Are the Caribbean Islands Zika Free?

The Caribbean Public Health Agency (CARPHA) announced that the World Health Organization (WHO) has removed its Zika virus country classification scheme for the Caribbean territories. 

CARPHA Executive Director Dr. C. James Hospedales explained in a letter that ‘the Zika classification by the WHO was having an adverse impact on the Caribbean Hotel and Tourism industry.’ 

The classification scheme was initially introduced in the ‘WHO interim guidance on surveillance for Zika Virus infection, microcephaly and Guillain-Barré syndrome”, published on April 7, 2016, and then expanded in the ‘Zika virus country classification scheme’, which was published on March 10, 2017. 

The country classification system was established in an effort to describe Zika virus circulation and transmission through the reporting of cases in a given place and time, facilitate Zika infection risk assessment, and guide public health recommendations. 

Dr. Hospedales stated, “The Caribbean is the most tourism-dependent region in the world.” 

“The Caribbean is also one of the most popular honeymoon destinations worldwide and ongoing classification as Category 1 is hurting the industry unnecessarily.’ 

CARPHA then provided evidence to the WHO that the Zika virus transmission in the Caribbean had been interrupted for over 12 months, or was at undetectable levels. 

“Therefore, CARPHA felt compelled to provide the evidence and to advocate for the removal of this WHO Zika classification system,” said Dr. Hospedales. 

This request lead the WHO Zika virus country classification scheme to become inactive on October 17, 2018. 

Does this mean the Caribbean Islands are Zika-free? 

Not really. 

The WHO actually discontinued the entire Zika classification system, and did not change any country’s rating. 

The WHO said ‘the country classification system no longer met the needs of surveillance in the post-epidemic period and has hence been discontinued as of October 17, 2018. 

And, the WHO said they would replace Zika country classification system with ‘frequent’ epidemiological updates, such as these PAHO reports.  

The WHO is currently working with the European Centre for Disease Prevention and Control on a new classification system to assess the risk for Zika virus transmission, reported Bloomberg.

A spokesperson for the CDC said that the move by WHO to eliminate its categorization system “is in line with Zika virus infection moving from an emergency response to a sustained longer-term program of work similar to other diseases.”

But, this WHO decision may be at odds with the US Centers for Disease Control and Prevention (CDC), who continues to publish Zika travel alerts when traveling to the Caribbean, and to many other countries. 

As of October 30, 2018, the CDC’s Travel Alert Level 2, Practice Enhanced Precautions, remained in effect for the Caribbean.   

As an example, the CDC’s Travel Alert for the US Virgin Islands says ‘Pregnant women should NOT travel to areas with risk of Zika, because Zika infection during pregnancy can pass the Zika virus to her fetus. 

And a Zika Infection during pregnancy can cause serious birth defects, such as microcephaly. 

In a CDC Morbidity Mortality Weekly Report published in August 2018, the agency revealed that pregnant women infected with Zika have a 1 in 7 chance of delivering a baby with neurological abnormalities or birth defects. 

Additionally, this US Virgin Island Travel Alert says: 

• Pregnant women should NOT travel to areas with risk of Zika. This is because Zika infection during pregnancy can cause serious birth defects.
• All travelers to areas with risk of Zika should (1) prevent mosquito bites and (2) use condoms or not have sex to protect against Zika during travel.
• And, they should continue to take these precautions after their trip to stop the spread of Zika to others back home.

Since this is a confusing situation, the best advice the CDC offers is to speak with a doctor, nurse or pharmacist regarding your personal situation.