Zika virus RNA was detected in semen of five men more than 90 days after symptom onset, with the longest period of reported detection 188 days after symptom onset ( 20, 26, 29, 30). Reports indicate that concentrations of detectable Zika virus RNA in semen decrease after infection ( 17, 19– 28). However, detection of Zika virus RNA in semen might not indicate the presence of infectious virus and thus the potential for sexual transmission. Among reported cases of sexually transmitted Zika virus infection, the longest reported period between sexual contact that might have transmitted Zika virus and symptom onset was 32–41 days (based on an incubation period of 3–12 days) ( 18).ĭata on the detection of Zika virus RNA in semen can inform estimates of the periods during which sexual transmission might occur. Sexual transmission of Zika virus has been associated with condomless anal sex and vaginal sex and possibly also with fellatio ( 17).
Two new reports describe one presumed and one more definitive case of sexual transmission from men with asymptomatic Zika virus infection to female sex partners ( 15, 16). Most reported sexual transmissions have been from persons with symptomatic Zika virus infections, including from men to female sex partners ( 10– 12), from a man to his male sex partner ( 13), and from a woman to her male sex partner ( 14). The risk for sexual transmission of Zika virus from a person infected with Zika virus remains unknown. Zika virus can also be transmitted through sex without a condom. Zika virus is transmitted primarily through the bite of Aedes aegypti mosquitoes. Infections with other viruses (e.g., cytomegalovirus, rubella, parvovirus) around the time of conception have been associated with congenital infection and adverse pregnancy outcomes, although the exact timing of infection relative to conception was sometimes uncertain ( 5– 9). To date, there have been no published reports of adverse pregnancy outcomes after periconceptional Zika virus infection. The risk for adverse pregnancy outcomes associated with maternal Zika virus infection around the time of conception is unknown. Zika virus infection during pregnancy is a cause of congenital microcephaly and serious brain abnormalities ( 4). These recommendations will be further updated when additional data become available. 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. 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. 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). 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).
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. Guidance for care for pregnant women with possible Zika virus exposure was previously published ( 3). 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.
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