Zika Virus: Preparation and Safety Advice for UK Travellers

Zika virus is a mosquito-borne infection that was first identified in 1947. While it gained global attention during the 2015-2016 outbreak in the Americas, it remains an ongoing concern for British travellers visiting tropical and subtropical regions. The virus is primarily transmitted through the bite of an infected Aedes aegypti or Aedes albopictus mosquito.

Unlike the mosquitoes that carry malaria, which typically bite at night, Zika-carrying mosquitoes are most active during the day, particularly around dawn and dusk. According to official NHS and NICE guidance, while the illness is usually mild for most adults, it is associated with severe birth defects if a woman is infected during pregnancy, most notably microcephaly (a condition where a baby's head is much smaller than expected).

It is estimated that up to 80% of people infected with Zika virus do not develop any symptoms at all. For those who do become ill, the symptoms usually appear between 3 and 12 days after the bite. Common signs include:

• A high temperature (fever), usually mild.
• An itchy, red, maculopapular rash.
• Muscle and joint pain, particularly in the hands and feet.
• Conjunctivitis (red, sore, or itchy eyes).
• Headache and general fatigue.

Symptoms typically last for two to seven days. Because these symptoms are often similar to other tropical infections like Dengue or Chikungunya, it is important to seek medical advice if you feel unwell after returning to the UK from a high-risk region.

The Risk to Pregnancy

The most significant concern regarding Zika virus is its impact on an unborn child. If a woman is infected while pregnant, the virus can pass to the foetus. This can lead to Congenital Zika Syndrome, which includes brain abnormalities and developmental issues. Consequently, UK health authorities advise that pregnant women should postpone non-essential travel to areas with a high risk of Zika transmission.

Sexual Transmission

A lesser-known fact is that Zika can be transmitted through sexual contact. The virus can persist in semen and vaginal fluids for a significant period after the initial infection has cleared. To prevent transmission, the NHS recommends using condoms for three months after a man returns from a risk area, and for two months for women. Couples planning to conceive should consult a healthcare professional about appropriate wait times after travelling.

As there is currently no vaccine to prevent Zika virus, the only way to avoid infection is to avoid mosquito bites. Travellers are advised to follow the 'triple-A' approach: Awareness, Avoidance, and Action.

• Use Repellent: Apply insect repellent containing at least 50% DEET to all exposed skin. This should be reapplied regularly, especially after swimming or heavy sweating.
• Wear Protective Clothing: Opt for long-sleeved shirts and long trousers. Light-coloured clothing is preferable as it is less attractive to some mosquito species and makes it easier to spot bugs.
• Treat Clothing with Permethrin: You can buy sprays to treat your clothes, which provides an extra layer of protection.
• Choose Accommodation Wisely: Stay in rooms with air conditioning and window screens. If sleeping in basic accommodation, use a mosquito net treated with insecticide.

Preparing for an international trip can be overwhelming, particularly when navigating complex travel health advice. You should consider speaking to an online GP in the UK if:

• You are planning a trip to South America, Southeast Asia, or the Pacific Islands and are unsure of the current risk status.
• You are pregnant or planning to conceive and need to discuss the safety of your destination.
• You have recently returned from a trip and are experiencing a rash, fever, or joint pain.
• You require advice on the appropriate insect repellents for children or those with sensitive skin.

Our online GP service can help you assess your personal risk and provide guidance on how to stay safe while abroad. While we cannot perform laboratory tests for Zika online, we can help determine if a referral for physical testing is necessary based on your travel history and symptoms.

While most people recover fully without lasting effects, there has been an observed link between Zika virus and Guillain-Barré syndrome. This is a rare but serious condition that affects the nervous system, causing muscle weakness and, in severe cases, paralysis. Most patients recover with hospital treatment, but the association highlights why avoiding the virus is important for all travellers, not just those who are pregnant.