The World Health Organization (WHO) said Monday in updated guidance for the prevention of sexual transmission of Zika virus that mounting evidence has shown that sexual transmission of Zika virus is possible and more common than previously assumed.
A dozen studies have been published concerning Zika sexual transmission, both on male-to-female and male-to-male transmission.
Ten countries have reported evidence of person-to-person transmission of Zika virus, probably via a sexual route: United States of America, France, Italy, Argentina, Chile, Peru, Portugal, New Zealand, Canada and Germany.
Zika virus has been documented in semen and other body fluids. One study this month reveals the virus detected in semen 62 days after becoming symptomatic.
In addition, the virus has been detected in saliva and urine.
WHO updated recommendations include:
1. Country health programs should ensure that:
a. All people (male and female) with Zika virus infection and their sexual partners (particularly pregnant women) receive information about the risks of sexual transmission of Zika virus, contraceptive measures and safer sexual practices, and are provided with condoms.
b. Women who have had unprotected sex and do not wish to become pregnant due to concerns about Zika virus infection have ready access to emergency contraceptive services and counselling.
c. In order to prevent adverse pregnancy and fetal outcomes, men and women of reproductive age, living in areas where local transmission of Zika virus is known to occur, be correctly informed and oriented to consider delaying pregnancy; and follow recommendations (including the consistent use of condoms) to prevent human immunodeficiency virus (HIV), other sexually transmitted infections, and unwanted pregnancies.
2. Sexual partners of pregnant women, living in or returning from areas where local transmission of Zika virus is known to occur, should practice safer sex or abstinence from sexual activity for at least the whole duration of the pregnancy.
3. Couples or women planning a pregnancy, living or returning from areas where transmission of Zika virus is a Safer sexual practices include: postponing sexual debut; non-penetrative sex; correct and consistent use of male or female condoms; and reducing the number of sexual partners.
4. Men and women returning from areas where transmission of Zika virus is known to occur should adopt safer sex practices or consider abstinence for at least 8 weeks upon return.
a. If before or during that period Zika virus symptoms (rash, fever, arthralgia, myalgia or conjunctivitis 29 ) occur, men should adopt safer sex practices or consider abstinence for at least 6 months. Women should be correctly informed about this recommendation.
b. WHO does not recommend routine semen testing to detect Zika virus. However, symptomatic men can be offered semen testing at the end of the 8 week period after return, according to country policy.
5. Independently of considerations regarding Zika virus, WHO always recommends the use of safer sexual practices including correct and consistent use of condoms to prevent HIV, other sexually transmitted infections and unwanted pregnancies.
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