Belize's Zika Status: What You Need To Know

Belize is a country in Central America that has been identified as a Zika risk area by the U.S. Centers for Disease Control and Prevention (CDC). The Zika virus is spread by the bite of an infected Aedes species mosquito, which bites during the day and night and is common in towns and cities. While the illness is usually mild, it can cause serious birth defects if a pregnant woman becomes infected. There is currently no vaccine available against the Zika virus, and it is recommended that travellers to Belize practice strict mosquito bite avoidance at all times. Additionally, pregnant women or those planning a pregnancy should consider avoiding travel to Belize or consult their doctor before travelling.

Zika virus transmission in Belize

The Zika virus is transmitted by the bite of an infected Aedes species mosquito (Ae. aegypti and Ae. albopictus). These mosquitoes bite during the day and night and are commonly found in towns and cities. The US Centers for Disease Control and Prevention (CDC) identifies Belize as a Zika risk area. Some cases of the Zika virus have been reported in Belize. The Pan American Health Organisation reported an increase in dengue cases in the Region of the Americas, including Belize, in 2023 and early 2024.

The Zika virus is a mild illness, but it can cause birth defects if a pregnant woman is infected. There is currently no vaccine against the Zika virus. The CDC recommends that pregnant women and couples planning a pregnancy within the next three months consult with a healthcare provider before travelling to Belize. The Australian Department of Health also recommends that pregnant women discuss their travel plans with their doctors and consider avoiding non-essential travel to affected areas.

To prevent mosquito bites, travellers to Belize are advised to use insect repellent and wear long, loose, light-coloured clothing. It is also important to ensure that accommodation is insect-proof. In addition to mosquito bites, other insect-borne diseases, such as chikungunya, malaria, and dengue fever, are prevalent in Belize. Dengue fever is transmitted by the same mosquito that spreads Zika and is more common in urban areas.

The CDC recommends that travellers to Belize practice enhanced precautions and be up-to-date on all recommended vaccinations. It is also important to be aware of the risk of other infectious diseases, such as waterborne and foodborne illnesses, which are common in Belize. Drinking boiled or bottled water and avoiding raw and undercooked food can help reduce the risk of these diseases.

Prevention of Zika infection

The Zika virus is primarily spread by the bite of an infected Aedes species mosquito (Ae. aegypti and Ae. albopictus). These mosquitoes are most active during the daytime, but they can also bite at night. They are commonly found in warm, tropical climates and do not survive in cooler temperatures.

To prevent Zika infection, it is crucial to focus on avoiding mosquito bites and reducing the risk of sexual transmission. Here are some detailed instructions for preventing Zika infection:

Preventing Mosquito Bites:

• Use mosquito repellent and follow the instructions on the product label.
• Wear long-sleeved shirts and long trousers to cover exposed skin.
• Stay and sleep in screened or air-conditioned rooms.
• Use mosquito netting, especially when sleeping, to provide an additional barrier of protection.
• Aedes aegypti mosquitoes are commonly found in tropical areas, so take extra precautions if you are in these regions.

Reducing Sexual Transmission Risk:

• Use condoms during sexual intercourse, including vaginal, anal, and oral sex.
• Consider abstaining from sex or using protective barriers like dental dams for oral sex.
• If you have recently returned from an area with active Zika transmission, continue to use condoms or abstain from sex for at least eight weeks.
• If you experienced symptoms of Zika, extend the use of condoms or abstinence to six months after the cessation of symptoms.

Additional Precautions:

• Avoid non-essential travel to areas affected by Zika if you are pregnant or planning to become pregnant in the near future.
• Consult with a healthcare provider before travelling to Zika-affected areas if you are pregnant or considering pregnancy.
• Prevent mosquito bites during and after travel to Zika-affected areas.
• Men with pregnant partners should use condoms or abstain from sex for the remainder of the pregnancy.
• Men with partners planning pregnancy should use condoms or abstain from sex for at least three months after returning from a Zika-affected area.

Zika risk to pregnant women

Zika poses a significant risk to pregnant women and their unborn babies. The virus, which is spread by the bite of an infected Aedes species mosquito, can be passed from a pregnant woman to her fetus, causing severe birth defects. These include microcephaly, incomplete brain development, eye damage, hearing loss, and restricted movement of arms and legs. The risk of Zika-related birth defects is highest during the first trimester, with 8% of women infected during this period having a baby with Zika-related birth defects. The risk decreases in the second and third trimesters, but it is still present, with 5% and 4% of infections resulting in birth defects, respectively.

