Analysis

Travellers warned about Zika virus

NHS staff working in primary care have been advised to take a more precautionary approach to the Zika virus, particularly with pregnant women

NHS staff working in primary care have been advised to take a more precautionary approach to the Zika virus, particularly with pregnant women.

Updated guidance from Public Health England (PHE) states that nurses should advise pregnant women to postpone non-essential travel to areas with disease outbreaks, where previously they would have been advised simply to reconsider such travel.

The PHE guidance also warns nurses and other clinicians to expect patients to ask for health advice and letters to justify suspension of travel to affected areas in South and Central America and the Caribbean.

Birth defects

The US Centers for Disease Control and Prevention has recently confirmed that the Zika virus causes birth defects, including microcephaly, a syndrome in which children are born with unusually small heads.

The National Travel Health Network and Centre provides the latest advice on which countries are affected. Brazil, where the Olympic and Paralympic Games are taking place later this year, is on the list.

Signs and symptoms of clinical illness in pregnant women can include: fever, rash, arthritis, conjunctivitis, myalgia, headache, retro-orbital pain and pruritus.

The PHE guidance states:

  • Women should be told to avoid becoming pregnant while in an area with active Zika transmission and for 28 days after return.
  • If a pregnant woman cannot postpone travel, she should be told about the risks.
  • Pregnant women who have recently travelled to affected countries should report this to their primary care clinicians, obstetricians or midwives.
  • Pregnant women who develop Zika virus symptoms should be tested for the infection when symptoms are present and referred for an ultrasound.
  • All people travelling to affected areas should take measures to avoid mosquito bites.

The advice also explains what patients should be told about taking precautions when having sex. The risk of transmission is ‘thought to be low’, the guidance says, but male-to-female sexual transmission has been reported.

  • Men who have travelled to affected areas should use condoms for 28 days, even if they have not had Zika symptoms.
  • Male travellers diagnosed with Zika or who are exhibiting its symptoms should continue to use condoms for six months.
  • Male travellers whose partners are pregnant should continue to use condoms throughout the pregnancy, regardless of whether they have developed symptoms of Zika.

The guidance adds that patients who have recovered from Zika require no further investigations and can be reassured that the infection is typically short lived. It also advises healthcare staff that people who have recently travelled to affected areas ‘do not pose a risk as long as universal precautions are followed’.

PHE director for health protection Paul Cosford says: ‘This advice will be kept under review and updated as more information becomes available.’

More information

Public Health England guidance

National Travel Health Network and Centre updates and advice 

 

 

 

 

 

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