West Nile virus (WNV) is an infectious disease that first appeared in the United States in 1999. Infected mosquitoes spread the virus that causes it. People who get WNV usually have no symptoms or mild symptoms. The symptoms include a fever, headache, body aches, skin rash, and swollen lymph glands. They can last a few days to several weeks, and usually go away on their own.

If West Nile virus enters the brain, however, it can be life-threatening. It may cause inflammation of the brain, called encephalitis, or inflammation of the tissue that surrounds the brain and spinal cord, called meningitis. A physical exam, health history and laboratory tests can diagnose it.

Older people and those with weakened immune systems are most at risk. There are no specific vaccines or treatments for human WNV disease. The best way to avoid WNV is to prevent mosquito bites:

• Use insect repellent
• Get rid of mosquito breeding sites by emptying standing water from flower pots, buckets or barrels
• Stay indoors between dusk and dawn, when mosquitoes are most active
• Use screens on windows to keep mosquitoes out

West Nile virus (WNV) is most often spread by the bite of an infected mosquito. Mosquitoes become infected when they feed on infected birds. In North America, cases of WNV occur during mosquito season, which starts in the summer and continues through fall. WNV cases have been reported in all of the continental United States. There are no vaccines to prevent or medications to treat WNV in people. Fortunately, most people infected with WNV do not have symptoms. About 1 in 5 people who are infected develop a fever and other symptoms. About 1 out of 150 infected people develop a serious, sometimes fatal, illness. You can reduce your risk of WNV by using insect repellent and wearing long-sleeved shirts and long pants to prevent mosquito bites.

Key Facts

• WNV is the most common virus spread by mosquitoes in the continental United States.
• There are no vaccines to prevent or medications to treat WNV in people.
• Most people infected with WNV do not have symptoms.
• About 1 in 5 people who are infected develop a fever and other symptoms.
• About 1 out of 150 infected people develop a serious, sometimes fatal, illness.
• You can reduce your risk of WNV by using insect repellent and wearing long-sleeved shirts and long pants to prevent mosquito bites

Prevent Mosquito Bites

The best way to prevent infection with WNV is to prevent mosquito bites. Choose an insect repellent with one of the following active ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone.

Standing Water

Control mosquitoes inside and outside your home. Once a week, empty and scrub, turn over, cover, or throw out any items that hold water like tires, buckets, planters, toys, pools, birdbaths, flowerpot saucers, or trash containers. Mosquitoes lay eggs in or near water.

Insect Repellent

Always follow instructions when applying insect repellent to children. Do not use insect repellent on babies younger than 2 months old. Do not use products containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD) on children under 3 years old. Do not apply insect repellent onto a child’s hands, eyes, mouth, and cut or irritated skin. Adults: Spray insect repellent onto your hands and then apply to a child’s face.

Prevention Tips

• Use Environmental Protection Agency (EPA)-registered insect repellents with one of the active ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone.
• Cover up: wear long-sleeved shirts and long pants.
• Keep mosquitoes out of your home. Use screens on windows and doors. Repair holes in screens to keep mosquitoes outside. Use air conditioning if available.
• Once a week, empty and scrub, turn over, cover, or throw out any item that holds water, such as tires, buckets, planters, toys, pools, birdbaths, or trash containers. Check inside and outside your home.

West Nile virus (WNV) is the leading cause of mosquito-borne disease in the continental United States. It is most commonly spread to people by the bite of an infected mosquito. Cases of WNV occur during mosquito season, which starts in the summer and continues through fall. There are no vaccines to prevent or medications to treat WNV in people. Fortunately, most people infected with WNV do not feel sick. About 1 in 5 people who are infected develop a fever and other symptoms. About 1 out of 150 infected people develop a serious, sometimes fatal, illness. You can reduce your risk of WNV by using insect repellent and wearing long-sleeved shirts and long pants to prevent mosquito bites.

Don’t let mosquitoes wreck your summer. Protect yourself and your family from mosquito bites.

Summertime means mosquitoes and West Nile virus (WNV) season. A bite from an infected mosquito can make you or a family member sick. In the United States, cases are reported from summer and continue into fall. WNV is the most common pathogen spread by mosquitoes in the continental United States.

