellent.)

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