Whitney Lutz said her team of health care professionals and nursing students expects to encounter the Zika virus on its next trip to the Dominican Republic, one of dozens of countries in Latin America and the Caribbean where the mosquito-borne virus that may be linked to birth defects has spread.

Lutz, a pediatric nurse practitioner and president of Partners for Rural Health, said the presence of the illness will not alter the organization’s plans to travel to the Caribbean nation in June to treat patients for a variety of tropical diseases. Her group made a trip to the Dominican Republic this month before it was added to the list of countries where local infections from the Zika virus have been found.

“We try to prepare the students and volunteers as best we can, letting them know what risks are involved in international travel. We spend a lot of time talking about malaria, dengue, Chikungunya,” Lutz said, referring to the most common mosquito-borne tropical illnesses. “Zika is new.”

Lutz said taking the proper precautions is the key to preventing the spread of mosquito-borne diseases.

“We recommend all our volunteers wear some form of mosquito protection, 30 percent DEET or more, longer sleeves, pants down to the ankles,” Lutz said. “We all have mosquito nets we sleep under, making sure there are no holes in the mosquito net and that it’s tucked in well.”

Other Mainers who routinely go to Latin America or the Caribbean or are planning trips to the region also said they are sticking to their plans and likewise will take steps to stave off the virus that global health organizations have said is spreading at an explosive rate.

Reports that the disease could be linked to birth defects have prompted health officials to advise pregnant women to consider postponing travel to the affected areas. Women who are trying to become pregnant or are considering doing so should consult with their doctors beforehand and take measures to avoid mosquito bites.

A map on the U.S. Centers for Disease Control and Prevention website shows the active transmission areas, which include Mexico and parts of Central America, much of northern South America, the Dominican Republic and U.S. Virgin Islands, as well as Samoa in the Pacific and Cape Verde off Africa.

While most people who are infected show no symptoms, about 20 percent will show mild symptoms including fever, rash, joint pain, and conjunctivitis (red eyes). The illness usually begins two to seven days after a mosquito bite and lasts for several days to a week.

In Colombia and Venezuela, researchers also are investigating whether the Zika virus is linked to cases of Guillain-Barre syndrome, The Associated Press reported Friday. Guillain-Barre is a rare disorder in which a person’s own immune system damages nerve cells, causing muscle weakness and sometimes paralysis, the CDC website says.

The recent outbreak of Zika virus is concentrated in Brazil and has spread quickly to other countries in South America, Central America, Mexico and the Caribbean. Cases of local infection have been reported in Puerto Rico and the U.S. Virgin Islands, as well as about 30 cases on the U.S. mainland, all of which involve people who contracted Zika while traveling.

Brazil also has reported over 4,000 suspected cases of microcephaly, a condition where a baby’s head is much smaller than expected, raising concerns of a link between the Zika virus and the birth defect.

Four U.S. airlines announced this week they will allow some customers to change or cancel flights to countries where the virus is active.

AIRLINES OFFER REFUNDS

American Airlines said pregnant women and their traveling companions could get a full refund with a doctor’s note. United and Delta are allowing any customer with a ticket to an affected country to rebook or get a refund. Southwest, which recently expanded its routes to Central America and the Caribbean, said it will continue its policy to offer changes without a fee.

Phil Dube, who manages Dube Travel in South Portland, hasn’t heard from clients who are concerned about the virus.

“We are aware of it, but I haven’t seen clients looking to change destinations,” Dube said. “If it continues to spread to more popular islands, and so forth, it might start to have an effect.”

Dr. Dora Anne Mills, vice president of clinical affairs at the University of New England, said she has fielded numerous questions on her Facebook page about the virus, and while there’s much uncertainty, the possible connection to birth defects should make women who are traveling while pregnant extremely cautious.

“The CDC is saying do not travel to these countries if you’re pregnant, and that’s very good advice,” said Mills, a former Maine CDC director. “It is transmitting and spreading very quickly.”

Mills said many Latin American countries don’t have great reporting systems in place for infectious diseases, so even if a country appears to be spared the effects of the Zika virus so far, it might be present.

“In case of potential harm to a child, I think the heightened concern needs to be paramount and they should make different plans,” said Dr. Thomas Courtney, head of the Travel Well consultation service at Southern Maine Medical Center in Biddeford. “Probably the best way to prevent infection is just not going.”

Courtney said it isn’t unusual for pregnant women to be advised against traveling to certain countries. Pregnant women cannot be vaccinated for protection against yellow fever and are advised to avoid those equatorial countries where it is present, he said.

Courtney said about 50 people a year – a mix of vacationers and mission and charity workers, as well as business people – consult with the travel center before visiting the countries where Zika virus has flared up, he said.

John Paterson of Freeport serves on the board of directors for Safe Passage, a volunteer organization that does mission work in Guatemala, one of the countries where the Zika virus is active. He is planning a five-day trip to Guatemala City for a board meeting in March and isn’t concerned about contracting the virus.

“I’ll be sure to take plenty of insecticide,” Paterson said. “It’s not going to deter me. I’m more likely to get sick from drinking than from the Zika virus.”

Anna Hodgkins, an 18-year-old student from Hallowell, traveled to Costa Rica over Christmas break on a sea turtle retreat organized by the Girl Scouts.

“A few weeks ago was the first time I heard of the Zika virus, and it sounds very frightening. However, when I was in Costa Rica approximately a month ago, there was no talk of it,” she said. “There were plenty of mosquitoes out and about, but it didn’t look like anyone was concerned about contracting diseases from them.”

‘IT’S PRETTY MISERABLE’

Dengue, West Nile virus, Chikungunya and Zika are from the same family of viruses and the three others have similar symptoms to Zika, including fever and aches. Zika also is known for causing body rashes and eye irritations.

“None of them is good. None of them are, in most circumstances, a risk to one’s life, but it’s pretty miserable,” Courtney said.

Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Disease, doubts the United States is vulnerable to an outbreak and believes it can be kept at bay by controlling the mosquito population.

While there have been no reports of cases in Maine, Massachusetts announced its first confirmed case Thursday in a person who had traveled to a region with the infection.

Lutz said the volunteers and nursing students, drawn from the University of Southern Maine and Husson College, treated close to 1,200 clients in their recent trip to the Caribbean. Many of the patients have had malaria or dengue, and many more had the Chikungunya virus, but they did not see anyone infected with the Zika virus, she said. She expects the students will change during the trip in June.

The primary carrier for the virus is the Aedes aegypti mosquito. Charles Lubelczyk, vector ecologist for Maine Medical Center Research Institute, said there is little chance the mosquito will show up in Maine because it needs a tropical climate.

“It doesn’t like cold. You won’t find it above Florida in the U.S.,” he said. “Right now, even winters in New Jersey or Virginia are still too cold for aegypti.”

Lubelczyk said people traveling to areas where the CDC is warning about the mosquito-borne illnesses should invest in long-sleeved, lightweight clothing designed to wear in the tropics. Some of them are impregnated with insect repellent.

Lubelczyk said an important step in reducing the number of mosquitoes carrying the disease is to reduce standing water where the insects lay their eggs.

In areas that are hard hit, officials may apply pesticides.

Staff Writers Dennis Hoey and Joe Lawlor contributed to this report.

 


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