Pregnant couples in which a male partner may have been exposed to the mosquito-borne Zika virus should use condoms during vaginal, anal and oral sex or be abstinent in order to prevent sexual transmission of the disease, according to new federal guidelines.
That's because sexually transmitting Zika virus to a pregnant partner may pose a threat to the fetus’ development in the womb, resulting in birth defects.
If pregnant women or their partners have traveled to an area with active Zika transmission, the guidelines say, they should discuss this potential exposure with an OB/GYN in order to determine if extra testing and evaluation is needed during the pregnancy.
So far the only bodily fluid associated with sex in which Zika has been found is sperm. And it’s currently unknown how long a person who has had Zika virus will be able to transmit the disease sexually, so researchers have yet to be determined how long men need to use condoms during sex to avoid passing the disease to someone else.
These new guidelines were released by the U.S. Centers for Disease Control and Prevention on Friday, two days after the agency confirmed that the first-ever local transmission of Zika virus in the U.S. happened through sexual contact. An unnamed patient in Dallas got the virus after sleeping with a partner who had recently traveled from Venezuela.
The Dallas case appears to confirm the likelihood of two initial reports of possible sexual transmission of Zika virus. The first case study, published in 2011, suggests that a man who contracted the disease while working in Senegal went on to sexually transmit it to his wife when he returned to his home in Colorado. The second case study reported that a Tahitian man showed signs of the virus in his semen, despite the fact that his blood no longer contained any traces of the pathogen.
The main mode of Zika virus transmission remains mosquito bites; the insect picks up the disease from an infected person and then transmits it to a second person. This method hasn't happened in the U.S. yet, although the CDC said last week that a small, time-limited outbreak of Zika virus here is "likely."
Here are the CDC's complete guidelines on sexual transmission of the virus, broken down by situation:
1. Couples that include a pregnant woman and a male partner who traveled to or lived in an area with ongoing Zika virus transmission
Use condoms during vaginal, anal and oral sex or be abstinent in order to prevent potential sexual transmission of the disease. You should also discuss both partners' travel history with an OB/GYN to determine if extra testing and evaluation is needed during the pregnancy.
2. Couples who aren't pregnant, but who are worried about sexual transmission because a male partner traveled to or lived in a Zika virus-affected area
Use condoms consistently during sex or consider abstaining, the CDC advised.
Before you make the decision to use condoms and/or abstain, the CDC wants you to know that the virus itself is usually mild. Symptoms can last up to one week, but 80 percent of infected people never even experience them.
Beyond simply being in an area with active Zika transmission, risk for the disease depends on how long a person was there, how many mosquito bites they got and the steps that were taken to prevent bites.
3. Couples who want to become pregnant, with a male partner that recently traveled or lived in an area with Zika virus transmission
Talk to your doctor to consider getting tested for Zika virus. However, CDC Director Dr. Thomas Frieden said in a press conference about these guidelines that pregnant women will be prioritized first for Zika virus testing.
4. Women who don't wish to become pregnant, but lived in or traveled in a Zika virus-affected area
If you're of reproductive age, discuss family planning and contraception strategies with your doctor with an eye toward mitigating Zika virus risk.
5. Pregnant women who just traveled in a Zika virus-affected area
The CDC's previous advice recommended Zika virus testing only for pregnant women who have disease symptoms (fever, rash, joint pain, conjunctivitis) or whose ultrasounds reveal cranial abnormalities in their fetus.
Now, the CDC says doctors can offer you Zika virus testing from two to 12 weeks after your trip to an area affected by the disease, or immediately if you show symptoms.
The CDC also recommends that if you're pregnant but asymptomatic, you get a Zika virus test at the beginning of prenatal care and then a follow-up around the middle of the second trimester if you live in an area with ongoing Zika virus transmission.
And, in keeping with the CDC’s initial set of guidelines for pregnant travelers, you should discuss with your doctors if additional ultrasounds are necessary to keep a close eye on fetal development. Signs of microcephaly, the birth defect associated with Zika virus infection, only show up on ultrasound scans around the end of the second trimester, notes the New York Times.
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