17 Oct 2018

Zika virus transmission: Change to risk category, Rajasthan, India

The first cases of Zika virus are reported from Rajasthan, India Zika virus transmission: Change to risk category, Rajasthan, India

The Ministry of Health and Family Welfare, Government of Rajasthan, reported the first confirmed cases of Zika virus (ZIKV) in Jaipur, Rajasthan. As of 8 October 2018, a total of 22 laboratory confirmed cases have been detected; public health measures including extensive surveillance and insect control measures are underway [1].

In 2017, the first laboratory confirmed case of ZIKV in India was detected in Ahmedabad, Gujarat followed by further cases in the state which were identified during surveillance and screening measures [2,3]. In 2017, transmission of ZIKV was also confirmed in Tamil Nadu state [4]. 

India is generally categorised by Public Health England and NaTHNaC as a country with moderate risk of ZIKV transmission. However, as of 15 October 2018, risk in the Indian state of Rajasthan has been upgraded to high risk for ZIKV transmission [5].

Experts agree that ZIKV is a cause of Congenital Zika syndrome if contracted during pregnancy (babies born with microcephaly i.e. a small sized head and brain with brain damage and other abnormalities). Further information about ZIKV and the rationale for travel guidance are available from Public Health England and Diseases in Brief: Zika Virus.

Detailed travel guidance can be found on the India country information: other risks page.

Advice for travellers

All travellers should avoid mosquito bites day and night. ZIKV may be a mild infection and you might not notice symptoms. 

If you are pregnant, you should postpone non-essential travel to high risk areas until after pregnancy.

You should consider postponing non-essential travel to moderate risk areas until after pregnancy.

If travel is essential, be aware of the risk, be scrupulous with insect bite avoidance day and night and seek advice from your GP or midwife on return, even if you have not been unwell.

Women should avoid becoming pregnant while travelling in, and for 8 weeks after leaving an area with active ZIKV transmission or 8 weeks after last possible ZIKV exposure. This means the date of leaving an area with high or moderate ZIKV risk, or the date on which unprotected sexual contact with a potentially infectious partner took place.
 
Couples should follow guidance on prevention of sexual transmission of ZIKV and avoid getting pregnant while travelling and for up to 6 months after return.

Further information about ZIKV and the rationale for the travel guidance are available in Diseases in Brief: Zika Virus and from Public Health England.

Detailed travel guidance can be found on the India country information: other risks page.

Advice for health professionals

Risk categories of countries and areas are subject to regular review and advice may change. Public Health England - Zika virus: clinical and travel guidance is available for health professionals undertaking pre-travel risk assessment and post travel management of the returned traveller.

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