“People need to put it in perspective,” said Robert Glatter, an emergency physician at Lenox Hill Hospital in New York, US. “There are many other diseases that are much more virulent including influenza, measles and chicken pox.”
Since then, a new study published in The Lancet on 15 March has said that women infected with the Zika virus during their first trimester have a one-in-100 chance of their baby developing microcephaly. Importantly, it is the first quantified link that scientists have made between the Zika virus and the birth defect. The study confirms that the risks associated with Zika are low in comparison to other viral infections – a one-per-cent chance is better than the 13-per-cent risk of complications for cytomegalovirus, or the 38-to-100-per-cent risk of conditions including heart abnormalities and hearing loss for rubella infections.
The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) are continuing to advise pregnant women, and those trying to conceive, to refrain from travel to areas where the mosquito-borne disease is endemic. The Hilton Worldwide and Hyatt hotel chains are waiving cancellation fees in affected areas, while Marriott International and Wyndham Hotels and Resorts are assessing on a case-by-case basis but generally waiving fees.
Jack Ezon, president of luxury travel company Ovation Vacations, said the company has had 82 cancellations due to the virus so far, with the majority of those cancelling switching destinations to places like Florida and Arizona. Ezon said that luxury hotels are feeling the economic impact of Zika and are offering promotions to encourage visitors.
“One important thing to note is areas that are actually Zika-free are in a blanketed ‘no-go’ region, which is totally harmful to economies,” he said. “For example, a small region in central Mexico has Zika and nothing in either Cancun or Cabos. That is like telling someone to flee America if there were cases in Arkansas.”
Fear outweighs threat
Katherine Harmon, director of health intelligence at risk management firm iJET International, agreed that tourists should not avoid the Caribbean entirely and noted that it is currently low season for mosquito-borne diseases. And while the CDC has issued travel warnings for Americans, particularly women, to avoid infected regions, according to the organisation’s statistics there have been just 52 travel-associated cases reported so far.
“The fear of Zika virus seems to be outweighing actual threat to the travelling public,” said Christopher Pardee, iJET’s manager of health intelligence. “It hasn’t truly decreased the volume of travel to the region yet. Many of our clients have not yet told their employees not to travel, most have focused on education and prevention [instead].”
As far as Brazil and its forthcoming summer Olympics goes, there is no travel ban so far. “Brazil is already facing the perception backlash,” said Pardee. “If we can extrapolate from dengue fever rates, mosquito-borne diseases will likely be on the downslide by August.”
It wasn’t until the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003 that international travel was considered to be an agent of spreading disease. While 8,000 people contracted SARS and 774 died as it spread to more than 24 countries worldwide, Zika has yet to be considered as lethal, according to WHO. SARS, unlike Zika, was spread through close contact with an infected person and transmitted through respiratory droplets when a person coughed or sneezed.
“That’s probably the most scared I’d been as an infectious disease doctor,” said Christopher Ohl, an infectious disease expert at the Wake Forest Baptist Medical Center, North Carolina. “[SARS] was fairly contagious and had a high mortality rate. The mortality rate with Zika is infinitely small.”
That being said, the spread of Zika through mosquitos is wide and some scientists believe this makes it a serious threat. “If you apply a one-per-cent risk to a large number of women, it’s still a large public health problem,” Simon Cauchemez, The Lancet study’s lead author told The New York Times.
What’s covered and what’s not
Meanwhile, according to the travel insurance industry standard worldwide, ‘fear of travelling’ – concerning Zika, terrorism or otherwise – is not considered to be a valid reason for cancellation. “This is an important distinction as it precludes trip cancellation based on state department advisories,” said Jason Schreier, CEO of APRIL USA. “Likewise, the Zika outbreak does not meet the criteria for trip cancellation under typical policy guidelines.”
The CDC has set the Zika virus alert at level 2, meaning that travellers are urged to be cautious. It would need to be set at alert level 3, urging Americans to avoid non-essential travel, to be considered for trip cancellation by most insurance underwriters (and the policy must be purchased before the CDC alert is updated). “Unfortunately, fear is never a covered reason,” said Rachael Taft of aggregator Squaremouth.