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World Health Organization (WHO) Update – Zika Virus

The World Health Organization (WHO) recently posted an interim guidance update for the prevention of sexual transmission of the Zika Virus. Here are some highlights from their release on May 30,2016:

WHO_ZIKV

2. Sexual transmission of Zika virus

2.1.3 Presence of the virus in semen

In 2016 two studies reported the presence of Zika virus in semen, detected by reverse transcription polymerase chain reaction (RT-PCR). One of the report documented that the virus was cultured from the semen specimen 14 days after diagnosis (thus more than 2 weeks after illness onset); and the viral load detected was 100 000 times that of his blood. In the second report and most recent study, published in May 201616, researchers reported the case of a 68 year-old man returning to the United Kingdom from the Cook Islands. His semen was positive for Zika virus 62 days after his symptoms began. This is the maximum documented time of Zika virus detection in semen. However, the full length of time that the virus can persist in semen after onset of symptoms remains unknown, as sequential samples were not collected.

3. Presence of Zika virus in other body fluids

Publications on the presence of Zika virus in other body fluids that may be involved in sexual transmission have also been considered. Studies have reported the presence of Zika virus by RT-PCR in saliva 17, 18 and urine 14, 15, 18-25. The persistent shedding of Zika virus ribonucleic acid (RNA) in both fluids has been found up to 29 days after the onset of infection. Culture of Zika virus in urine 14, 18, 20, 26 and saliva 18 has also been reported, with the virus cultured at day six after symptom onset for both fluids.

4. Interim recommendations

2. Sexual partners of pregnant women, living in or returning from areas where local transmission of Zika virus is known to occur, should practice safer sex or abstinence from sexual activity for at least the whole duration of the pregnancy.

3. Couples or women planning a pregnancy, living or returning from areas where transmission of Zika virus is known to occur, are strongly recommended to wait at least 8 weeks before trying to conceive to ensure that any possible Zika virus infection has cleared; and 6 months if the male partner was symptomatic.

4. Men and women returning from areas where transmission of Zika virus is known to occur should adopt safer sex practices or consider abstinence for at least 8 weeks upon return.

a. If before or during that period Zika virus symptoms (rash, fever, arthralgia, myalgia or conjunctivitis 29) occur, men should adopt safer sex practices or consider abstinence for at least 6 months. Women should be correctly informed about this recommendation.

b. WHO does not recommend routine semen testing to detect Zika virus. However, symptomatic men can be offered semen testing at the end of the 8 week period after return, according to country policy.

Click HERE to view complete WHO release.



Dr. Paul A. Bergh, MD, FACOG

Reproductive Medicine Associates of New Jersey

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