In response to reports in Brazil of microcephaly (birth defect where a baby's head is smaller than expected) and other poor pregnancy outcomes in babies of mothers who were infected with the Zika virus while pregnant, the Centers for Disease Control and Prevention (CDC) has issued a travel alert for people traveling to regions and certain countries where Zika virus transmission is ongoing. The notice is an Alert Level 2 that calls for travelers to follow enhanced precautions or recommended preventive measures for these destinations.

While some travel related cases of Zika virus infection have been reported in Europe, no cases have originated here. The virus can only be spread by being bitten by an infected mosquito and the type of mosquito that can spread the disease is not found in Europe.

The Zika virus is spread to people through mosquito bites. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon. No locally transmitted Zika cases have been reported in the continental United States, but cases have been reported in returning travelers. Locally transmitted Zika virus has been reported in the Commonwealth of Puerto Rico. The number of Zika cases among travelers visiting or returning to the United States will likely increase.

Who is at risk of being infected? Anyone who is living in or traveling to an area where Zika virus is found who has not already been infected with Zika virus, including pregnant women. Until more is known and out of an abundance of caution, the CDC recommends special precautions for pregnant women and women trying to become pregnant:

• Pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing. Pregnant women who do travel to one of these areas should talk to their doctor or other healthcare provider first and strictly follow steps to avoid mosquito bites during the trip.

• Women trying to become pregnant should consult with their healthcare provider before traveling to these areas and strictly follow steps to prevent mosquito bites during the trip. For more information on the Zika virus, visit the CDC web site at http://www.cdc.gov/zika/index.html.
Countries and territories with active Zika virus transmission include:

AMERICAS Barbados •Bolivia •Brazil •Colombia •Ecuador •El Salvador •French Guiana •Guadeloupe •Guatemala •Guyana •Haiti •Honduras •Martinique •Mexico •Panama •Paraguay •Puerto Rico •Saint Martin •Suriname •Venezuela PACIFIC ISLANDS -- Samoa AFRICA - Cape Verde

Information for Travelers -- Please visit the CDC's Travelers Health website to see if the country you plan to visit has any travel health notices: http://wwwnc.cdc.gov/travel/notices. Mosquito bite prevention for travelers can be found at:

http://www.cdc.gov/chikungunya/pdfs/fs_mosquito_bite_prevention_travelers.pdf.