IMA ZIKA Alert: Do not ignore dengue or Chikungunya-like symptoms with red eyes Local mosquito transmission of Zika virus infection has been reported in Singapore. Local mosquito transmission means that mosquitoes in the area are infected with Zika virus and are spreading it to people. Because Zika virus is primarily spread by mosquitoes, Indian Medical Association (IMA) recommends that travelers to Singapore protect themselves from mosquito bites. A pregnant woman can pass Zika virus to her fetus. And, infection during pregnancy can cause serious birth defects. IMA recommends special precautions for the following groups: Women who are pregnant • Pregnant women should avoid traveling to Singapore. If at all necessary, they should first talk to their doctor and strictly follow measures to prevent mosquito bites during their stay. • If you have a partner who lives in or has travelled to Singapore, either use condoms (or other barriers to prevent infection) or do not have sex (vaginal, anal, or oral) during your pregnancy. Women who are trying to become pregnant • If you are planning a pregnancy, talk to your doctor about your plans to become pregnant and the risk of Zika virus infection before either of you travel. • You and your partner should strictly follow steps to prevent mosquito bites. Sexual transmission of Zika virus is also possible, so travelers are encouraged to use condoms (or other barriers to prevent infection) or not have sex. What can travelers do to prevent Zika? There is no vaccine or medicine for Zika virus infection. Travelers can protect themselves by preventing mosquito bites: • Wear long-sleeved shirts and long pants to cover exposed skin. • Use EPA-registered insect repellents that contain DEET, picaridin, oil of lemon eucalyptus (OLE, also called para-menthane-diol [PMD]) or IR3535. o Pregnant and breastfeeding women can use all EPA-registered insect repellents, including DEET, according to the product label. o Most repellents, including DEET, can be used on children older than 2 months (Avoid OLE in children younger than 3 years.) • Stay in places with air conditioning and window/door screens to keep mosquitoes outside. • Sleep under a mosquito bed net if air conditioned or screened rooms are not available or if sleeping outdoors. • Mosquito netting can be used to cover babies younger than 2 months old in carriers, strollers, or cribs to protect them from mosquito bites. • Use condoms as Zika is known to spread via sexual transmission. After travel Many people infected with Zika virus do not feel sick. If a mosquito bites an infected person while the virus is still in that person’s blood, it can spread the virus by biting another person. Even if they do not feel sick, travelers returning to the United States from Singapore should take steps to prevent mosquito bites for 3 weeks so that they do not spread Zika to uninfected mosquitoes. Travelers returning from Singapore who have a pregnant partner should either use condoms or not have sex for the rest of the pregnancy. People who have travelled to Singapore should use condoms for at least 8 weeks after travel to protect their sex partners. Men who have Zika symptoms or are diagnosed with Zika should use condoms for at least 6 months after symptoms start; women with symptoms should use condoms for at least 8 weeks after symptoms start. Travelers who are thinking about pregnancy should talk with their health care provider. Men who have travelled to Singapore should wait at least 8 weeks after travel before trying to conceive or at least 6 months after symptoms start if they develop symptoms of Zika. Women who have travelled to Singapore should wait at least 8 weeks after travel before trying to get pregnant, or at least 8 weeks after symptoms start if they develop symptoms. If you feel sick and think you may have Zika • Talk to your doctor if you develop a fever with a rash, joint pain, or red eyes. Tell your doctor about your travel history. • Take paracetamol to relieve fever and pain. Avoid aspirin, products containing aspirin, or other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. • Get lot of rest. • Drink plenty of liquids. If you are pregnant • Talk to a doctor or other health care provider after your trip, even if you have no symptoms. • Pregnant travelers returning from Singapore, or who have had possible sexual exposure, should be offered testing for Zika virus infection. • Consult your doctor immediately if you develop fever with a rash, joint pain, or red eyes, and tell him or her about your travel or possible sexual exposure. • If you do not have symptoms, testing should be offered if you see a health care provider, up to 12 weeks after you return from travel or your last possible sexual exposure.