The Expert Committee of Travel Medicine (ECTM) recommends for
Travellers visiting countries with active ZIKV transmission should be informed about the ongoing outbreak, the possibility of sexual ZKV transmission and the risk of ZIKV infection on the foetus during pregnancy. Counselling on safer sex practice and on contraceptive methods is recommended. Protection against mosquito bites (indoors and outdoors) during daytime, evening and early night time hours (especially in the mid-morning and late afternoon to dusk) by using repellents (DEET), wearing long-sleeved shirts and long pants of light colours that should be impregnated or sprayed with an insecticide, sleeping under mosquito bed nets or in air conditioned rooms.
For the risk assessment of possible neonatal malformation while infected by ZIKV during pregnancy
- All pregnant women (regardless of pregnancy trimester) and women who wish to become pregnant or who cannot rule out a pregnancy should be advised not to travel to areas with active ZIKV transmission. If travel cannot be avoided, special pre-travel advice is necessary including advice of strict protection against mosquito bites.
- Safer sex practice for the whole duration of pregnancy, if the partner had a ZIKV exposure*
Couples and women who are planning a pregnancy:
They should avoid becoming pregnant while travelling in an area with active ZIKV transmission. As per current knowledge, to avoid sexual transmission following timeframes** after potential ZIKV exposure* are advised before trying to conceive (safer sex practice during theses timeframes):
- Women: at least 8 weeks after symptoms onset (if symptomatic) or after last ZIKV exposure* (if asymptomatic)
- Men: at least 6 months after symptoms onset (if symptomatic) or after last ZIKV exposure* (if asymptomatic)
- Discuss with their healthcare provider the period for deferring conception/pregnancy in relation to individual exposure characteristics and availability of test results.
Patients with underlying immune disease and/or severe chronic diseases
They should take maximal protection against mosquitos.
- * Definition of a ZIKV exposure: a) History of travel/residence in an area with active ZIKV transmission and/or b) unprotected sexual contact (without a condom) with a woman within 8 weeks and/or with a man within 6 months after their return from an area with active ZIKV transmission. irrespectively whether she/he had ZIKV symptoms or not.
- ** The timeframes can be considered to prolong up to 6 months for both, women and men, after potential ZIKV exposure as proposed by WHO.
- With regard to testing after ZIKV exposure, please see below section ZIKV diagnostics in Zika information file.
- Travel to areas with sporadic ZIKV transmission (outside of Central/ South America, Caribbean, Cape Verde, Singapore, Thailand, Philippines, Vietnam and Pacific Islands): pregnant women or women who are planning to get pregnant should consider postponing travel. To the current knowledge, in areas with sporadic ZIKV transmission the risk of an infection or even damage to the unborn child cannot be excluded but is estimated to be very low.
- Travellers with clinical suspicion of ZIKV infection within 3 weeks of their return from a ZIKV endemic area should seek a physician and should mention their travel destination.
- In case of travel to/ or stay in a ZIKV endemic area during pregnancy, women (asymptomatic or symptomatic) should inform their gynaecologist for further follow up.
- Pregnant women should discuss the sex partner’s possible history of having been in areas with active ZIKV transmission and history od illness consistent with ZIKV disease