CDC issues Interim Guidelines for Preventing Sexual Transmission of Zika Virus and Updated Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure

CDC has issued new interim guidance on preventing sexual transmission of Zika virus after confirming through laboratory testing, in collaboration with Dallas County Health and Human Services, the first case of Zika virus infection in a non-traveler in the continental United States during this outbreak.

Although sexual transmission of Zika virus infection is possible, mosquito bites remain the primary way that Zika virus is transmitted. Because there currently is no vaccine or treatment for Zika virus, the best way to avoid Zika virus infection is to prevent mosquito bites.

Based on what we know now, CDC is issuing interim recommendations to prevent sexual transmission of Zika virus. To date, there have been no reports of sexual transmission of Zika virus from infected women to their sex partners. CDC expects to update its interim guidance as new information becomes available.

New recommendations for pregnant women, and men with pregnant sex partners who live in or have traveled to Zika-affected areas:

• Pregnant women and their male sex partners should discuss the male partner’s potential exposures and history of Zika-like illness with the pregnant woman’s health care provider (http://www.cdc.gov/zika/symptoms/). Providers should consult CDC’s guidelines for evaluation and testing of pregnant women.
• Men with a pregnant sex partner who reside in or have traveled to an area of active Zika virus transmission and their pregnant sex partners should consistently and correctly use condoms during sex (vaginal, anal, or oral) or abstain from sexual activity for the duration of the pregnancy. Consistent and correct use of latex condoms reduces the risk of sexual transmission of many infections, including those caused by other viruses.

New recommendations for non-pregnant women, and men with non-pregnant sexual partners who live in or have traveled to Zika-affected areas:

• Couples in which a man resides in or has traveled to an area of active Zika virus transmission who are concerned about sexual transmission of Zika virus may consider using condoms consistently and correctly during sex or abstaining from sexual activity.  
• Couples may consider several factors when making this complex and personal decision to abstain or use condoms:
  • Zika virus illness is usually mild. An estimated 4 out of 5 people infected never have symptoms; when symptoms occur they may last from several days to one week.
  • The risk of Zika infection depends on how long and how much a person has been exposed to infected mosquitoes, and the steps taken to prevent mosquito bites while in an affected area.
• The science is not clear on how long the risk should be avoided. Research is now underway to answer this question as soon as possible. If you are trying to get pregnant, you may consider testing in discussion with your health care provider.

Updated interim guidelines for healthcare providers

CDC also has updated its interim guidance for healthcare providers in the United States caring for pregnant women and women of reproductive age with possible Zika virus exposure.

The updated guidelines recommend that pregnant women without symptoms of Zika virus disease can be offered testing 2 to 12 weeks after returning from areas with ongoing Zika virus transmission.

New recommendations for women who reside in areas with ongoing Zika virus transmission, both pregnant women and women of reproductive age, include the following:

• For pregnant women experiencing symptoms consistent with Zika virus disease, testing is recommended at the time of illness.
• For pregnant women not experiencing symptoms consistent with Zika virus disease, testing is recommended when women begin prenatal care. Follow-up testing around the middle of the second trimester of pregnancy is also recommended, because of an ongoing risk of Zika virus exposure. Pregnant women should receive routine prenatal care, including an ultrasound during the second trimester of pregnancy. An additional ultrasound may be performed at the discretion of the health care provider.
• For women of reproductive age, healthcare providers should discuss strategies to prevent unintended pregnancy, including counseling on family planning and the correct and consistent use of effective contraceptive methods, in the context of the potential risks of Zika virus transmission.
• Local health officials will need to determine when to implement testing recommendations for pregnant women without symptoms based on information about local levels of Zika virus transmission and local laboratory capacity.

All travelers to or residents of areas with ongoing Zika virus transmission should strictly follow measures to prevent mosquito bites.

CDC continues to work with other public health officials to monitor for ongoing Zika virus‎ transmission. CDC has issued travel alerts (Level 2-Practice Enhanced Precautions) for people traveling to regions and certain countries where Zika virus transmission is ongoing. For a full list of affected countries/regions, check this site regularly: http://www.cdc.gov/zika/geo/index.html.

CDC guidance on Zika virus, its transmission, treatment, and response to the outbreak will continue to be updated as more becomes known.  

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES