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(This is the most current advice and updates the news item of 29 July 2016)
In May 2015, Brazil announced an outbreak of the mosquito-borne flavivirus Zika virus (ZIKV). Since then the virus has spread widely. To date, 263 travel associated cases
of ZIKV infection have been reported in UK travellers linked to this outbreak.
Whilst ZIKV is predominantly spread by the bite of infected Aedes mosquitos, cases of sexual transmission of the virus have been documented, although the risk of this appears to be low. ZIKV has been found in the semen of symptomatic males up to 6 months after the infection has resolved although to date, sexual transmission has not been recorded beyond 2 months after infection. ZIKV has not been found to persist in the female genital tract beyond 3 weeks. The majority of cases of sexual transmission of ZIKV have occurred from men with symptomatic infection, however sexual transmission of ZIKV from an asymptomatic man to his female partner has been documented twice. There is a very low risk of female to male sexual transmission.
In September, the WHO updated their guidance on preventing sexual transmission of ZIKV and in an attempt to simplify the messaging around advice, recommended that all travellers (whether male/female or symptomatic/asymptomatic) should use safe sex practices for 6 months after return from areas with active ZIKV transmission. WHO acknowledge that this approach is highly precautionary, and it has not been adopted in full by all countries, including the UK and USA who advise a shorter time period of risk for females in accordance with the evidence.
After careful consideration the UK has now adopted the WHO guidance for men. This means that men, irrespective of symptoms are being advised to use condoms during travel and for 6 months afterwards to avoid the risk of sexual transmission of ZIKV, particularly during conception or pregnancy. The advice for females has not changed, and an 8 week window is advised.
This will allow straightforward communications on preventive action, until further data is available on which to base precise estimates of risk.
This decision also reflects the seriousness of any Congenital Zika Syndrome that may occur as a result of sexual transmission.
A TRAVAX Zika Virus Infection FAQ has been produced giving additional explanation for men, and their partners, who have returned from an area with ZIKV more than 2 months ago, who have remained asymptomatic and will be affected by this change in guidance.
All travellers to countries that have reported ZIKV infection must consider:
Use contraception and condoms during travel and for 8 weeks afterwards to avoid the risk of ZIKV in an unplanned pregnancy and prevent sexual transmission.
Use condoms during travel and for 6 months afterwards to avoid the risk of sexual transmission of ZIKV, particularly during conception or pregnancy.
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