You may remember the concerns around the Zika virus during the Rio Olympics but did you know how much it could impact on your fertility?
Zika virus infection, a condition mainly transmitted by mosquitoes, has been declared an international public health emergency by the World Health Organisation (WHO).
The infection is a mild flu-like illness, but has devastating impact on the health of an unborn child if either parent has been exposed to the virus – it causes microcephaly, which is a birth defect where a baby's head is smaller than expected when compared with other babies of the same sex and age.
Toby Long, Associate Professor in Paediatrics at Georgetown University, Washington DC, USA, said: "Children who have been exposed to Zika and are born with microcephaly are at high risk for a range of disabilities, including physical, language, and cognitive." These disabilities persist throughout their lives.
There is currently no medication to treat Zika infection or vaccination against it.
And in parts of the USA, Africa and Asia, the virus is still in active transmission, which means it is still being spread.
As a result, it's important to be aware of the presence of Zika when you are travelling.
Anyone can be infected by the Zika virus, but health professionals are most concerned about men and women of reproductive age who travel to Zika-affected regions.
It particularly affects people who are trying to conceive and woman who are already pregnant.
If you are in these categories and have travel plans this year, the first thing you need to do is check if Zika is active in the country you are travelling to - use the NHS Fit for Travel website.
If you are not pregnant or planning to conceive, there is no need to avoid travel, as complications from Zika are rare, Professor Whitworth, Professor of International Public Health at the London School of Hygiene & Tropical Medicine, told NetDoctor.
However, it is important to make sure you still do the following:
- Avoid mosquito bites by wearing loose-fitting, long-sleeved shirts and trousers and using mosquito repellent, says Professor Whitworth. Aedes aegypti mosquitos, which carry the Zika virus, are most active during the day, so take extra precautions at these times.
- The virus can sometimes be transmitted sexually, so avoid unprotected sex and start using barrier protection even before travelling, a spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG) told NetDoctor.
- Continue using condoms after you've returned from travel, adds Professor Whitworth – women should use barrier protection for 8 weeks after returning, while men should use barrier protection for six months after returning.
- If you're a woman who has recently returned from an area with active Zika transmission and are experiencing symptoms such as a fever, rash or flu-like illness, seek medical attention immediately, advises the RCOG spokesperson.
If you are pregnant or trying to conceive, avoid non-essential travel to areas with high or moderate Zika virus transmission.
Airlines may offer reimbursement or offer to rearrange your holiday for another time.
If you can't avoid travel, make sure you do the following:
- Use condoms during and after your stay – for six months after returning for men and eight weeks after returning for women
- Protect yourself from mosquito bites (see above on how to do this)
- Get tested for the Zika virus during your stay or soon after you get back, advises Jutta Wohlrab, an international midwife and bestselling author. Guidance from Public Health England recommends that GPs should offer blood tests for Zika virus infection on all patients returning from Zika-affected regions who are showing symptoms, while pregnant women should be offered an ultrasound.
- Seek psychosocial support, says Ana Ayala, global health law LL.M. programme director at Georgetown Law's O'Neill Institute for National and Global Health Law. She told NetDoctor that the WHO wants governments to provide psychosocial support to people affected by Zika to help "build public awareness about the risks of Zika and ways of preventing getting infected, and ensure the necessary care and support to affected individuals… to address possible stigma and discrimination that affected individuals might face."
The WHO's website currently lists countries in Europe as being at moderate risk from Zika – including France, Italy and Malta – see their website for a comprehensive list.
Professor Whitworth said: "Zika virus is mainly transmitted by the bite of an infected female Aedes aegypti mosquito.
"There is no risk of the virus being spread by mosquitoes in the UK as Aedes aegypti are not found here because our climate is too cold. So, at present in the UK and for the foreseeable future the risks of Zika are entirely travel-related."