Zika Virus

There was a recent outbreak of Zika virus with a lot of media coverage. This virus was widely unknown until now and while the euphoria has died down, it helps to recognise the symptoms and what to do if concerned with possible exposure to the virus.

What is Zika virus and how is it transmitted?

Zika virus is a flavivirus that was first discovered in Africa in 1947. Prior to 2015, there had only been a few documented outbreaks.

• Zika virus is primarily transmitted by the bite of an infected Aedes mosquito. Aedes mosquitos bite in the day and are most active midmorning and late afternoon to dusk. They are unlikely to be found at altitudes above 2000m.

• A small number of cases of Zika virus infection have occurred via sexual transmission or mother to baby via the placenta. Apart from in these specific situations, it is NOT passed from person to person.

• There is currently no Zika virus vaccine

Symptoms of Zika virus disease

Incubation period is 3-12d but it can be shorter or longer.

• Most people have minimal symptoms with a mild, short lived (2-7d) febrile disease. Typical symptoms:

• low-grade fever

• joint pain (may have swelling of smaller joints of the hands and feet)

• rash, sometimes itchy

• conjunctivitis

• headache

• myalgia

• eye pain.

• Symptoms are similar to dengue and chikungunya which are also transmitted by the Aedes mosquito.

Implications for UK

• So far, there have been 5 confirmed cases of Zika virus infection diagnosed in travellers returning to the UK.

• The public health risk of Zika virus infection in travellers returning to the UK is negligible as the UK climate is too cool for the Aedes mosquito to breed so there is no vector for onwards transmission.

Active transmission of Zika virus has been reported in the following countries

• Americas: Barbados, Bolivia, Brazil, Columbia, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname, U.S. Virgin Islands, Venezuela

• Pacific Islands: Samoa

• Africa: Cape Verde

Advice for travellers to areas of Zika virus transmission

• The WHO emergency committee found no public health justification for restricting travel or trade to prevent the spread of Zika virus.

• Provide advice on mosquito bite avoidance: use an insect repellent containing DEET on exposed skin. Apply the repellent after sunscreen. Cover-up with light clothing (remember Aedes is a day biting mosquito).

Women who are pregnant or planning pregnancy

• Should consider avoiding travel to areas with active Zika virus transmission.

• If travel is unavoidable then take scrupulous precautions to avoid mosquito bites.

• Avoid conception while traveling in an area with Zika virus transmission. On return to the UK, avoid pregnancy for a further 28d.

Men

• The risk of sexual transmission is very low.

• The virus has been found in semen but it is not yet known how long this can persist.

• If their female partner is at risk of pregnancy or already pregnant, condom use is advised for the male traveller: for 28d after return from Zika virus transmission area if no unexplained fever/rash or for 6m following recovery from illness consistent with Zika virus or laboratory confirmed Zika virus infection.

by Dr Precious Osula

F7 | LIFESTYLE

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