Zika virus infection remains a risk to travelers who are pregnant or who may conceive in the near future. Women of reproductive age should discuss Zika prevention strategies with their doctor before planning a trip to Zika-affected countries, according to infectious disease specialists from Emory University School of Medicine.

An article discussing the current state of Zika virus is scheduled to be published in Annals of Internal Medicine. The authors are all in the infectious disease division of Emory University School of Medicine’s Department of Medicine: infectious disease fellow and former preventive medicine resident Daniel Graciaa, MD, MPH; instructor Matthew Collins, MD, PhD; and assistant professor Henry Wu, MD. Wu is director of the Emory TravelWell Center.

The prevalence of Zika virus has decreased since its peak in 2016. However, the actual risk of infection for individual travelers is difficult to predict, and the risk of localized outbreaks will likely persist for the immediate future, the authors warn. A confounding aspect of Zika virus infection is that up to 80% of cases may be asymptomatic.

In concurrence with recommendations from the Centers for Disease Control and Prevention (CDC), the authors advise pregnant women not to travel to Zika-affected areas. Returned travelers should take precautions against conception until 2 months after travel or symptomatic infection for women, and 6 months for men.

The authors note that new prevention strategies are needed, as couples may be reluctant to follow these recommendations given time constraints for conception or frequent travel to Zika-affected areas. Tests now under development and improved surveillance data may help travelers make more informed decisions in the future.

The authors recommend that patients contemplating travel to Zika-affected areas should engage in shared decision-making with their care providers regarding travel plans and testing for Zika infection and continue to take precautions against infection.