CDC Updates Recommendations Related to Zika Virus

Agency offers guidance on preventing sexual transmission

The Centers for Disease Control and Prevention (CDC) has issued new guidance and information to prevent Zika virus transmission and its health effects. The new information includes updated interim guidance for healthcare professionals for counseling patients about pregnancy planning and the timing of pregnancy after possible exposure to Zika virus; updated interim guidance for preventing sexual transmission, with information about how long men and women should consider using condoms or not having sex; and considerations and challenges, based on Puerto Rico’s experience, for reducing unintended pregnancy in areas with active Zika transmission.

The updated CDC recommendations for pregnant and reproductive-age women are as follows:

  • For women and men who have been diagnosed with Zika virus or who have symptoms of Zika including fever, rash, joint pain, or red eyes after possible exposure to Zika virus, the CDC recommends that health care providers advise that 1) women wait at least eight weeks after their symptoms first appeared before trying to get pregnant, and 2) men wait at least six months after their symptoms first appeared to have unprotected sex.
  • For men and women without symptoms of Zika virus but who had possible exposure to Zika from recent travel or sexual contact, the CDC recommends that health care providers advise their patients to wait at least eight weeks after their possible exposure before trying to get pregnant in order to minimize risk.
  • For men and women without symptoms of Zika virus who live in an area with active Zika transmission, the CDC recommends that health care providers talk with their patients about their pregnancy plans during a Zika virus outbreak, about the potential risks of Zika, and about how they can prevent Zika virus infection.

The CDC’s prior recommendations for men who live in or travel to an area with active Zika virus transmission who have a pregnant partner remain the same. The CDC recommends that men with a pregnant partner should use condoms every time they have sex or should not have sex for the duration of the pregnancy. This includes vaginal, anal, or oral sex.

The updated guidance includes new timeframes for men and their nonpregnant partners based on the couple’s situation, including whether the man lives in or has traveled to an area with active Zika virus transmission and whether he develops symptoms of possible Zika infection. The guidance is based on available information about how long the virus remains in semen and about the risks associated with Zika based on whether or not men had symptoms of infection:

  • Couples with men who have confirmed Zika infection or symptoms of Zika should consider using condoms or not having sex for at least six months after symptoms begin. This includes men who live in or traveled to areas with Zika.
  • Couples with men who traveled to an area with Zika but did not develop symptoms of Zika should consider using condoms or not having sex for at least eight weeks after their return in order to minimize risk.
  • Couples with men who live in an area with Zika but have not developed symptoms might consider using condoms or not having sex while there is active Zika transmission in the area.

Because of the potential for Zika virus to affect pregnant women and their fetuses, strategies to prevent unintended pregnancy are a critical part of current efforts to prevent Zika-related health effects. Based on Puerto Rico’s experience, the CDC has identified considerations and challenges in reducing unintended pregnancies in areas with active Zika transmission.

Researchers have estimated that approximately 138,000 women in Puerto Rico may be at risk of unintended pregnancy and are not using one of the most effective or moderately effective forms of birth control. In areas with active Zika transmission, women and their partners who do not want to get pregnant should be advised about the range of effective birth control methods and counseled that correct and consistent use of these methods is important if they do not want to become pregnant.

The Department of Health and Human Services (HHS) is working to leverage existing programs that currently provide resources for or access to contraception in Puerto Rico. The HHS is also coordinating with federal, local, and private partners to identify additional resources to support increased access to the most effective forms of contraception.

Source: CDC; March 25, 2016.