We are aware that many travellers are concerned about the risk of Zika Virus which has recently been highlighted in the news. It can be very worrying when planning time abroad or having recently returned from an endemic country and we hope the following information will assist and reassure travellers.

There has been a significant increase in the number of cases reported globally and in particular in Latin America. The worrying finding is the potential risk in pregnancy to the unborn child and the World Health Organisation has therefore declared a Public Health Emergency.

Until more has been established regarding Zika Virus, the WHO and Public Health in the UK have recommended additional advice is offered to travellers to support a precautionary approach to risk.

The situation is varied across each country and more detailed information on individual country risk can be found here.

Signs and Symptoms of Zika

The symptoms of Zika Virus are similar to other mosquito-borne infections such as dengue, chikungunya and malaria so laboratory testing is essential for the correct diagnosis. Zika Virus is generally mild and self-limiting, lasting 2 to 7 days.

Symptoms of Zika Virus infection may include:

  •  fever
  • joint pain
  •  itching
  •  rash
  •  conjunctivitis or red eyes
  •  headache
  •  muscle pain
  •  eye pain

Public Health England is proactively monitoring the risks from Zika Virus and is working with government and NHS colleagues to ensure the UK remains alert to, and prepared for, cases returning with Zika Virus infection.

Prevention

Mosquito bite avoidance is strongly recommended for all travellers to Zika Virus affected countries. Individuals will be helped to understand the risks and to make an informed decision on whether to change their travel plans. It is important to remember there are other mosquito borne infections which may also be a risk such as Dengue Fever. A vaccine against Zika virus is not available.

If travelling to a Zika endemic area, rigorous measures to avoid mosquito bites during both daytime and night time hours are vital. It is not sufficient to assume that Aedes mosquitoes will only bite in daytime. Aedes sp mosquitoes are particularly persistent and aggressive biters. Winchester Travel Health strongly reccomend DEET- based insect repellents at a concentration of 50%, which should be applied regularly.

Mosquito Bite Avoidance:

    

  • Wearing loose, cover-up clothing is recommended.
  • Insecticide-impregnated (treated) bed nets and air conditioning should be used in bedrooms.
  • Reduction of mosquito breeding sites around hotel rooms/homes is advised for longer- term stays. Some resorts will provide this.
  • 50% DEET based skin repellent
  • Skin repellents should be applied 30 minutes after sun protection and should be repeated after swimming or if sunscreen is reapplied.
  • Once a day sunscreen may help reduce frequent applications
  • Fabric Spray is useful for clothing repellence and can be effective for 120 days or 36 washes so can be applied prior to travel.
  • Plug-In repellents can also help reduce mosquito bites.

Pregnancy

Women who are pregnant, or have plans to become pregnant, and who are considering travel to a country where Zika Virus is circulating, are strongly urged to seek pre-travel advice. Winchester Travel Health can offer a 30 minute personalised consultation assessing the risk and providing preventative advice and care. It may be advisable to postpone or cancel travel to a Zika Virus risk area but our specialist nurses can advise on an individual basis.

DEET is appropriate for use in pregnancy. If DEET is unsuitable then another, proven alternative should be used.

Women who have visited a Zika affected area whilst pregnant should arrange to have their next antenatal check promptly on return home, even if feeling well. This is not intended to cause undue anxiety, but merely as a precaution. In addition, medical attention must be sought quickly for any feverish illness experienced whilst travelling or on return.

Guidance from The Royal College of Obstetricians & Gynaecologists.

What is the advice for women planning a pregnancy who have visited a country with active Zika virus transmission?

On returning to the UK from a country with active Zika virus transmission, women should avoid becoming pregnant for a further 28 days, even if they haven’t experienced any symptoms – this allows for a maximum two-week incubation period (the time between exposure to an infection and
the appearance of the first symptoms).

What is the advice for a woman whose partner has been to an area with active Zika virus transmission?

The risk of sexual transmission of Zika virus is thought to be very low. However, Zika virus has been identified in semen of men who have had Zika infection, and it is not known how long this can persist. If a woman’s partner has travelled to a country with active Zika virus transmission, effective contraception is advised to avoid pregnancy (and the use of condoms could be considered to prevent against infection acquisition):

  • For 28 days after his return home if he had no Zika virus symptoms, either whilst abroad or within two weeks of his leaving the affected country
  •  For 6 months following recovery if he did experience Zika symptoms during that period

Ref: https://www.rcog.org.uk/en/news/qas-related-to-zika-virus-and-pregnancy/#q4