Zika Virus has made a lot of headlines recently, and it’s a terrifying reality that pregnant women (or those hoping to become pregnant) are being advised to avoid travel to many Caribbean and South American countries.
But Zika is just one Caribbean mosquito virus present in the Caribbean and in other parts of the world. Visiting some of the most popular Caribbean destinations has always meant possible exposure to a number of mosquito-borne diseases. When visiting these destinations, it’s imperative to prevent mosquito bites.
The main risk for birth defects (in Zika’s case) is becoming infected while pregnant. But what about Zika in children?
I thought it would be a good idea to summarize all the Caribbean mosquito virus risks, symptoms, and treatments, and spell it all out in case you’re considering traveling there with a baby or young child.
Caribbean Mosquito Virus: Zika
The CDC has a map of countries and territories with active, local transmission of Zika virus–meaning the Zika-carrying mosquitos are present and people are acquiring the illness via mosquito bites. Caribbean destinations include Aruba, Barbados, Bonaire, Puerto Rico, Curacao, Dominican Republic, Guadeloupe, Haiti, Jamaica, Martinique, Mexico, Saint Martin, Trinidad and Tobago, U.S. Virgin Islands, and Venezuela. If you are pregnant, or thinking about becoming pregnant in the next little while, it’s best to not visit these countries, and you are advised to change any current travel plans you may have to these areas.
According to the CDC, “…Zika virus disease in children is usually mild, and treatment is supportive; this includes rest and fluids to prevent dehydration.” The symptoms typically last for a few days to a week after being bitten by an infected mosquito, and only about one in five people infected with Zika virus actually develop the illness. Obviously, Zika’s real (and significant) danger is to infants in utero.
Because the illnesses present similar symptoms, in treating Zika in kids, the CDC recommends that, “Non-steroidal anti-inflammatory drugs (NSAIDS) should not be used until dengue is ruled out as a cause of illness and should be avoided in children aged < 6 months. Aspirin is not recommended for use with acute viral illnesses due to the risk of Reye’s syndrome. You’ll notice that Zika treatment is pretty much the same as how you should treat all mosquito-borne illnesses in kids.
Caribbean Mosquito Virus: Chikungunya
The CDC updates their Chikungunya map weekly. Chikungunya was first identified in Africa, Asia, Europe, and the Indian and Pacific Oceans. At present, however, local transmission has been identified in 45 countries or territories throughout the Americas, including popular Caribbean destinations like Mexico, Jamaica, Turks and Caicos, Bahamas, St. Maarten, Cayman Islands, and Dominican Republic. To date, Cuba is the only Caribbean country to not have any locally transmitted cases of chikungunya.
The symptoms of chikungunya in children include fever, rash, severe headaches, chills, nausea and vomiting, severe pain in the joints, and diarrhea. Children are more likely to have more severe chikungunya symptoms than adults. Children are also more likely to have rashes, but joint pain is not as common.
Children rarely die from chikungunya.
If your child is exhibiting symptoms of chikungunya, contact your doctor immediately. There is no cure or vaccine for chikungunya. Acetaminophen may help reduce fever and pain. Avoid aspirin and ibuprofen, as their anti-inflammatory properties can affect blood platelet counts. Symptoms and fatigue can last for several weeks. Ensure your child gets plenty of rest, plenty of fluids, and nutritious food.
Caribbean Mosquito Virus: Dengue
The CDC’s Dengue map is continually updated. Since the 1950s, dengue has become a worldwide problem. It rarely occurs in the continental United States, but it is endemic in Puerto Rico and in many popular tourist destinations in Latin America, Southeast Asia and the Pacific islands, including Hawaii. Turks and Caicos appears to be the one Caribbean destination with the most unlikely probability of dengue.
Dengue in infants and toddlers usually presents itself similar to a flu, with a high fever, runny nose, cough, and a mild skin rash. Older children may also experience pain behind the eyes and in the joints, and backaches or headaches. Other dengue symptoms include loss of appetite, nausea, vomiting, weakness and extreme fatigue.
If you suspect your child has dengue, contact your doctor immediately. He or she may order a blood test to confirm the diagnosis, as dengue and chikungunya exhibit similar symptoms. There is no cure or vaccine for dengue. Rest, plenty of fluids, and acetaminophen will all help alleviate symptoms, which can last for a month or more. As with Chikungunya treatment, aspirin and ibuprofen should be avoided. There are three closely related versions of the dengue virus, and recovering from one does not give you immunity against the other two.
Untreated dengue can lead to dengue haemorrhagic fever (DHF) which can cause bleeding, liver failure, convulsions, and even death.
Caribbean Mosquito Illness: Malaria
Unlike Zika, Chikungunya, and Dengue, Malaria is a mosquito-borne illness caused by a parasite, not a virus. It is still a big problem in Africa, where half a million people (mostly children) died from malaria in 2013. The CDC frequently updates its Malaria Map. Most Caribbean destinations have no malaria risk with the exception of Belize and certain parts of Mexico, which are considered “Very Low” risk and the only measures necessary are mosquito bite prevention. However, Dominican Republic is considered “Low” risk by the CDC, and taking antimalarials is recommended for travel there.