Stay healthy this summer. Take steps to prevent mosquito bites.

The most effective way to avoid getting WNV is to prevent mosquito bites.

Prevention

• Use insect repellent: When used as directed, Environmental Protection Agency (EPA)-registered insect repellents are proven safe and effective, even for pregnant and breastfeeding women. Use an (EPA)-registered insect repellent with one of the following active ingredients:
  • DEET
  • Picaridin
  • IR3535
  • Oil of lemon eucalyptus (OLE)
  • Para-menthane-diol (PMD)
  • 2-undecanone

• Cover up: Wear long-sleeved shirts and long pants.
• Keep mosquitoes outside: Use air conditioning or window and door screens.

Risk

The first case of WNV was discovered in New York City 20 years ago. Though the total number of cases differ from year to year and state to state, since WNV was introduced in 1999, all 48 continental United States have reported cases. More than 2,647 cases of people sick from WNV were reported to CDC in 2018.

Symptoms of WNV

No symptoms in most people. Most people (8 out of 10) infected with WNV do not develop any symptoms.

Mild illness with fever in some people. About 1 in 5 people who are infected develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea, or rash. Most people recover completely, but feeling tired and weakness can last for weeks or months.

Serious symptoms in a few people. About 1 in 150 people who are infected develop a severe illness affecting the central nervous system such as encephalitis (inflammation of the brain) or meningitis (inflammation of the membranes that surround the brain and spinal cord).

• Symptoms of severe illness include high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness, and paralysis.
• Severe illness can occur in people of any age; however, people over 60 years of age are at greater risk. People with certain medical conditions, such as cancer, diabetes, hypertension, kidney disease, and people who have received organ transplants, are also at greater risk.
• Recovery from severe illness might take several weeks or months. Some effects to the central nervous system might be permanent.
• About 1 out of 10 people who develop severe illness affecting the central nervous system die.

Control mosquitoes in and around your home

Remove standing water where mosquitoes lay eggs

• Once a week, empty and scrub, turn over, cover, or throw out any items that hold water like tires, buckets, planters, toys, pools, birdbaths, flowerpot saucers, or trash containers. Mosquitoes lay eggs in or near water.
• Tightly cover water storage containers (buckets, cisterns, rain barrels) so that mosquitoes cannot get inside to lay eggs.
• For containers without lids, use wire mesh with holes smaller than an adult mosquito.
• Use larvicides to treat large containers of water that will not be used for drinking and cannot be covered or dumped out.
• If you have a septic tank, repair cracks or gaps. Cover open vent or plumbing pipes. Use wire mesh with holes smaller than an adult mosquito.

Keep mosquitoes out!

• Install or repair and use window and door screens. Do not leave doors propped open.
• Use air conditioning when possible.

West Nile virus is most commonly spread to people by the bite of an infected mosquito.

Mosquitoes become infected when they feed on infected birds. Infected mosquitoes then spread West Nile virus to people and other animals by biting them.

In a very small number of cases, West Nile virus has been spread through:

• Exposure in a laboratory setting
• Blood transfusion and organ transplant
• Mother to baby, during pregnancy, delivery, or breast feeding

West Nile virus is not spread:

• Through coughing, sneezing, or touching
• By touching live animals
• From handling live or dead infected birds. Avoid bare-handed contact when handling any dead animal. If you are disposing of a dead bird, use gloves or double plastic bags to place the carcass in a garbage can.
• Through eating infected animals, including birds. Always follow instructions for fully cooking meat.

Can I get infected with West Nile virus by donating blood?

No. You cannot get West Nile virus by donating blood.

Can I get infected with West Nile virus by receiving a blood transfusion?

Yes, but it is unlikely. A small number of West Nile virus infections have been reported from blood transfusions. However, blood collection agencies have been screening all donated blood for West Nile virus since 2003 to minimize this risk.

Is donated blood tested for West Nile virus?

Yes. All donated blood is tested for West Nile virus. Any blood product found to be infected is removed from the blood supply.

Can I donate blood if I was diagnosed with West Nile virus infection?

