Zika virus is spread via mosquito bites, the common symptoms are pyrexia, rash, arthralgia and conjunctivitis. The illness is usually asymptomatic or causes mild symptoms for up to a week. Hospitalisation is uncommon.
In May 2015 the first confirmed Zika virus infection in Brazil was reported. The outbreak in Brazil has resulted in reports of Guillain-Barre syndrome and pregnant women giving birth to babies with congenital infection, abnormalities (including microcephaly) and poor pregnancy outcomes.
Advice from the Rare and Imported Pathogens Laboratory, Public Health England, Porton:
GPs (and HPTs) should be directed to PHE’s guidance for GPs and, if appropriate, the RCOG interim guidance for pregnant women. If they need further help then they should be contacting their local Trust Microbiologist/Virologist/ID physician.
We would expect that you, the local Infection specialists, would be able to address most GP and local obstetric queries and for those you can’t, as ever, you could call us on the general RIPL number 01980 612348 or, for immediate management/diagnostic advice on an acutely sick patient, on the IFS number.
Essence of the guidance:
Current Zika-like symptoms (that began whilst in affected country or within 2/52 of leaving) and pregnant: test blood and urine
Current Zika-like symptoms (that began whilst in affected country or within 2/52 of leaving) and not pregnant: test blood only
(Note that in acutely sick returning traveller, the broader differential incl malaria needs to be considered, AS USUAL)
Previous Zika-like symptoms (that began whilst in affected country or within 2/52 of leaving) and pregnant: don’t test (U/S follow up)
Previous Zika-like symptoms (that began whilst in affected country or within 2/52 of leaving) and not pregnant: don’t test
Patients should be tested only if they have current symptoms, irrespective of duration.
RIPL are receiving considerable numbers of samples. Note that if the form is very poorly completed and, in particular, if there is no indication that the patient has current Zika-like symptoms, the sample may be stored without testing.
Information on Zika virus can be found via links on our Guideline page or below:
Zika virus resources
Countries and territories with active Zika virus transmission (23/01/2016, source CDC):
- Cape Verde
- El Salvador
- French Guiana
- Puerto Rico
- Saint Martin