Public Health Notice - Zika Virus (Canada)

Why you should take note

The Public Health Agency of Canada has recently confirmed travel-related cases of Zika virus from Central and South America, and from the Caribbean. Since Zika virus is spread through mosquito bites, travellers to countries where the Zika virus is actively circulating, particularly pregnant women or those considering becoming pregnant, should protect themselves from mosquito bites. Mosquitoes known to transmit the virus to humans are not present in Canada.

Countries affected by Zika virus

Zika virus has been reported in Africa and parts of Asia since the 1950s, and in the southwestern Pacific Ocean in 2007. In 2015, Zika virus emerged in South America with widespread outbreaks reported in Brazil and Colombia. For the latest updates on countries affected by Zika virus, please visit the World Health Organization's website. For the latest map of confirmed cases in the Americas visit the Pan American Health Organization's website.

Microcephaly and Guillain-Barré Syndrome

In November 2015, a Brazilian investigation indicated an average twenty-fold increase in the incidence of microcephaly (abnormally small head) among newborns born in areas where Zika virus was known to be in circulation.
An association between Zika virus infection and Guillain-Barré Syndrome (GBS) has been observed in a few countries where the Zika virus is actively circulating. Investigations to better understand the relationship between Zika virus infection and the increase in cases of GBS is ongoing.
On February 1, 2016 the World Health Organization declared that the recent cluster of microcephaly cases and other neurological disorders reported in Brazil, following a similar cluster of neurological disorders in French Polynesia in 2014, constitutes a Public Health Emergency of International Concern. The investigation is ongoing to confirm whether Zika virus may be the cause of these microcephaly cases and this announcement recommends that actions be taken to standardize and enhance surveillance, as well as to intensify research. No restrictions on travel or trade with countries, areas and/or territories with Zika virus transmission have been recommended.

Blood donations

Canadian Blood Services (CBS) is carefully monitoring the Zika virus issue. They have revised their eligibility criteria for donors to mitigate the risk of the virus entering the Canadian blood supply. Anyone who has travelled outside of Canada, the continental United States and Europe will now be temporarily ineligible to give blood for three weeks. This new waiting period is currently being implemented across the country and will take full effect in all CBS clinics on February 5, 2016.
This 21-day waiting period ensures enough time has passed for the virus to be eliminated from a person’s bloodstream, and begins the day a person returns to Canada. The waiting period also applies to cord blood and stem cell donors who have travelled to affected areas. Héma-Québec (Quebec’s blood operator) will implement the same change.
The risk of Zika virus transmission from a Canadian donor to a blood recipient is very low. Canadians may consider donating blood before they travel.

Symptoms and Treatment

Twenty to twenty-five percent of people infected with Zika virus are believed to develop symptoms. These include: low-grade fever, joint pain, red eyes, rash and generalized symptoms such as muscle pain, physical weakness, lack of energy and headaches.
The incubation period of Zika virus ranges from 3 to 12 days. The disease symptoms are usually mild and last for 2 to 7 days.  Most people recover fully without severe complications, and hospitalization rates are low. Zika virus infection may go unrecognized or be misdiagnosed as dengue, chikungunya or other viral infections causing fever and rash.
Currently, there is no prophylaxis, vaccine or treatment for Zika virus. Treatment is generally limited to symptom relief.

Risk to Canadians

Based on the Agency’s Rapid Risk Assessment, the overall risk to Canadians, in Canada, is very low, as mosquitoes known to transmit the virus are not established in Canada and are not well-suited to our climate. The risk to travellers to affected countries is low; however, pregnant women and those considering becoming pregnant, should take special precautions. (See section below).
Current evidence suggests that Zika virus is likely to persist and spread in the Americas and the South Pacific. Although the risk of virus establishment in Canada is low, there is ongoing risk to Canadians travelling to outbreak regions.

Advice to Canadians

Canadian travellers visiting affected areas, should help protect themselves against Zika virus by taking individual protective measures to prevent mosquito bites, including using insect repellent, protective clothing, mosquito nets, screened doors and windows. There is no vaccine or medication that protects against Zika virus infection.

Pregnant women and women considering becoming pregnant

It is recommended that pregnant women and those considering becoming pregnant discuss their travel plans with their health care provider to assess their risk and consider postponing travel to areas where the Zika virus is circulating. If travel cannot be postponed, then strict mosquito bite prevention measures should be followed to protect themselves against bites.

Travel information

A Travel Health Notice has been posted to provide advice to Canadian travellers. We will continue to monitor this situation very closely and advise Canadians as appropriate.
If you develop symptoms similar to Zika virus infection when you are travelling, or after you return, see a health care provider and tell them where you have been travelling or living.

What the Public Health Agency of Canada is doing

The Public Health Agency of Canada works with its national and international partners, including the World Health Organization, to monitor and share information. The Agency tracks diseases in Canada and around the world.
The Agency is working with Canada’s health care professionals to develop clinical guidelines for identifying and managing suspected Zika virus infections. The Agency will continue to assess the risk on an ongoing basis by working with our partners, and support enhanced awareness for the travelling public.
The Public Health Agency's National Microbiology Laboratory is able to detect the virus, and is in a position to support Provinces and Territories to test specimens.