If you have been diagnosed with West Nile virus by your doctor, you should not donate blood for 120 days. If you are diagnosed shortly after giving blood, you should tell your blood center. Donation centers try to ensure that donors who recently had West Nile virus do not give blood for 120 days. Let the center know if you have had a West Nile virus infection. They will help you decide if it is safe for you to donate.

I recently had a transfusion. Should I be concerned about getting infected with West Nile virus?

If you recently had a transfusion, you should be aware of the very small risk for West Nile virus infection. This risk may be higher during the summer when West Nile virus is most likely to infect blood donors. You should contact your doctor if you think you have symptoms caused by West Nile virus or other concerns.

Can I be treated if I get West Nile virus disease after receiving blood?

There are no specific medicines that can treat West Nile virus infection. You should contact your doctor if you think you have symptoms of West Nile virus. They may be able to give you medicine to help lessen some of your symptoms.

Can I get West Nile virus infection from a transplanted organ?

Yes, it is possible and a few cases have been documented. The risk of getting West Nile virus from an organ is not known. The number of West Nile virus cases in a year, the time of year, and where the organ donor lives can impact your chance of getting West Nile virus from a transplanted organ.

Are organ donors tested for West Nile virus?

Unlike blood donors, not all organ donors are tested for West Nile virus. However, some centers do test organ donors for West Nile virus . Organ donors might not be tested because of the time it may take to get results. In addition, the current tests for West Nile virus may not work well for all organ donors.

Can I be an organ or tissue donor if I was previously infected with West Nile virus?

You can still become an organ or tissue donor if you have had West Nile virus infection in the past. A small number of patients have been infected with West Nile virus from a transplanted organ. However, those organs came from donors who were infected with West Nile virus days to weeks (not months or years) before their donation. Currently, most organ donors are not screened for West Nile virus.

Will I get very ill if I get West Nile virus infection after having a transplant?

The risk of a transplant patient getting very ill from West Nile virus is not known. One study of transplant patients found less than 1 in 100 infected persons get very ill. This is similar to people who have not had a transplant. A second study found that 1 in 40 persons infected with West Nile virus after a transplant got severe disease. The chance of getting West Nile virus disease may depend on your age, other health conditions, medications you are taking, and (for example WN virus is most commonly spread in late summer).

Can I be treated if I get West Nile virus disease after receiving blood?

There are no specific medicines that can treat West Nile virus infection. You should contact your doctor if you think you have symptoms of West Nile virus. They may be able to give you medicine to help lessen some of your symptoms.

I am pregnant. Am I at higher risk for getting infected with West Nile virus?

No. Pregnant women are not at higher risk for West Nile virus infection.

I am pregnant and was just diagnosed with West Nile virus infection. Is my baby at risk of infection?

A woman who is infected with West Nile virus during pregnancy can possibly transmit the virus to her baby, but the risk is low. Only a few cases of West Nile virus in newborns have been reported. Pregnant women should take precautions to reduce their risk for West Nile virus infection by avoiding mosquitoes, wearing protective clothing, and using insect repellent.

If I am pregnant or breastfeeding, should I use insect repellents?

Yes. Protecting yourself from mosquito bites is the only way to prevent infection with West Nile virus. In addition to wearing protective clothing such as long-sleeve shirts and long pants, use insect repellents. Repellents containing active ingredients which have been registered with the EPA are considered safe for pregnant and breastfeeding women. More information about insect repellents is available here.

Can West Nile virus be transmitted through breast milk?

Possibly. It appears that West Nile virus may be transmitted through breast milk, although this is likely a rare occurrence.

In 2002, a woman developed encephalitis due to West Nile virus from a blood transfusion she received shortly after giving birth. Laboratory analysis showed evidence of West Nile virus in breast milk collected from the mother soon after she became ill. She had been breastfeeding her baby and about 3 weeks after birth the infant tested positive for West Nile virus. Because of the infant’s minimal outdoor exposure, it’s unlikely that infection was from a mosquito. The infant had no symptoms of West Nile virus infection and remained healthy.

Should I continue breastfeeding if I have West Nile virus disease?

