5 minutes on Zika Virus
What is Zika Virus, how is it transmitted and what do I do in terms of prevention?
Zika virus (ZIKV) infection was first identified in a monkey in the Ugandan Zika forest in 1947. This viral infection can now be found in a number of countries in the Americas, Africa, Asia and the Pacific islands. Zika virus infection often occurs without any symptoms but one in four people develop mild fever, rash, conjunctivitis, muscle or joint pain. It is usually a mild and self-limiting disease, and may last from 4-7 days. Severe cases are uncommon.
An increase in congenital neurological malformations in new-born babies, including microcephaly (abnormal smallness of the head, along with incomplete brain development) have been reported, mainly from Brazil but also from Colombia, Cape Verde, French Polynesia, Martinique and Panama. In addition a number of countries with active ZIKV transmission have reported an increase in a neurological condition called Guillain-Barré syndrome. There is now growing scientific evidence that these conditions are caused by ZIKV.
ZIKV is transmitted by the Aedes mosquito - all travellers are at risk of being bitten. Aedes mosquitos bite in the day and are most active mid-morning and late afternoon to dusk. The virus has been detected in semen and a small but increasing number of cases of sexual transmission have been reported.
Prevention is by avoiding mosquito bites. Wear loose fitting clothing that cover arms and legs, wear effective insect repellent on exposed skin and sleep under mosquito nets.
Pregnant? Or planning to become pregnant?
Knowledge about ZIKV and pregnancy is still evolving so it is very important to keep up to date with the most current information as guidance is changing regularly. The guidance as of today, 25th August 2016, is as follows;
Currently pregnant women are being advised to postpose any non-essential travel to areas classified as ‘High Risk’ (and consider postponing travel to ‘Moderate Risk’ areas) until after pregnancy. If travel is unavoidable a pregnant woman should be made aware of the risks that ZIKV may present and be fully informed that scrupulous insect bite avoidance measures should be taken.
If a pregnant woman has returned from a country with active ZIKV transmission within the last 9 months, they should seek advice from their GP or midwife so that they can be monitored, even if they do not have any symptoms.
Women are advised to avoid becoming pregnant while travelling in areas with active ZIKV transmission and for 8 weeks after returning home.
Women planning to become pregnant should discuss their travel plans with a health adviser to assess their risk for ZIKV infection. If their male partner has travelled to an area with active ZIKV transmission, contraception is advised to prevent pregnancy plus condom use is advised for 8 weeks after his return if he has shown no symptoms of the virus, and for 6 months if reporting clinical illness compatible with Zika or laboratory-confirmed Zika infection.
If the male partner has had an illness compatible with ZIKV, then condom use is advised for the duration of his partner’s pregnancy from the start of his illness as a precautionary measure.
The risk of sexual transmission of Zika virus is thought to be low but the number of reported cases are increasing. It is not yet known how long the virus can remain in semen. Couples not at risk of pregnancy who wish to reduce the risk of transmission may consider the use of condoms during any sexual contact if the male has had clinical illness compatible with ZIKV. This condom use should commence at the start of illness and continue for 6 months
Want to read more?
In July 2016, Public Health England (PHE) updated its Health Protection Guidance on Zika virus. They have classified each country into High, Moderate, Low or Very Low Risk.
This guidance on travel and clinical advice is extensive: its content includes a list of countries with active Zika virus transmission, conception/pregnancy advice, sexual transmission and the immunocompromised traveller. Please check for up to date information as this advice is being constantly reviewed:
You may also wish to visit the TravelHealthPro website - http://travelhealthpro.org.uk/zika-virus-update-and-advice-for-travellers-including-pregnant-women/