Malaria tends to be more severe in children younger than five. Symptoms start showing about ten days to four weeks after being bitten by a malaria-infected mosquito. Watch out for fever and chills, irritability and fatigue, loss of appetite, insomnia, vomiting, stomach pain, and rapid breathing. Children with malaria older than five also may experience body aches.
If you suspect your child may have malaria, bring them to the doctor immediately. Only a blood test can confirm a malaria diagnosis. Children under five are at the most risk of death. Those diagnosed with malaria are generally categorized as having either uncomplicated or severe malaria. Uncomplicated malaria is usually effectively treated with oral antimalarials. Severe malaria can result in renal failure, acute respiratory distress, and a whole host of other terrifying maladies, necessitating the use of intravenous antimalarial medications.
Antimalarial medications can be given to children prior to a trip, however the possible side effects are not insignificant. Pediatric doses of antimalarials are determined by weight. More information can be found here on the CDC’s website.
Caribbean Mosquito Virus: Yellow Fever
Yellow Fever Locations:
Yellow Fever risk is pretty widespread in lots of African countries, but it also is present in Central and South America. Wandering over to Caribbean destinations, Yellow Fever is present in Panama, Colombia, and Venezuela. Trinidad and Tobago is the only Caribbean destination proper that poses a risk of Yellow Fever transmission, and only on Trinidad, not Tobago.
Yellow Fever Symptoms:
Yellow Fever’s symptoms are flu-like, with sudden onset of fever, headache, muscle and joint ache, loss of appetite, chills, and a jaundiced (yellow) appearance. Most recover from Yellow Fever in under a week, unless you’re one of the unlucky 15% who enter the toxic phase, which sees the aforementioned symptoms plus abdominal pain, vomiting (sometimes with blood) seizures, delirium, decreased urination, and bleeding from the nose, mouth, and eyes.
Yellow Fever Treatment:
Yellow fever is potentially deadly, and (so far) it is the most most serious mosquito virus in Caribbean countries to really fear, so fortunately it’s not that widespread. There is a vaccine available that is often recommended before travel to affected countries, and proof of vaccination is often required to visit.
But not all vaccines are effective or recommended for children and infants. According to the CDC:
Infants aged <9 months are at higher risk for developing encephalitis from yellow fever vaccine, which is a live virus vaccine. Studies conducted during the early 1950s identified 4 cases of encephalitis out of 1,000 children aged <6 months vaccinated with yellow fever vaccine. An additional 10 cases of encephalitis associated with yellow fever vaccine administered to infants aged <4 months were reported worldwide during the 1950s.
Travelers with infants aged <9 months should be advised against traveling to areas within the yellow fever–endemic zone. ACIP recommends that yellow fever vaccine never be given to infants aged <6 months. Infants aged 6–8 months should be vaccinated only if they must travel to areas of ongoing epidemic yellow fever and if a high level of protection against mosquito bites is not possible.
This is not a medical site, so please consult with your doctor before visiting any destination considered a risk for illness.
Preventing a Caribbean mosquito virus is as simple as not getting bitten by infected mosquitos.
Oh, but only if it was that simple… especially with kids!
Here are some tips to avoid mosquito-borne diseases in the Caribbean:
- wear or dress baby in loose-fitting, light coloured clothing with long sleeves and pant legs
- avoid being outside at dawn and dusk, which are peak times for mosquito activity
- Use an insect repellent with DEET. According to the CDC, “DEET may be used on adults, children, and infants older than 2 months of age. Protect infants younger from mosquito bites by using a carrier draped with mosquito netting with an elastic edge for a tight fit.”
- Do not allow children under 10 years of age to apply insect repellent themselves.
- Do not apply insect repellent to young children’s hands or around eyes and mouth.
Consumer Reports had this to say about alternatives to DEET-based insect repellent:
Picaridin and oil of lemon eucalyptus—two repellents introduced in the last decade—make good alternatives to deet. Here’s why:
They work. The repellents we tested that contain 20 percent picaridin and 30 percent oil of lemon eucalyptus (p-Menthane-3,8-diol) warded off mosquitoes for at least 7 hours and kept deer ticks away for at least 6 hours. But the concentration is important: A spray that contained just 5 percent picaridin performed worse than the 7 percent deet product we tested.
They’re safer. Picaridin is made to resemble the compound piperine, which occurs naturally in black pepper plants. Oil of lemon eucalyptus comes from the gum eucalyptus tree. Both have less serious side effects than deet has. Oil of lemon eucalyptus can cause temporary eye injury. The Food and Drug Administration says it should not be used on children under age 3. Of the two, picaridin is a better choice for kids, although it can cause some irritation of skin, eyes, and lungs.
Before traveling with your baby or toddler, please consult with your doctor.