The guideline
The recent outbreak of Zika has been linked with an increase in cases of congenital malformations such as microcephaly. This health protection guidance from Public Health England looks at reducing the risk in pregnant women following travel abroad.
Key points for GPs
• Zika is a mosquito-borne infection causing a mild, short-lived febrile disease, with symptoms including low-grade fever, joint pain and a rash.
• Any pregnant woman returning from Central or South America, or the Caribbean, should be referred for foetal ultrasound.
• PCR testing can detect Zika virus, but only if the patient is symptomatic.
• If travel to affected areas is unavoidable, people should be advised on insect bite avoidance. This includes using a repellent containing N,N-diethyl-meta-toluamide (DEET) on exposed areas, and light cover-up clothing, day and night.
• Women who have returned from an active Zika area should not attempt to conceive for 28 days.
• Men should use a condom if having sex within 28 days of returning from a Zika-affected area.
Practical issues
Check for changes to recommendations as new evidence emerges.
Expert comment
Berkshire GP and president of the British Global and Travel Health Association, Dr George Kassianos, says: ‘Management of returning travellers, as well as precautions travellers need to take are well covered. It is important GPs and their teams remain vigilant if we see unwell patients returning from affected areas.
‘The majority of infected patients will present with mild symptoms, but some cases may be severe. Symptoms that should alert us to a Zika infection include myalgia, joint pain, headache, eye pain, fever, and there may be a rash and itch.’
The guideline
Public Health England. Zika virus infection: guidance for primary care. London: PHE; 2016
