Aedes mosquitoDoes all the news about the Zika virus have you concerned about your next trip? Hopefully the answers to these common questions will help address your concerns.

So what is Zika virus?
Zika virus occurs in a large number of tropical countries, and there is currently a large outbreak in Brazil and other parts of the Americas. People get Zika virus when they get bitten by mosquitoes carrying it; other viruses such as Dengue are passed on the same way, as is Malaria.

How do I know I am infected?
If you get bitten by mosquitoes, a few days later, Zika virus may infect you. The infection may be very mild, and often may go unnoticed. Some people will, however. get symptoms, not unlike having a mild version of the ‘flu: a low fever, some headache, muscle and joint pains, as well as red eyes and a non-itchy flat rash.

Why the big splash then?
Zika virus has spread very considerably in Brazil for quite a while. The worry is that this has been accompanied by a large and as yet unexplained increase in the number of babies born with a condition called “microcephaly” – literally meaning “small brain”, which means that normal brain development in the womb has stopped, and that these children’s brains are much smaller than they should be at birth. The two might be linked, but we don’t know yet.

Can the disease be imported?
Yes. For example, 5-6 cases of Zika virus infection were imported into the UK from various South American countries.

Is it safe to travel to Brazil and other affected countries?
The world’s best health authorities are working on what this might mean for travelers to this region of the world. This, of course, is especially important for people residing in or near an affected country, or are thinking of attending the Olympic Games in Rio. People who get infected with Zika virus have a mild illness which resolves in a few days; many won’t even know they’ve got the virus. The problem relates to people who are pregnant.

What’s the link with pregnancy?
While a clear link between birth abnormalities and Zika virus infection in pregnancy has yet to be established, it seems self-evident that pregnant women should consider avoiding travel to areas where there is Zika virus. If travel is unavoidable, the key is an excellent anti-mosquito regimen, which could include wearing long sleeves, using insect repellent containing DEET and sleeping under insecticide-impregnated bed nets.  Discuss the best protocols for you with your Obstetrician.  Currently we have nothing else to fight this virus; there’s no vaccine and there’s no other treatment that can prevent a person developing Zika.

Can Zika virus be transmitted to others?
Zika virus infection is transmitted by mosquitoes.  It can only be passed on in countries where the transmitting mosquito lives, which include Africa, Asia, the Americas and parts of southern Europe. It’s clear that person-to-person transmission is very unlikely – but there’s a small chance that sexual transmission might be possible.

I’m pregnant and have recently visited an affected area – what should I do?
If you are well, you should still discuss this with your Obstetrician.  They will be able to advise further about the risks, although this is an area where we are learning more every day, and the full facts are not yet known. It’s likely that what your doctors will decide to do is keep an extra close eye on you throughout your pregnancy, to make sure that all is well.

If you have recently come back from affected areas and had, or have, symptoms suggesting a viral illness within the last 2-3 weeks, you should actively seek medical advice and state that you wish to be tested for Zika.

What are the tests for Zika virus infection?
There are blood and urine tests for Zika virus, but they can only be done up to 2-3 weeks after developing symptoms. The blood test in true infection is likely to be positive early on the illness; the urine test may pick the virus up some weeks later.

There is no test currently available for people who have always remained well, or if the symptoms were more than 2-3 weeks ago.

Author: Dr. Vanya Gant
Dr. Vanya Gant, PhD, FRCP FRCPath is a specialist in Infectious Diseases and Microbiology.  He is Divisional Clinical Director for Infection at University College London Hospitals Trust in London, England.  In addition to patient care and clinical service redesign, Dr. Gant develops new techniques and materials for combating infection. He has appeared in several Public service and independent programs on matters of infection and microbiology, some of which he co-wrote.  

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