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Zika Advice for Travellers - Revised Risk Categories

29 July 2016

(There is a more current update posted here)

In May 2015, Brazil announced an outbreak of the mosquito-borne flavivirus Zika virus (ZIKV). Since then the virus has spread widely. To date, 53 confirmed cases of ZIKV infection have been reported in UK travellers linked to this outbreak.

Health Protection Scotland (TRAVAX) working in collaboration with Public Health England (NaTHNaC) has defined four categories of risk of ZIKV transmission to assist with delivering country specific travel advice in the face of changing ZIKV epidemiology. These categorisations are specifically to inform pre-travel advice.

Countries/territories/areas are assigned into categories of risk of ZIKV transmission as determined by data provided by ECDC. The outbreak of ZIKV is evolving; the risk of transmission in countries/territories/areas changes as the outbreak progresses and these categories are regularly updated. For the purposes of pre-travel guidance, the risk has been defined as below:

All travellers to countries that have reported ZIKV infection must consider:

  • Mosquito bite avoidance measures
  • Travel insurance
  • Any additional recommendations for pregnant travellers, women of childbearing age and for preventing onward sexual transmission (based on risk of ZIKV transmission at destination).

Main points to note in the new guidance

Recommendations for Pregnant Women

Until the link between ZIKV and adverse pregnancy outcomes has been fully clarified pregnant women should:

  • Postpone non-essential travel to High risk country/territory/areas.
  • Consider postponing non-essential travel to Moderate risk country/territory/areas.
    Although transmission is not widespread in these countries, pregnant women may still be exposed to infection.
  • For travel to Low and Very Low country/territory/areas there is no ZIKV specific advice against travel, but it requires to be an informed decision after individual risk assessment

Further information and detailed explanation of these categories and associated travel advice can be found on the TRAVAX ZIKV Infection page

Recommendations for preventing sexual transmission.

ZIKV has been detected in semen and in the female genital tract. A small, but growing number of probable hetero and homosexually transmitted cases of ZIKV infection have been reported. To reflect the growing evidence on sexual transmission, although the risk remains low, guidance on preventing sexual transmission of ZIKV has been updated:

Asymptomatic male and all female travellers (pregnant, non-pregnant, asymptomatic or symptomatic) should use contraception and condoms during travel and for 8 weeks on return if sexually active, to reduce the risk of sexual transmission of ZIKV, particularly around the time of conception and during pregnancy.

Men who develop symptoms should continue to use condoms for 6 months if sexually active after return.

Further Resources