Saturday, October 01, 2016

MMWR: Updated Interim Guidance for Preconception Counseling and Prevention of Sexual Transmission of Zika Virus


The Zika virus continues to surprise, and as more is learned about how it affects human health and the ways it can be transmitted, the CDC has repeatedly updated their interim guidance.

The fact that it is sexually transmitted at all was unexpected, but its persistence in semen (see Eurosurveillance: 2 Reports Of Zika RNA Detection In Semen Six Months After Infection) was particularly surprising. 

Yesterday the CDC released a new MMWR report (see below) which details (at length) the evidence and new recommendations to prevent the sexual transmission of the Zika virus.

The headline is that all men with possible Zika exposure (symptomatic or asymptomatic) should now wait at least six months before attempting to father a child.

I've only excerpted (and split into 6 paragraphs for better readability) the opening paragraph of the report.  Hopefully the CDC will release a more consumer friendly summary of this advice in the days to come.

In the meantime, follow the link to read:

 Emily E. Petersen, MD1; Dana Meaney-Delman, MD1; Robyn Neblett-Fanfair, MD1; Fiona Havers, MD1; Titilope Oduyebo, MD1; Susan L. Hills, MBBS1; Ingrid B. Rabe, MBChB1; Amy Lambert, PhD1; Julia Abercrombie, MPH1; Stacey W. Martin, MSc1; Carolyn V. Gould, MD1; Nadia Oussayef, JD1; Kara N.D. Polen, MPH1; Matthew J. Kuehnert, MD1; Satish K. Pillai, MD1; Lyle R. Petersen, MD1; Margaret A. Honein, PhD1; Denise J. Jamieson, MD1; John T. Brooks, MD1 (View author affiliations)
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CDC has updated its interim guidance for persons with possible Zika virus exposure who are planning to conceive (1) and interim guidance to prevent transmission of Zika virus through sexual contact (2), now combined into a single document. Guidance for care for pregnant women with possible Zika virus exposure was previously published (3). 

Possible Zika virus exposure is defined as travel to or residence in an area of active Zika virus transmission (, or sex* without a condom with a partner who traveled to or lived in an area of active transmission. 

Based on new though limited data, CDC now recommends that all men with possible Zika virus exposure who are considering attempting conception with their partner, regardless of symptom status,§ wait to conceive until at least 6 months after symptom onset (if symptomatic) or last possible Zika virus exposure (if asymptomatic). 

Recommendations for women planning to conceive remain unchanged: women with possible Zika virus exposure are recommended to wait to conceive until at least 8 weeks after symptom onset (if symptomatic) or last possible Zika virus exposure (if asymptomatic). 

Couples with possible Zika virus exposure, who are not pregnant and do not plan to become pregnant, who want to minimize their risk for sexual transmission of Zika virus should use a condom or abstain from sex for the same periods for men and women described above. 

Women of reproductive age who have had or anticipate future Zika virus exposure who do not want to become pregnant should use the most effective contraceptive method that can be used correctly and consistently. These recommendations will be further updated when additional data become available.

(Continue . . . )

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