Monday, July 25, 2016

MMWR: Two Interim Guidance Updates For Zika Virus (Pregnancy & Prevention Of Sexual Transmission)












#11, 580



The CDC has released two new sets of updated interim guidance on the Zika virus, with the first geared to clinicians and public health officials, dealing with providing care to pregnant women who may have been exposed to the Zika virus.


Due to its length and complexity I've only posted the summary, the link, and graphic of the testing decision tree.


Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States, July 2016

July 25, 2016
CDC has updated its interim guidance for health care providers in the United States caring for pregnant women with possible Zika virus exposure, based on emerging data indicating Zika virus RNA can be detected for prolonged periods in some pregnant women. To increase the proportion of pregnant women with Zika virus infection who receive a definitive diagnosis, this guidance includes recommendations to expand real-time reverse transcription–polymerase chain reaction testing.

Pregnancy Testing Zika Decision Tree


The second update deals with preventing the sexual transmission of the Zika virus, guidance that has been revised in the wake of last week's MMWR: 1st Female-to-Male Sexual Transmission of the Zika Virus - NYC.

Today's update expands previous recommendations to cover all pregnant couples, including pregnant women with female sex partners.

Once again, follow the link to read the full release.


Update: Interim Guidance for Prevention of Sexual Transmission of Zika Virus — United States, July 2016

July 25, 2016
CDC has updated interim guidance for the prevention of sexual transmission of Zika virus. The recommendations apply to all men and women who have traveled to or reside in areas with active Zika virus transmission and their sex partners. The recommendations in this report replace those previously issued and are now updated to reduce the risk for sexual transmission of Zika virus from both men and women to their sex partners. This guidance will be updated as more information becomes available.
Summary 

Recommendations for prevention of sexual transmission of Zika virus for couples in which one or both partners have traveled to or reside in an area with active Zika virus transmission
Couples in which a woman is pregnant

Couples in which a woman is pregnant should use barrier methods against infection consistently and correctly or abstain from sex for the duration of the pregnancy.

Couples who are not pregnant and are not planning to become pregnant*

Couples in which a partner had confirmed Zika virus infection or clinical illness consistent with Zika virus disease should consider using barrier methods against infection consistently and correctly or abstain from sex as follows:
― Men with Zika virus infection for at least 6 months after onset of illness;
― Women with Zika virus infection for at least 8 weeks after onset of illness.

Couples in areas without active Zika transmission in which one partner traveled to or resides in an area with active Zika virus transmission but did not develop symptoms of Zika virus disease should consider using barrier methods against infection or abstaining from sex for at least 8 weeks after that partner departed the Zika-affected area.

Couples who reside in an area with active Zika virus transmission might consider using barrier methods against infection or abstaining from sex while active transmission persists.

* Couples who do not desire pregnancy should use the most effective contraceptive methods that can be used correctly and consistently in addition to barrier methods to protect against infections, such as condoms, which reduce the risk for both sexual transmission of Zika and other sexually transmitted infections. Couples planning conception might have multiple factors to consider, which are discussed in more detail in the following: Petersen EE, Polen KN, Meaney-Delman D, et al. Update: interim guidance for health care providers caring for women of reproductive age with possible Zika virus exposure—United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:315–22.