This Guidelines summary includes:
- A revised algorithm for the assessment of pregnant women with a history of travel to an area at risk
- Travel advice
- Advice for pregnant women and couples considering pregnancy returning from a country or area with risk for Zika virus transmission.
Particular attention is required for women who are pregnant or who are considering a pregnancy because of the risk to the developing fetus associated with Zika virus infection in pregnancy. UK travel health advice in relation to Zika virus is therefore primarily focussed on pregnant women and their partners and couples planning pregnancy.
- There is currently no vaccine or drug to prevent Zika virus infection. The majority of Zika virus cases are acquired via mosquito bite, although sexual transmission of Zika virus infection can occur. The overall risk of sexual transmission of Zika virus is, however, considered to be low. Prevention of Zika relies primarily on avoidance of mosquito bites.
- Travellers to countries or areas with risk for Zika virus transmission should ideally seek travel health advice from their GP, practice nurse or a travel clinic at least 4 to 6 weeks before they travel. Even if time is short it is still not too late to get travel advice. Zika risk ratings for destinations are available.
Pregnancy and travel
- Zika virus infection in women who are pregnant or planning to get pregnant can result in serious birth defects. Although the probability of a fetus developing complications resulting from Zika infection is low, the impact of these complications, should they occur, are very serious. Travel advisories are therefore focussed on pregnant women, their partners and couples planning pregnancy.
- Before booking travel, pregnant women and couples considering pregnancy within 3 months following travel should check the Zika risk for their destination (see country A to Z and consider any travel advisories (see Table 1).
|Country risk rating||Pregnant women||Couples considering pregnancy|
|Risk||Specific recommendations for pregnant women considering travel to affected countries or areas can be found in the ‘other risks’ section of the NaTHNaC country information pages||Couples should follow guidance on prevention of sexual transmission of Zika and avoid conception while travelling and for 3 months on return|
|Very low risk||No specific travel advisory||No specific travel advisory|
|NaTHNaC=National Travel Health Network and Centre.|
- Further details including specific recommendations on prevention of sexual transmission are available on individual country pages on the National Travel Health Network and Centre (NaTHNaC) website (also accessed via the country A to Z).
Preventing infection by mosquito bites
- Travellers should use mosquito bite avoidance measures if they are travelling in countries or areas below or around 2,000 metres (m). All travellers should take insect bite avoidance measures during daytime and night time hours to reduce the risk of infection with Zika and other mosquito borne diseases.
- A good repellent containing N, N-diethylmetatoluamide (DEET) should be used on exposed skin, together with light cover-up clothing. If sunscreen is needed, repellent should be applied after sunscreen. Sunscreen should be 30 SPF or above to compensate for DEET-induced reduction in SPF.
- Read the mosquito bite avoidance for travellers leaflet.
Advice for pregnant women and couples considering pregnancy returning from a country or area with risk for Zika virus transmission
Advice for women who have recently been to an affected country or area and suspect they have Zika virus
- The symptoms of Zika virus infection can be similar to other mosquito-borne infections, such as dengue, chikungunya and malaria, and also more common infections seen in pregnancy, so medical assessment is essential for the correct diagnosis.
- Anyone who has recently returned from a country or area at risk for Zika virus transmission and has a fever, rash or flu-like illness, should seek medical attention without delay to exclude Zika and other illnesses.
- Specific recommendations for pregnant women considering travel to affected countries or areas can be found in the ‘other risks’ section of the NaTHNaC country information pages.
- Women should avoid becoming pregnant while travelling to a country or area with risk for Zika virus transmission. On returning to the UK, they should avoid becoming pregnant for a further 2 months if only the woman travelled, and for 3 months if both partners or just the male partner travelled. See guidance on preventing infection by sexual transmission.
Advice for pregnant women recently returned from an affected country or area who have not experienced symptoms
- Any woman who is worried should contact their GP or midwife. They will advise on what assessments are required; these might include ultrasound scanning and taking a blood sample.
If a sexual partner has been to a Zika-affected country (see Table 2)
- If a female partner is pregnant, condom use is advised for travelling partners to reduce the risk of transmission during travel and for the duration of the pregnancy (see Table 2).
- For couples considering pregnancy, consistent use of effective contraception to prevent pregnancy and barrier methods for vaginal, anal and oral sex are advised during and after travel to reduce the risk of sexual transmission which could result in the developing fetus being exposed to Zika virus (see Table 2).
|Country risk rating||Advice for pregnant women and their sexual partners||Advice for couples considering pregnancy|
Pregnant women and their sexual partners should consistently use barrier methods (e.g. condoms) during and after travel to reduce the risk of the developing fetus being exposed to Zika virus.
Barrier methods should be continued for the duration of the pregnancy if the couple both travelled, or if just the male partner travelled.
If the pregnant woman is the only traveller, barrier methods should be considered for 2 months after travel to prevent sexual transmission to her partner.
Couples should use barrier measures even in the absence of Zika symptoms.
Consistent use of effective contraception and consideration of barrier methods for vaginal, anal and oral sex during and after travel is advised to reduce the risk of conception and sexual transmission which could result in the developing fetus becoming infected with Zika virus.
These measures should be used while travelling and if:
Very low risk
No specific precautions required
No specific precautions required
- Last possible Zika virus exposure is defined as the later of either the date of leaving a country or area with risk for Zika virus transmission, or the date on which last unprotected sexual contact with a potentially infectious partner took place.
- There is a theoretical risk of female to female transmission of Zika virus. To reduce the risk of transmission to their partner, females with Zika symptoms may consider using condoms or other barrier methods during sexual activity.
- PHE may revise this sexual transmission advice as more information becomes available. Anyone with concerns regarding potential sexual transmission of Zika virus should contact their GP for advice.
© Crown copyright 2019 Public Health England. Zika virus risk: algorithm for assessing pregnant women. London: Public Health England. Updated February 2019. Available from: www.gov.uk/government/publications/zika-virus-interim-algorithm-for-assessing-pregnant-women-with-a-history-of-travel
© Crown copyright 2019 Public Health England. Zika virus: travel advice. Updated February 2019. Available from: www.gov.uk/guidance/zika-virus-travel-advice
© Crown copyright 2019 Public Health England. Health advice for women returning from a country or area with risk for Zika virus transmission. London: Public Health England. Updated February 2019. Available from: assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/781232/Zika_health_advice_pregnancy_leaflet_comments.pdf
Contains public sector information licensed under the Open Government Licence v3.0.