66 UK patients diagnosed with Zika virus after travelling to affected areas

A total of 66 cases of Zika virus infection have been identified in UK travellers since 2015, and GPs may expect more exhibiting symptoms this summer as patients return from holidays in South America and the Caribbean.

Guidance from Public Health England (PHE) urges patients returning with symptoms from active Zika transmission areas to visit their GP, particularly if they are pregnant.

These include many countries in South and Central America – including Brazil, host of the Rio 2016 Olympic Games – as well as the Caribbean, Melanesia, Micronesia and Polynesia.

The guidance, backed by the RCGP and BMA, says GPs should perform blood tests for Zika virus infection on all patients with symptoms who return from transmission areas. Pregnant women should be referred for ultrasound.

The mosquito-borne virus does not occur naturally in the UK, but a total of 66 cases have been diagnosed in UK travellers since 2015, PHE confirmed. It is recognised by the WHO as a 'public health emergency of national concern'.

Zika virus

Zika infection is typically mild and short-lived, and many patients are asymptomatic. But the virus is known to cause microcephaly, Guillain-Barré syndrome and other congenital anomalies when pregnant women are infected.

The PHE guidance warned that GPs should not discount other travel-associated infections such as dengue, chikungunya or malaria in patients with symptoms.

GPs should advise pregnant women intending on traveling to active transmission areas to postpone travel until after pregnancy, if possible.

Women who visit a transmission area should avoid becoming pregnant for up to eight weeks following their return.

Men returning from infection areas should be advised to maintain condom use with female partners for up to eight weeks if they did not experience symptoms and six months if they did to cut the risk of sexual transmission of the disease, which is considered rare.

Sexual transmission

If their partner is pregnant, men should use condoms during vaginal, anal and oral sex for the duration of pregnancy.

These ‘precautionary’ recommendations come after Zika virus RNA was detected in a patient’s semen 62 days following the onset of symptoms.

Incidences of female-to-male and male-to-male sexual transmission have also been reported, but both are considered to be ‘very rare’.

PHE said: ‘Those working in primary care may be consulted by patients travelling to or returning from areas with active Zika virus transmission. Pregnant women may also request letters to justify suspension of travel to affected areas on medical grounds.

‘In such cases, those working in primary care can refer to updated National Travel Health Network and Centre (NaTHNaC) advice, which has been produced in response to the on-going Zika virus outbreak mostly focussed in South and Central America and the Caribbean.’

CPD on advising patients on the Zika virus on MIMS Learning

Photo: iStock

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