GPs advised to test for Zika virus in patients returning from affected areas

GPs should perform blood tests for Zika virus infection on all patients with symptoms who are returning from transmission areas and refer all pregnant women for ultrasound, according to updated primary care advice.

The RCGP and BMA have backed primary care Zika advice from Public Health England (PHE) advising all pregnant women who have recently travelled to transmission areas to notify their GP, obstetrician or midwife to receive tests and monitoring.

GPs should advise women to not try to conceive for 28 days after leaving an area with active Zika transmission. This covers a 14-day incubation period and an estimated 14-day period of viraemia.

GPs are notified that pregnant women may also request letters to justify suspension of travel to affected areas on medical grounds.

Pregnant women returning from infected areas who show symptoms of the Zika virus should be tested for the infection and be referred to a local antenatal ultrasound service for a baseline fetal ultrasound.

Zika guidance

PCR blood tests and urine samples should be taken and sent to the local laboratory, with both a standard request form and a Rare and Imported Pathogens Laboratory (RIPL) form.

All other pregnant women who travelled to transmission areas should be offered a baseline ultrasound scan.

Other non-pregnant patients who are exhibiting symptoms should also be tested for the virus.

Non-pregnant patients who were diagnosed elsewhere and have now recovered do not require further investigation and should be assured that Zika virus is typically short-lived and self-resolving.

Male travellers should be advised about sexual transfer of the disease. Condom use is recommended for 28 days following return from a transmission area if they experienced no Zika-like symptoms and for at least six months following recovery is compatible symptoms or laboratory-confirmed Zika virus is reported.

Zika virus has now been detected in semen of three infected male patients and two cases of male-to-female sexual transmission have been reported. The sexual transfer risk, although still largely unknown, is considered to be very low.

Prevention

There is no vaccine or drug to prevent Zika infection. Travellers should take insect bite avoidance measures to reduce their risk of infection, such as by applying DEET to exposed skin and wearing light cover-up clothing.

A total of six cases have been confirmed in UK travellers between 2014 and the end of January 2016. All had recently visited South and Central American countries, including Colombia, Guyana, Venezuela, Suriname and Mexico.

The majority of people affected have minimal to no symptoms, but those that do typically exhibit a mild febrile disease over two to seven days. Usual symptoms include a low-grade fever, joint pain, rashes, conjunctivitis, headaches, eye pain and muscle pain.

But mounting evidence has linked the virus to microcephaly and other congenital brain malformations when women are infected during pregnancy.

Photo: iStock

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

GP training: Useful resources when preparing for the AKT

GP training: Useful resources when preparing for the AKT

Dr Branavan Anandasundaram highlights useful resources that GP trainees can use to...

GP training: How to succeed in the AKT

GP training: How to succeed in the AKT

Dr Branavan Anandasundaram passed the AKT earlier this year with a score of 89.5%....

Medico-legal: Advice on prescribing opioids

Medico-legal: Advice on prescribing opioids

The MDU's Dr Ellie Mein advises on how to avoid the medico-legal risks associated...

Map: How CQC ratings for general practice vary across England

Map: How CQC ratings for general practice vary across England

An overwhelming 95% of GP practices in England are rated either 'good' or 'outstanding'...

Rise in GP waiting times 'driving more patients to Google health advice'

Rise in GP waiting times 'driving more patients to Google health advice'

Longer waits for GP appointments may be pushing more patients to search for health...

GP locum rates continue to rise in most parts of the UK, poll reveals

GP locum rates continue to rise in most parts of the UK, poll reveals

Average hourly rates received by locums have risen across England over the past 12...