Zika virus

A public health emergency of international concern has been declared by the World Health Organisation (WHO) following the recent cluster of Zika virus infections in South and Central America and the Caribbean.

What is Zika virus?

Zika virus is a mosquito born viral infection, which is closely related to dengue virus. It was first isolated in the Zika forest, Uganda, in 1947 and is known to be endemic in parts of Africa and Asia. Zika virus is also known to circulate in the Americas, and the Western Pacific. Since January, three cases have been identified in the UK, but these have all been imported cases with the patients exposed in known infected areas.

How is it transmitted?

Zika virus is transmitted through bites from an infected mosquito, and cases of sexual transmission have also been documented. Some evidence suggests there could be transmission through blood transfusions and from mother to foetus, but these modes of transmission are considered rare.

The mosquitoes predominantly bite during the day, but especially during mid-morning and late afternoon to dusk (as opposed to mosquitoes that transmit malaria, which bite at night between dusk and dawn).

What are the symptoms?

Symptoms include mild fever less than 38.5^OC, conjunctivitis, headache, joint pain and skin rash. Symptoms usually last for two to seven days.

The incubation period for Zika virus is unclear, although it is thought to be between two and 12 days following the mosquito bite. One in four people bitten will go onto develop symptoms of the infection.

There is evidence to link Zika virus during pregnancy to babies born with microcephaly (abnormally small head), so it is recommended that anyone infected with the virus during pregnancy is monitored closely. More evidence is required before this can be fully confirmed.

How infectious is it?

Zika virus is rarely contagious, and is not spread through social contact with an infected person. Only one in five people will develop symptoms following infection.

Is it treatable?

There is no specific treatment for Zika virus. Rest, hydration and analgesia are usually sufficient to treat symptoms.  Most people fully recover without any complications; however, those infected are advised to seek further medical advice if symptoms worsen. Severe disease requiring hospitalisation is uncommon.

Is there a vaccine available?

There is no vaccine available.

What precautions should I take?

Zika virus is not transmissible from person to person so normal standard precautions should be utilised.

Thorough hand decontamination should be undertaken before and after all patient contact, after the removal of protective clothing and following the cleaning of re-usable equipment and the environment. Compliance with bare below the elbows is vital for ensuring adequate hand decontamination.

Aprons and gloves must be worn during patient contact but must be removed and hands decontaminated following patient contact to limit the environmental spread of the bacteria.

After transporting a patient the ambulance surfaces and re-usable equipment should be cleaned using detergent/disinfectant wipes.

Pregnant women and Zika virus infection

Efforts are focussed on trying to prevent Zika virus infections in pregnant women or in women who are planning pregnancy. Such women should have pre-departure travel advice that includes considering avoiding non-essential travel to countries with active transmission until after pregnancy is concluded, and advice on measures that can be taken to limit infection risk when travel is unavoidable.

How do we transport patients?

There are no specific transport arrangements required for transporting patients infected with Zika virus. Transport should be undertaken as per usual process. 

What if I have been exposed?

Although there is no specific follow up or treatment required after transporting a potentially infectious patient, if you have transported a patient who you suspect to have Zika virus please notify the EOC.

Further guidance relating to Zika virus is available on the PHE website, or click here.

Published 16th February, 2016