Zika, contraception and the 2016 Olympics

FSRH provides an overview to the Zika Virus and signposts to relevant guidance for those wishing to travel to Brazil for the 2016 Olympics.

The Zika virus has been a hot news topic over the last few months. The World Health Organization has declared it a “public health emergency of international concern”. It is of particular relevance to sexual and reproductive healthcare as it has important implications for pregnancy and childbearing and may be transmitted sexually.

There is no medicine or vaccine that prevents Zika virus. NHS fitfortravel advises travelers to potentially affected countries to avoid mosquito bites through using repellents containing at least 50% DEET, wearing loose, cover-up clothing and using insecticide-impregnated bed nets and air conditioning at night. Women who are pregnant are advised to postpone non-essential travel to all countries with active Zika virus transmission at present. The RCOG currently provides advice for women who are pregnant and do decide to travel.

For women who are not pregnant and wish to travel to Brazil for the 2016 Olympics, FSRH’s Clinical Effectiveness Committee echoes the Government’s advice that women should follow National Travel Network Centre guidance, advising that:
“[…]women who plan to travel to the Olympic Games in Rio in August should ensure that they have no risk of pregnancy at the time of travel, during their stay and for 28 days after their return to the UK. It is therefore recommended that women commence effective contraception well in advance of travel.”

Contraception advice for individuals travelling to Brazil for the 2016 Olympics and their partners travelling to Brazil for the 2016 Olympics.

Countries that have active Zika virus transmission at the time of writing are largely confined to Central and South America and the Pacific Islands).
Women living in some affected countries, including El Salvador, Colombia, Ecuador and Jamaica have been advised to avoid pregnancy, possibly until 2018. However, for many women in countries in Latin America, access to family planning is poor and access to emergency contraception and abortion legally restricted. Many births are the result of intended pregnancies, highlighting the need for increased access to contraception if woman are to heed this advice.

The Zika virus is a mild disease that can cause general malaise, mild fever, skin rash, conjunctivitis, muscle and joint pains, or headache, but many people are unaware they have it. It is spread by bites from the Aedes mosquito (which usually bite during the day). However, there is also a small risk of spread through sexual transmission and blood transfusion. Recently, a possible link between Zika infection and pregnancy complications has been recorded in Brazil, with babies being born with microcephaly (smaller than normal head). Recent research has strengthened the association between Zika virus and both microcephaly, other fetal malformations and neurological disorders.

With increasing numbers of countries being affected by Zika virus and more research showing the potential effects of Zika on pregnancy, this is a constantly evolving situation. The outbreak highlights the importance of contraception and family planning services- both for people travelling to potentially affected areas, and for women living in the countries affected.

Read the overview in full below.