Patient discussions

General information

Mosquito bite prevention

  • Patients should be advised to avoid mosquito bites in at least the first week of illness by using the following measures: [133] [134]

    • Wearing clothes that cover as much of the body as possible (e.g., long-sleeved shirts and long trousers); clothes may be treated with permethrin

    • Staying in places with air conditioning or that use window and door screens to keep mosquitoes outside

    • Sleeping under a mosquito net (possibly impregnated with insecticide)

    • Using approved insect repellent (if ≥2 months of age); can be used safely in pregnant and breastfeeding women when used as directed EPA: find the insect repellent that is right for you

    • Covering cribs, strollers, or baby carriers with a mosquito net

    • Emptying, cleaning, or covering containers that can hold water to reduce areas where mosquitoes can breed including in and around households.

    • CDC: mosquito bite prevention for travelers

  • Travellers returning from areas of ongoing transmission should use mosquito bite prevention measures for 3 weeks after returning to prevent spread to uninfected mosquitoes. [134]

Sexual health

  • Recommendations for pregnant couples: the CDC recommends that pregnant women with male or female sex partners who live in or have travelled to an area with active transmission should abstain from sex (vaginal, anal, oral) or use barriers against infection (e.g., condoms) during sex for the duration of the pregnancy. Additionally, the CDC recommends that pregnant women talk with their healthcare providers about their sex partner’s potential exposures to Zika virus and symptoms of Zika-like illness. [139]

  • Recommendations for non-pregnant couples: the CDC recommends that if only the female partner travels to an area with risk for transmission, the couple should use condoms and abstain from sex for at least 2 months after the female partner's symptom onset (if symptomatic) or last possible exposure (if asymptomatic). However, if the male partner (or both partners) travel to an area with risk for transmission, the couple should use condoms and abstain from sex for at least 3 months after the male partner's symptom onset (if symptomatic) or last possible exposure (if asymptomatic). [139]

  • The WHO still recommends safe sex practices for at least 6 months in men or women returning from areas with active transmission, regardless of whether they are symptomatic or asymptomatic. [70]

Zika and pregnancy

  • Women living in endemic areas should consult local health authorities for advice before becoming pregnant. In Brazil, there are no formal recommendations to avoid pregnancy because of the Zika virus outbreak; the choice to get pregnant is regarded as a personal decision. [142]

  • The CDC has produced information for pregnant women and Zika virus infection:

Travel advice

  • The CDC recommends that pregnant women should not travel to any area where there is a risk of Zika virus infection, including: [144]

    • Areas where the virus has been newly introduced or re-introduced and local transmission is ongoing

    • Areas where the virus was endemic (present before 2015) and there is no evidence that transmission has stopped

    • Areas where the virus is likely to be circulating but has not been documented.

  • To help pregnant women and others identify areas of Zika risk, the CDC has produced an interactive map that allows people to search for location-specific information and travel recommendations:

  • Advice varies internationally and travellers should stay informed about Zika virus outbreaks:

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