Yes. The risk for West Nile virus transmission through breastfeeding is unknown. However, the health benefits of breastfeeding are well established. Therefore, there are no recommendations for a woman to stop breastfeeding because of West Nile virus illness.

West Nile virus has been detected in variety of bird species. Some infected birds, especially crows and jays, are known to get sick and die from the infection. Reporting and testing of dead birds is one way to check for the presence of West Nile virus in the environment. Some surveillance programs rely on citizens to report dead bird sightings to local authorities.

How do birds get infected with West Nile virus?

West Nile virus is transmitted to birds through the bite of an infected mosquito. Mosquitoes become infected by biting infected birds. Some birds that are predators (such as hawks and owls) or scavengers (such as crows) may become infected after eating sick or dead birds that were already infected with West Nile virus. Some birds that eat infected mosquitoes may also become infected.

Do birds infected with West Nile virus die or become ill?

Although some infected birds, especially crows and jays, frequently die of infection, most birds survive. Since West Nile virus was discovered in the United States in 1999, the virus has been detected in over 300 species of dead birds.

Can I get West Nile virus directly from birds?

There is no evidence that a person can get infected from handling live or dead infected birds. However, you should avoid bare-handed contact when handling any dead animal. If you must pick up a dead bird, use gloves or an inverted plastic bag to place the bird in a garbage bag.

What should I do if I find a dead bird?

State and local agencies have different policies for collecting and testing birds, so check with your state health department or state wildlife agency for information about reporting dead birds in your area. Wildlife agencies routinely investigate sick or dead bird events if large numbers are impacted. This type of reporting could help with the early detection of illnesses like West Nile virus or avian influenza (bird flu), known to cause death in birds. If local authorities tell you to simply dispose of the bird, don’t handle it with your bare hands. Use gloves or an inverted plastic bag to place the bird in a garbage bag, which can then be disposed of in your regular trash.

Why did some states and local areas stop collecting dead birds to test for West Nile virus?

West Nile virus is found in all 48 contiguous states (not in Alaska) and the virus circulates in mosquitoes and birds every year. Because West Nile virus is well established, some states and local jurisdictions are no longer collecting dead birds for testing. Instead, they have chosen to shift staff and funding resources away from testing of dead birds to other areas of West Nile virus surveillance and control.

No symptoms in most people. Most people (8 out of 10) infected with West Nile virus do not develop any symptoms.

Febrile illness (fever) in some people. About 1 in 5 people who are infected develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea, or rash. Most people with febrile illness due to West Nile virus recover completely, but fatigue and weakness can last for weeks or months.

Serious symptoms in a few people. About 1 in 150 people who are infected develop a severe illness affecting the central nervous system such as encephalitis (inflammation of the brain) or meningitis (inflammation of the membranes that surround the brain and spinal cord).

• Symptoms of severe illness include high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis.
• Severe illness can occur in people of any age; however, people over 60 years of age are at greater risk for severe illness if they are infected (1 in 50 people). People with certain medical conditions, such as cancer, diabetes, hypertension, kidney disease, and people who have received organ transplants, are also at greater risk.
• Recovery from severe illness might take several weeks or months. Some effects to the central nervous system might be permanent.
• About 1 out of 10 people who develop severe illness affecting the central nervous system die.

If you think you or a family member might have West Nile virus disease, talk with your health care provider.

• Healthcare providers diagnose West Nile virus infection based on:
  • Signs and symptoms
  • History of possible exposure to mosquitoes that can carry West Nile virus
  • Laboratory testing of blood or spinal fluid
• Your healthcare provider can order tests to look for West Nile virus infection or other infections that can cause similar symptoms.

• No vaccine or specific medicines are available for West Nile virus infection. Antibiotics do not treat viruses.
• Rest, fluids, and over-the-counter pain medications may relieve some symptoms.
• In severe cases, patients often need to be hospitalized to receive supportive treatment, such as intravenous fluids, pain medication, and nursing care.

West Nile virus (WNV) is spread to people through the bite of an infected mosquito. Mosquitoes bite during the day and night. There is no vaccine to prevent WNV infection. The best way to prevent ­­­West Nile is to protect yourself from mosquito bites. Use insect repellent, wear long-sleeved shirts and pants, treat clothing and gear, and take steps to control mosquitoes indoors and outdoors.