Pregnant women are at a higher risk of mosquito-borne illnesses, such as Zika, due to changes in their bodies during pregnancy. These include an increased respiratory rate, resulting in more carbon dioxide exhaled, a warmer body temperature, and increased sweating, all of which make it easier for mosquitoes to find and target pregnant women. As such, it is crucial for pregnant women to take measures to protect themselves from mosquito bites, especially when travelling to areas with a risk of Zika, such as Belize.

The Public Health Agency of Canada (PHAC) recommends that pregnant women discuss potential travel to Zika-risk areas with a healthcare professional and may choose to avoid or postpone their trip. If travel is necessary, pregnant women should take special precautions to avoid mosquito bites and protect themselves from contact with bodily fluids, such as semen, vaginal fluid, and blood. The use of insect repellent and condoms is advised. Additionally, men with pregnant partners who are travelling to Zika-risk areas should also take similar precautions to prevent mosquito bites and sexual transmission of the virus upon their return.

For women planning a pregnancy, it is recommended to wait at least two months after returning from a Zika-risk area before trying to conceive, to reduce the risk of passing the virus to the unborn baby. Men should wait at least three months, as infectious Zika virus has been found in the semen of infected men for a prolonged period.

Zika symptoms

The Zika virus is primarily transmitted by the bite of an infected Aedes species mosquito. These mosquitoes bite during the day and night. The Zika virus can also be transmitted from mother to fetus during pregnancy, as well as through sexual contact, transfusion of blood and blood products, and possibly through organ transplantation.

Approximately 80% of people infected with the Zika virus are asymptomatic. Symptoms, when they occur, usually last for several days to a week and are generally mild. The most common symptoms of the Zika virus are:

• Conjunctivitis (red eyes)
• Skin rash
• Fever
• Muscle and joint pain
• Malaise
• Headache

In rare cases, the Zika virus may cause severe disease affecting the brain, causing swelling of the brain (encephalitis), tissues around the brain (meningitis), or spinal cord (myelitis). Zika may also cause a blood disorder that can result in bleeding, bruising, or slow blood clotting.

Zika infection during pregnancy can cause serious birth defects and is associated with other pregnancy problems. Infants born to mothers infected with Zika during pregnancy may have microcephaly (smaller than normal head size) and other congenital malformations, including limb contractures, high muscle tone, eye abnormalities, and hearing loss. These clinical features are collectively referred to as congenital Zika syndrome.

In rare cases, Zika infection may cause Guillain-Barré syndrome (GBS), a condition in which the body's immune system attacks its own nerve cells, causing muscle weakness and sometimes paralysis. Most people fully recover from GBS, but some may have permanent damage.

Zika treatment

The Zika virus is primarily transmitted by infected mosquitoes of the Aedes (Stegomyia) genus, mainly Aedes aegypti, in tropical and subtropical regions. Aedes mosquitoes usually bite during the day, but they can also bite at night. These mosquitoes also transmit dengue, chikungunya, and urban yellow fever.

The Zika virus is also transmitted from mother to fetus during pregnancy, as well as through sexual contact, transfusion of blood and blood products, and possibly through organ transplantation.

There is currently no vaccine or specific treatment available for the Zika virus infection or disease. Treatment is focused on addressing the symptoms, and cases usually clear up on their own. Here are some recommended treatments for the Zika virus:

• Pregnant women living in areas with Zika transmission or who develop symptoms of Zika infection should seek medical attention for laboratory testing, information, counselling, and other clinical care.
• People with symptoms such as a rash, fever, or joint pain should get plenty of rest, drink fluids, and treat symptoms with antipyretics and/or analgesics. Nonsteroidal anti-inflammatory drugs should be avoided until dengue virus infections are ruled out because of the bleeding risk.
• If symptoms worsen, patients should seek medical care and advice.
• To prevent mosquito bites, it is recommended to wear long-sleeved shirts and long pants to limit skin exposure, stay indoors in screened-in or air-conditioned rooms, and use mosquito netting.
• Pregnant women can safely use Environmental Protection Agency-approved bug spray with DEET or picardin, or wear permethrin-infused clothing.
• To prevent sexual transmission, it is advised to use condoms correctly and consistently or abstain from sexual activity, especially if one of the partners is pregnant or planning to become pregnant.

Frequently asked questions