Zika virus - travel advice if you're pregnant or trying for a baby
Trying to conceive or pregnant and planning a holiday this year? You might be at risk of the Zika virus, which can cause serious birth defects, in particular, microencephaly. Cases have recently been reported in Europe and women who are pregnant or trying to conceive have been warned not to travel to areas with a high risk of transmission.
Zika fever is a viral illness transmitted by Aedes mosquitoes. Although the infection in an adult is mild, it can cause severe harm to babies. Zika is associated with microcephaly, a condition in which the head and brain are unusually small, and which can occur in the womb or in infancy. For this reason, women who are pregnant or trying to conceive are being advised to avoid visiting locations where cases of Zika have been reported.You can get private blood tests when you return. We went on honeymoon to Florida last year, in the neighbourhood of an active Zika outbreak and took all precautions such as DEET, nets, homeopathic repellents etc. Although we were careful we both still had a couple of bites. When we returned we paid for private blood tests which confirmed neither of us had been infected and therefore were ok to continue TTC.
I'm pregnant and planning to travel to a Zika infected country, should I cancel my holiday?
Currently the FCO advises that travellers who are pregnant (in any trimester) or planning to become pregnant should consider avoiding travel to an area where active Zika transmission is being reported.
Will my insurance cover me if I have to cancel my trip?
ABTA have advised that if you are already pregnant and have a doctor's certificate saying you should not travel, your insurance claim should be straightforward. If you are pregnant and book a trip in a month or two, you may find your insurance company refuses to reimburse you on the grounds that you should have been aware of the dangers.
Can I minimise my chances of catching Zika if I am trying to conceive?Thailand's risk is classed as high because it's had Zika reported within the last three months in local areas. The nurse told us there's no way around it and to take extra care when we're back and to not TTC for six months.
There is currently no vaccination or medication available for Zika. The Aedes mosquito which is responsible for transmitting the Zika virus also carries chikungunya, dengue and yellow fever, so you should avoid getting bitten as far as possible anyway. They predominantly bite during the day, particularly at mid-morning and around dusk, but typically avoid areas above 2,000 metres above sea level.
Use a DEET-based repellent on exposed skin and cover up with light clothing. If you're wearing sunscreen, apply the repellent afterwards and ensure it's 30 SPF or above to compensate for the fact that DEET will reduce its effects. If you're pregnant, you'll likely want to stay cool and out of the sun anyway.
The FCO says “Whilst almost all cases of Zika are acquired via mosquito bites, a small number of cases have occurred through sexual transmission or by transmission from mother to foetus via the placenta.”
If your partner has been exposed to the virus, you should use barrier methods of contraception during travel and pregnancy to reduce the risk of transmission.
If you're planning to become pregnant within six months after travel, you should talk to your doctor to assess the risk of infection for you and your partner. They will likely run some blood tests if you think you've been exposed. Due to the serious effect Zika has on a developing foetus, you should avoid getting pregnant using the most effective contraceptive method for you during the period of potential exposure There is some evidence that the Zika virus can remain present in sperm for up to six months after initial exposure. If you catch the virus yourself and you're planning to get pregnant, you should get tested and avoid getting pregnant for eight weeks.
What should I do if I think I've got Zika?
If you have just returned from a country where Zika has been reported and you're pregnant, then you should inform your obstetrician or midwife straight away.
Otherwise, WHO advice states “Zika virus disease is usually relatively mild and requires no specific treatment. People who contract the with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice.” The incubation period is not clear, but is thought to be a few days. The symptoms are usually mild and last for two to seven days.
What are the symptoms of the Zika virus?
The majority of people infected will not display symptoms – only one in four, according to WHO. For those that do display symptoms, Zika virus generally causes a mild illness lasting between two and seven days. Typical symptoms include:
- Low-grade fever
- Joint pain (with possible swelling mainly in the smaller joints of the hands and feet)
- Conjunctivitis/red eyes
- Muscle pain
- Eye pain
We're trying to conceive. Is it safe to travel to Europe?
It is thought that the warmer summer weather could bring Aedes mosquitoes (which carry the virus) to Europe. The World Health Organisation has said the risk of contracting Zika varies from country to country. The areas classified as high risk are the Madeira Island in Portugal and the northeastern Black Sea Coast.
The areas where there is moderate risk are:
- Bosnia and Herzegovina
- San Marino
Which countries in Central and South America are affected by Zika?
The World Health Organisation has now issued warnings for the following countries in Central and South America:
- Costa Rica
- Dominican Republic
- El Salvador
- French Guiana
- Puerto Rico
- Saint Lucia
- Saint Martin
- Trinidad and Tobago
- British Virgin Islands
- US Virgin Islands
Cases have also been reported in Cape Verde. The advice for travellers is being updated on a weekly basis, so check the Foreign and Commonwealth Office (FCO) website to stay informed.
Is there a Zika outbreak in Asia? Is it safe to go there if I'm pregnant?
The FCO has classified the following Asian countries as high-risk:
- Malaysia (moderate risk)
What is the risk of catching Zika in Oceania?
The countries in Oceania classified as high-risk are the following:
- New Caledonia
- Papua New Guinea
- Solomon Islands
- Tonga (moderate risk)