Zika-virus

What we know

  • No vaccine exists to prevent Zika virus disease (Zika).
  • Prevent Zika by avoiding mosquito bites.
  • Mosquitoes that spread Zika virus bite mostly during the daytime.
  • Mosquitoes that spread Zika virus also spread dengue and chikungunya viruses.
  • Prevent sexual transmission of Zika by using condoms or not having sex
  • Pregnant women can be infected with Zika virus.
    • The primary way that pregnant women get Zika virus is through the bite of an infected mosquito.
    • Zika virus can be spread by a man to his sex partners.
  • A pregnant woman can pass Zika virus to her fetus.
    • Zika virus can be passed from a pregnant woman to her fetus during pregnancy or at delivery.

What we do not know

  • If a pregnant woman is exposed
    • We don’t know how likely she is to get Zika.
  • If a pregnant woman is infected
    • We don’t know how the virus will affect her or her pregnancy.
    • We don’t know how likely it is that Zika will pass to her fetus.
    • We don’t know if the fetus is infected, if the fetus will develop birth defects.
    • We don’t know when in pregnancy the infection might cause harm to the fetus.
    • We don’t know whether her baby will have birth defects.
    • We don’t know if sexual transmission of Zika virus poses a different risk of birth defects than mosquito-borne transmission.

February 2016

On 1st February 2016 the World Health Organization declared that the recent cluster of microcephaly (abnormally small head) cases and other neurological disorders reported in Brazil, following a similar cluster in French Polynesia in 2014, constitutes a Public Health Emergency of International Concern.

This allows for a coordinated international response to improve surveillance and detection, to intensify the control of mosquito populations, and to fast track the development of diagnostic tests and vaccines. The World Health Organization has found no public health reasons for restrictions on travel or trade to prevent the spread of Zika virus.

However, because of the apparent association of Zika virus infections with an increase in the number of new cases of microcephaly national health authorities, including the Australian Department of Foreign Affairs and Trade, advise that pregnant women should avoid travelling to Zika affected countries. It is impossible at this time to say for how long such advice is valid.

The rapid rise in the number of countries detecting and reporting locally transmitted Zika infections means that current published lists are likely to be incomplete. It should be assumed that South Pacific and Caribbean islands are likely to be infected as well as Central and South American countries in the tropical belt.

For those pregnant women who do travel to a potentially infected country or region, as well as for everyone else, anti-mosquito precautions are of prime importance. These include the use of personal insect repellants containing DEET (such as Repel) or Picaridin, and the use of Permethrin impregnated outer clothing and bed nets where these are needed. DEET is safe for use on the skin of pregnant women.  Other methods of repelling mosquitoes such as wristbands, Vitamin B etc. are not as effective as personal repellants.

A meticulously studied cohort of 119 virologically proven adult cases of Zika virus infection in Rio de Janeiro has defined the clinical syndrome more precisely than before. The most common symptoms were rash lasting a median of 5.5 days (97%), pruritus (79%), headache (66%), arthralgia (63%), myalgia (61%), and non-purulent conjunctivitis (56%). Fever was present in only 36% of cases and lasted for less than 1 day.

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What is Zika Virus?

Zika virus infection is caused by a virus which is spread by the bite of an infected mosquito. The illness is typically mild and lasts only a few days. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon although there have been increasing reports of a causal link to more severe complications, such as microcephaly, Guillain-Barre syndrome, and other autoimmune and neurological disorders.

Information for Travellers

  1. Zika virus is transferred to humans by day-biting Aedes mosquitoes. Aedes mosquitoes breed in small collections of water. They prefer to bite humans, primarily feed outdoors near dwellings. They are aggressive daytime biters, but can also bite indoors and at night. Other virus infections such as dengue and chikungunya fevers are also conveyed by these species of mosquitoes.
  2. Most infections produce no symptoms and have been detected retrospectively by blood testing.
  3. Infections can produce a mild-to-moderate fever, headaches, muscle aches and pains similar to the symptoms of influenza as well as the early stages of dengue and chikungunya fevers. A measles-like skin rash and conjunctivitis can also occur. Symptoms should abate in 3 – 7 days.
  4. There is increasing evidence that Zika infection in the developing foetus can result in a condition of microcephaly with possible mental retardation. Although the association is not absolutely proven it is wiser and safer at this stage to take precautions either by deferring pregnancy if it is intended to travel to an infected country, or by deferring travel if pregnant.
  5. A few cases of a neurological complication called Guillian-Barre syndrome resulting in muscle paralysis have been reported but the association is not certain.
  6. There is no specific treatment but paracetamol can help with the fever and muscle aches, and keeping up fluid intake is essential.
  7. There is currently no vaccine to prevent infection.  Prevention of mosquito bites is the only method of preventing infection.  Personal repellants containing DEET or Picaridin are essential. Outer clothing can be soaked in the safe insecticide Permethrin.
  8. When using both sunscreen and insect repellent, apply the sunscreen first and then the repellent.