What advice should I provide to patients regarding mosquito bite prevention in areas where Zika virus is endemic?

Advice for patients to prevent mosquito bites in areas endemic for Zika virus:

• Advise patients that Zika virus is transmitted primarily by Aedes mosquitoes, which bite mainly during the day, especially mid-morning and late afternoon to dusk, so mosquito bite prevention should focus on these times ¹.
• Recommend wearing full-length, loose-fitting, light-coloured clothing covering arms and legs to reduce skin exposure to mosquito bites ¹,².
• Encourage the use of effective insect repellents containing 50% DEET on exposed skin, suitable for people over 2 months old; DEET should be applied after sunscreen if both are used ¹,².
• Advise patients to avoid contact of DEET with plastics such as watch straps or jewellery, as it can cause damage ¹,².
• Suggest using physical barriers such as insecticide-treated bed nets, window and door screens, and mosquito nets especially if sleeping outdoors or in unscreened accommodation, although Aedes mosquitoes bite mainly during the day ¹,².
• Inform patients to stay in well-screened or air-conditioned areas when possible to reduce mosquito exposure ¹.
• Emphasize the importance of avoiding pregnancy during travel to Zika-affected areas and for 2-3 months after returning, due to the risk of severe fetal complications including microcephaly and congenital Zika syndrome ¹.
• Advise sexual partners of travelers to use barrier contraception for at least 2-3 months after travel or symptom onset to prevent sexual transmission of Zika virus ¹.
• Highlight that while Zika infection is often mild or asymptomatic, prevention of mosquito bites is critical to reduce transmission risk and protect vulnerable populations such as pregnant women ¹[(Garnica et al., 2024)].

Summary: Patients should be counselled on rigorous daytime mosquito bite prevention using physical barriers and chemical repellents, avoidance of pregnancy during and shortly after travel to endemic areas, and sexual transmission precautions. These measures align with UK Public Health England guidance and are supported by recent literature emphasizing the importance of vector control in Zika virus endemic regions ¹[(Garnica et al., 2024)].