I’ll continue to monitor and track Zika news to share with you as I learn about it. My inboxes keep filling up with Zika questions even though I think the risks to our families, if you’re not pregnant or not thinking of getting pregnant, is low. That being said, if you’re thinking of having a baby now or in the next 6 months or if you are not using contraception and are sexually active, listen up.
Last Friday, the Centers for Disease Control and Prevention (CDC) presented new guidelines for preventing the sexual transmission of the Zika virus. The news and recommendations regarding transmission and our behavior is evolving and changing rapidly as researchers, doctors and medical experts learn more about Zika. This science is not complete, but these guidelines best attempt to keep our population the safest it can be with the information we have. Here is a short rundown on the new guidelines.
New CDC Updates And Reminders About Zika:
Number one reason for this is that although daytime-biting mosquitos are the primary transmission of Zika virus (in areas with Zika — click here for info and world maps) sexual transmission of Zika has been documented here in the United States after travel/exposure —> infection). As of March 23rd, of the 273 travel-associated Zika infections documented in the US, 19 cases are in pregnant women and 6 were sexually transmitted.
The below info helps shape ways to protect yourself:
- WOMEN: If a woman has been diagnosed with Zika (or has symptoms of Zika after possible exposure) it’s recommended she wait at least 8 weeks after her symptoms first appear before trying to get pregnant. As a reminder, symptoms of Zika include rash, red eyes, joint aches, overall feeling of being unwell. Secondary reminder, and one that makes this advice a bit of a challenge to interpret, only 1 in 5 who get Zika virus will have symptoms in the first place. Therefore, if we want to be really careful consider this: if you’ve traveled to a Zika-affected area you may want to wait 8 weeks after returning home before attempting to get pregnant, with or without symptoms.
- MEN: If a man has been diagnosed with Zika (or has symptoms of the illness), he should wait at least 6 months from those first signs of the illness before having unprotected sex. This recommendation comes off news that the virus has been found live in semen 62 days. The 6 months is a conservative calculation.The CDC took the longest known risk period (about 2 months) and then multiplied that by 3 for conservative recommendations to ensure no transmission.
- MEN WHO TRAVEL AND HAVE PREGNANT PARTNERS: Men who travel to areas with Zika outbreaks need to prevent transmission to pregnant partners for the rest of the pregnancy. CDC recommends: “Men who have traveled to or reside in an area with active Zika virus transmission and their pregnant sex partners should consistently and correctly use condoms during sex (i.e., vaginal intercourse, anal intercourse, or fellatio) or abstain from sex for the duration of the pregnancy. This course is the best way to avoid even a minimal risk of sexual transmission of Zika virus, which could have adverse fetal effects when contracted during pregnancy. Pregnant women should discuss their male sex partner’s history of travel to areas with active Zika virus transmission and history of illness consistent with Zika virus disease with their health care provider; providers can consult CDC’s guidance for evaluation and testing of pregnant women“
- The CDC is NOT recommending that that men and women living in Zika-affected regions postpone pregnancy all-together like other countries (think Ecuador).
- Infectious Disease experts feel that a Zika virus infection in a woman who is not pregnant would not pose a risk for birth defects in future pregnancies after the virus has cleared from her blood (roughly about a week after infection is over).
- They have also updated their Question/Answer page that is chalk full of helpful information.
Blood Testing For Suspected Zika Virus:
For Men, at this time, CDC advises that testing of exposed, asymptomatic men (men with no Zika symptoms but who have traveled) for the purpose of assessing risk for sexual transmission is not recommended.
For men and for women, regardless of pregnancy status, get tested if you develop two or more of the following symptoms during or within two weeks of travel to an area of active Zika virus transmission OR within two weeks of unprotected sex with a man who tested positive for Zika virus or had symptoms of Zika infection during or within two weeks of return from travel to an area with Zika transmission:
- acute onset of fever
- maculopapular rash (red, raised spotty rash)
- arthralgia (joint aches)
- conjunctivitis (symptoms consistent with “pink eye”)
***It is important to obtain specimens during the first week of illness if possible as the test results are more reliable. Don’t wait to go in if you develop these symptoms after travel!
Pregnant women (regardless of symptoms) should be tested if they suspect possible exposure to Zika virus through travel to an area of active Zika virus transmission during pregnancy or through sexual exposure to a man who has traveled to an area of Zika transmission and developed symptoms of Zika virus infection. It’s important in this case to obtain specimens within the first week of illness if ill or within 2-12 weeks of an exposure (including any travel to a Zika affected area in the 8 weeks before conception) if asymptomatic.
Pregnant women who have at least one sign or symptom of Zika virus disease after unprotected sex with an asymptomatic male partner who had exposure to Zika virus can be tested. In this case, your doctor needs to obtain specimens during the first week of illness if at all possible.
Newborn Babies: If your infant has two or more of the following symptoms within 2 weeks of birth, they should be tested for potential Zika.
- acute onset of fever (as a reminder, young infants should ALWAYS be seen by a health care provider if they develop fever)
- maculopapular rash (spotted rash on their body)
- arthralgia (joint aches — very unsure how we’d know this in a newborn!)
- conjunctivitis (as in “pink eye” symptoms, red or pink whites of the eyes)
Helpful Zika Resources:
- CDC Zika and Pregnancy Q&A
- Where is Zika? (maps and information of worldwide outbreaks)
- Seattle Mama Doc Blog On Zika
- Washington Post Article, “Sex in a time of Zika”
- Zika Virus recommendations for Health Care Providers