Protect Yourself and Your Family from Mosquito Bites

Use insect repellent

Use Environmental Protection Agency (EPA)-registered insect repellents with one of the active ingredients below. When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breastfeeding women.

• DEET
• Picaridin (known as KBR 3023 and icaridin outside the US)
• IR3535
• Oil of lemon eucalyptus (OLE)
• Para-menthane-diol (PMD)
• 2-undecanone

Find the right insect repellent for you by using EPA’s search tool.

Tips for babies and children

• Dress your child in clothing that covers arms and legs.
• Cover strollers and baby carriers with mosquito netting.
• When using insect repellent on your child:
  • Always follow label instructions.
  • Do not use products containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD) on children under 3 years old.
  • Do not apply insect repellent to a child’s hands, eyes, mouth, cuts, or irritated skin.
    • Adults: Spray insect repellent onto your hands and then apply to a child’s face.

Tips for everyone

• Always follow the product label instructions.
• Reapply insect repellent as directed.
  • Do not spray repellent on the skin under clothing.
  • If you are also using sunscreen, apply sunscreen first and insect repellent second.

Natural insect repellents (repellents not registered with EPA)

• We do not know the effectiveness of non-EPA registered insect repellents, including some natural repellents.
• To protect yourself against diseases spread by mosquitoes, CDC and EPA recommend using an EPA-registered insect repellent.
• Choosing an EPA-registered repellent ensures the EPA has evaluated the product for effectiveness.
• Visit the EPA website to learn more.

Wear long-sleeved shirts and long pants

Treat clothing and gear

• Use 0.5% permethrin to treat clothing and gear (such as boots, pants, socks, and tents) or buy permethrin-treated clothing and gear.
  • Permethrin is an insecticide that kills or repels mosquitoes.
  • Permethrin-treated clothing provides protection after multiple washings.
  • Read product information to find out how long the protection will last.
• If treating items yourself, follow the product instructions.
• Do not use permethrin products directly on skin.
• Watch the video, What You Need to Know About Permethrin.

Take steps to control mosquitoes indoors and outdoors

• Use screens on windows and doors. Repair holes in screens to keep mosquitoes outdoors.
• Use air conditioning, if available.
• Stop mosquitoes from laying eggs in or near water.
  • Once a week, empty and scrub, turn over, cover, or throw out items that hold water, such as tires, buckets, planters, toys, pools, birdbaths, flowerpots, or trash containers.
  • Check for water-holding containers both indoors and outdoors.

Prevent Mosquito Bites When Traveling Overseas

Remember to pack the following items

• EPA-registered insect repellentsexternal
• Long-sleeved shirts and long pants. Mosquitoes may bite through thin clothing.
• Clothing and gear (such as boots, pants, socks, tents) treated with 0.5% permethrin. You can treat your own items or purchase permethrin-treated clothing and gear.
• Mosquito net if you will be sleeping outside or when screened rooms are not available.

Keep mosquitoes out of your hotel room or lodging

• Choose a hotel or lodging with air conditioning or window and door screens.
• Use a mosquito net if you are unable to stay in a place with air conditioning or window and door screens or if you are sleeping outside.

Sleep under a mosquito net

Sleep under a mosquito net if you are outside or when screened rooms are not available. Mosquitoes can live indoors and bite during the day and night.

• Buy a mosquito net at your local outdoor store or online before traveling overseas.
• Choose a mosquito net that is compact, white, rectangular, with 156 holes per square inch, and long enough to tuck under the mattress.
• Permethrin-treated mosquito nets provide more protection than untreated nets.
  • Permethrin is an insecticide that kills mosquitoes and other insects.
  • To determine if you can wash a treated mosquito net, follow the label instructions.

Use mosquito nets correctly

Mosquito nets can be hung above a bed or crib to protect against mosquito bites. Adults and children should sleep under a mosquito net if air conditioned and screened rooms are not available.

