What is the current situation?
Local mosquito transmission of Zika virus infection (Zika) has been reported in Bolivia. 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, CDC recommends that travelers to Bolivia protect themselves from mosquito bites. The mosquitoes that spread Zika usually do not live at elevations above 6,500 feet (2,000 meters) because of environmental conditions. Travelers whose itineraries are limited to areas above this elevation are at minimal risk of getting Zika from a mosquito. The following map shows areas of Bolivia above and below 6,500 feet.* For more information, see Questions and Answers: Zika risk at high elevations.
Zika Virus in Pregnancy
A pregnant woman can pass Zika virus to her fetus. Infection during pregnancy can cause serious birth defects. CDC recommends special precautions for the following groups:
- Women who are pregnant:
- Should not travel to any area of Bolivia below 6,500 feet (see map).
- If you must travel to one of these areas, talk to your doctor first and strictly follow steps to prevent mosquito bites during your trip. If your itinerary is limited entirely to areas above 6,500 feet, there is minimal risk of getting Zika from a mosquito.
- If you have a partner who lives in or has traveled to Bolivia, either use condoms or do not have sex (vaginal, anal, or oral) during your pregnancy.
- Women who are trying to become pregnant:
- Before you or your partner travel, talk to your doctor about your plans to become pregnant and the risk of Zika virus infection.
- See CDC guidance for how long you should wait to get pregnant after travel to Bolivia.
- People who have traveled to Bolivia and have a pregnant partner should use condoms or not have sex (vaginal, anal, or oral) during the pregnancy.
Sexual transmission of Zika virus is also possible, so travelers are encouraged to use condoms or not have sex.
Many people infected with Zika virus do not get sick. Among those who do develop symptoms, sickness is usually mild, with symptoms that last for several days to a week. Guillain-Barré syndrome (GBS), a rare disorder that can cause muscle weakness and paralysis for a few weeks to several months, is very likely triggered by Zika in a small proportion of infections, much as it is after a variety of other infections. Most people fully recover from GBS, but some have permanent damage.
As more information becomes available, this travel notice will be updated. Please check back frequently for the most up-to-date recommendations.
What can travelers do to prevent Zika?
There is no vaccine or medicine for Zika. Travelers can protect themselves by preventing mosquito bites:
- Cover exposed skin by wearing long-sleeved shirts and long pants.
- Use EPA-registered insect repellents containing DEET, picaridin, oil of lemon eucalyptus (OLE, also called para-menthane-diol [PMD]), or IR3535. Always use as directed.
- Pregnant and breastfeeding women can use all EPA-registered insect repellents, including DEET, according to the product label.
- Most repellents, including DEET, can be used on children older than 2 months. (OLE should not be used on children younger than 3 years.)
- Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents). You can buy pre-treated clothing and gear or treat them yourself.
- Stay in places with air conditioning and window and 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.
Because Zika can be sexually transmitted, if you have sex (vaginal, anal, or oral) while traveling, you should use condoms.
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 Bolivia should take steps to prevent mosquito bites for 3 weeks so that they do not spread Zika to uninfected mosquitoes.
Travelers returning from Bolivia who have a pregnant partner should either use condoms or not have sex for the rest of the pregnancy.
People who have traveled to Bolivia but don’t have symptoms 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 traveled to Bolivia should wait at least 8 weeks after travel before trying to get pregnant or at least 6 months after symptoms start if they develop symptoms of Zika. Women who have traveled to Bolivia 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.
For more information, see Zika and Sexual Transmission.
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 him or her about your travel.
- Take acetaminophen (paracetamol) to relieve fever and pain. Do not take aspirin, products containing aspirin, or other nonsteroidal anti-inflammatory drugs, such as ibuprofen.
- Get lots of rest and drink plenty of liquids.
If you are pregnant:
Pregnant travelers returning from Bolivia can be tested for Zika virus infection.
- If you develop a fever with a rash, joint pain, or red eyes, talk to your doctor immediately and tell him or her about your travel.
- If you do not have symptoms, testing can be considered 2–12 weeks after you return from travel.
Health care providers should be alert to pregnant patients returning from Bolivia. Clinicians should test pregnant women with symptoms of Zika during travel or within 2 weeks of travel. Asymptomatic pregnant women who have traveled to Bolivia can also be offered testing.
- For pregnant women with symptoms of Zika, testing is recommended at the time of clinical illness.
- For asymptomatic pregnant women, testing can be offered 2–12 weeks after return from travel.
- Pregnant women with possible sexual exposure to Zika virus should also be tested.
See Clinical Guidance for Healthcare Providers Caring for Pregnant Women for additional recommendations related to Zika testing and follow-up care.
Clinical Guidance for Healthcare Providers Caring for Infants & Children is also available.
Source: Travel Health