Early in February, the Centers for Disease Control and Prevention (CDC) issued new interim guidance on preventing sexual transmission of Zika virus. Yesterday, federal health officials updated the guidance as follows:

Image/CDC
Image/CDC

Men and their nonpregnant sex partners (couples) who want to reduce the risk for sexual transmission of Zika virus should use condoms consistently and correctly during sex or abstain from sex. Based on expert opinion and limited but evolving information about the sexual transmission of Zika virus, the recommended duration of consistent condom use or abstinence from sex depends on whether men had confirmed infection or clinical illness consistent with Zika virus disease and whether men are residing in an area with active transmission (see box on the left). The rationale for selection of these timeframes is available elsewhere.

Several factors could influence a couple’s level of concern about sexual transmission of Zika virus. The risk for acquiring mosquito-borne Zika virus in areas with active transmission depends on the duration and extent of exposure to infected mosquitoes and the steps taken to prevent mosquito bites. According to currently available information, most Zika virus infections appear to be asymptomatic, and when illness does occur, it is usually mild with symptoms lasting from several days to a week; severe disease requiring hospitalization is uncommon. Transmission of Zika virus is of particular concern during pregnancy. Couples who do not desire pregnancy should use available strategies to prevent unintended pregnancy, including use of the most effective contraceptive methods that can be used correctly and consistently. In addition, couples should be advised that correct and consistent use of condoms reduces the risk for sexually transmitted infections.

At present, Zika virus testing for the assessment of risk for sexual transmission is of uncertain value, because current understanding of the duration and pattern of shedding of Zika virus in the male genitourinary tract is limited. Therefore, neither serum nor semen testing of men for the purpose of assessing risk for sexual transmission is currently recommended.

Zika virus testing is recommended for persons who have had possible sexual exposure to Zika virus and develop signs or symptoms consistent with Zika virus disease. A pregnant woman with possible sexual exposure to Zika virus should be tested if either she or her male partner developed symptoms consistent with Zika virus disease. CDC urges health care providers to report cases of suspected sexual transmission of Zika virus to local and state health departments.

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