When using a mosquito net:

• Tuck the net under the mattress to keep the mosquitoes out.
• Tuck netting under the crib mattress or select a mosquito net long enough to touch the floor.
• Pull the net tightly to avoid choking hazards for young children. Check label instructions for additional information.
• Hook or tie the sides of the net to other objects if they are sagging in towards the sleeping area.
• Check for holes or tears in the net where mosquitoes can enter.
• DO NOT hang the net near any candles, cigarettes, or open fires, as it can catch on fire.
• DO NOT sleep directly against the net, as mosquitoes can still bite through holes in the net.

What is West Nile virus?

West Nile virus is mainly spread to people through the bite of an infected mosquito. However, there have been a very small number of cases where the virus was spread by blood transfusion, organ donation, or from mother to baby during pregnancy, birth, or when breastfeeding.

Most people who get West Nile virus infection do not feel sick. For people who do feel sick, symptoms can include fever, headache, tiredness, nausea, vomiting, muscle aches, and a rash. Symptoms usually last from a few days to a few weeks.

Some people can have more serious disease. Adults over 60 years old or people with certain medical conditions are more likely to get seriously ill. Symptoms of serious West Nile virus disease include high fever, headache, neck stiffness, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness, and paralysis.

Who can get West Nile virus?

West Nile virus is found in countries throughout the world. Travelers going to Africa, Europe, the Middle East, west and central Asia, or North America can get West Nile virus.

The following activities can increase a traveler’s chance of getting infected:

• Spending a lot of time outdoors
• Traveling during times of the year when mosquitoes are more common, such as during the summer.

What can travelers do to prevent West Nile virus?

There are no vaccines or medicines that prevent West Nile virus. Travelers can protect themselves against West Nile virus infection by preventing mosquito bites.

Use an EPA-registered insect repellent

• Use Environmental Protection Agency (EPA)-registered insect repellents with one of the active ingredients below. When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breastfeeding women. If also using sunscreen, always apply insect repellent after sunscreen.
  • DEET
  • Picaridin (known as KBR 3023 and icaridin outside the US)
  • IR3535
  • Oil of lemon eucalyptus (OLE)
  • Para-menthane-diol (PMD)
  • 2-undecanone

• Insect Repellent Tips for Babies and Children
  • Dress your child in clothing that covers arms and legs.
  • Cover strollers and baby carriers with mosquito netting.
  • When using insect repellent on your child:
    • Always follow label instructions.
    • Do not use products containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD) on children under 3 years old.
    • Do not apply insect repellent to a child’s hands, eyes, mouth, cuts, or irritated skin.
      • Adults: Spray insect repellent onto your hands and then apply to a child’s face.
    • If also using sunscreen, always apply insect repellent after sunscreen.

Wear long-sleeved shirts and long pants

Treat clothing and gear with permethrin

• Use 0.5% permethrin to treat clothing and gear (such as boots, pants, socks, and tents) or buy permethrin-treated clothing and gear.
  • Permethrin is an insecticide that kills or repels mosquitoes.
  • Permethrin-treated clothing provides protection after multiple washings.
  • Read product information to find out how long the protection will last.
• If treating items yourself, follow the product instructions.
• Do not use permethrin products directly on skin.
• Watch the CDC video How to Use Permethrin.

Keep mosquitoes out of your hotel room or lodging

• Choose a hotel or lodging with air conditioning or window and door screens.
• Use a mosquito net if you are unable to stay in a place with air conditioning or window and door screens or if you are sleeping outside.

Sleep under a mosquito net

• Sleep under a mosquito net if you are outside or when screened rooms are not available. Mosquitoes can live indoors and bite during the day and night.
• Buy a mosquito net at your local outdoor store or online before traveling overseas.
• Choose a mosquito net that is compact, white, rectangular, with 156 holes per square inch, and long enough to tuck under the mattress.
• Permethrin-treated mosquito nets provide more protection than untreated nets.
  • Permethrin is an insecticide that kills mosquitoes and other insects.
  • To determine if you can wash a treated mosquito net, follow the label instructions.

If you are bitten by mosquitoes, avoid scratching the bites and apply over-the-counter anti-itch or antihistamine cream to relieve itching.

If you traveled and feel sick, particularly if you have a fever, talk to a healthcare provider, and tell them about your travel. Avoid contact with other people while you are sick.