Interim recommendations for reducing the risk of sexual transmission of Zika virus

These recommendations will be updated as new information becomes available.

Page last updated: 05 May 2016

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There is only limited information available from which to estimate the risk of sexual transmission of Zika virus, but the risk is considered to be low particularly when compared to the risk of transmission from infected mosquitoes.

Multiple cases of suspected or probable sexual transmission of Zika virus from men to their sexual partners have now been reported.1,2 3 There have been cases reported in which Zika virus was detected in semen, with detection up to nine weeks after symptomatic infection in one case.3,4 In all instances, the men had symptoms of infection at the time of sexual intercourse or shortly after.

Zika virus is estimated to remain in the blood for three to five days following symptom onset. Viral genetic material (RNA) has been detected in saliva or urine more than a week after clearance of virus from the blood. The timing and duration for Zika virus presence or persistence in the semen and infectivity is currently unknown.

A pregnant woman with Zika virus can pass it on to the baby. Very rarely, this can lead to microcephaly (a small head and brain) in the unborn baby. It is not yet possible to know how likely it is that a pregnant woman with Zika virus will have a baby with microcephaly (a small head and brain) or other problems.

General recommendations

All people travelling to areas of ongoing Zika virus transmission should take steps to prevent Zika virus infection through measures to prevent mosquito bites.

Given the potentially serious implications of sexual transmission of Zika virus to a pregnant woman and the risk of local transmission in North Queensland (NQ), the following recommendations are provided. These recommendations apply to men who have travelled to areas with ongoing Zika virus transmission (refer to the Department of Health website) and their sexual partners.

  • Men who have travelled to areas with ongoing Zika virus transmission whose partner is pregnant should abstain from sexual activity (vaginal, anal, or oral) or consistently use condoms for the duration of the pregnancy, whether symptomatic or asymptomatic.
  • Men who have had a confirmed Zika virus infection, whose partner is not pregnant should abstain from sexual activity (vaginal, anal, or oral) or consistently use condoms for 3 months following the resolution of symptoms.

Men who have recently travelled to areas with ongoing Zika virus transmission and who develop symptoms compatible with Zika virus infection should be medically assessed and tested for Zika virus infection or another illness. These men should abstain from sexual activity or use condoms consistently while their illness is being investigated.

In the following circumstances, in order to exclude Zika virus infection consideration could be given to serological testing of asymptomatic men at least 4 weeks after last potential exposure, following discussion with a Clinical Microbiologist, noting the limitations of this testing:

  • men who have travelled to a Zika virus affected area and are part of a couple planning pregnancy
  • men who have travelled to a Zika virus affected area but did not suffer symptoms of a Zika virus infection and whose partner is pregnant.
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Summary of recommendations for men who have recently travelled to areas with ongoing Zika virus transmission

Men with: Recommendations
Pregnant partner Use condoms consistently or abstain from sexual activity for the duration of pregnancy#.
Confirmed Zika infection and non pregnant partner Use condoms consistently or abstain from sexual activity for 3 months following resolution of symptoms#.

#In some circumstances, consideration could be given to serological testing of asymptomatic men with a pregnant partner, at least 4 weeks after last potential exposure, following discussion with a pathologist, noting the limitations of testing in this circumstance.

  1. McCarthy M. Zika virus was transmitted by sexual contact in Texas, health officials report. BMJ 2016;352.
  2. Foy BD, Kobylinski KC, Chilson Foy JL, et al. Probable non-vector-borne transmission of Zika virus, Colorado, USA. Emerg Infect Dis 2011;17:880–2.
  3. Oster AM, Brooks JT, Stryker JE, et al. Interim Guidelines for Prevention of Sexual Transmission of Zika Virus — United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:120–121. DOI:(dx.doi.org/10.15585/mmwr.mm6505e1)
  4. Atkinson B, Hearn P, Afrough B, Lumley S, Carter D, Aarons EJ, et al. Detection of Zika virus in semen (letter). Emerg Infect Dis. 2016 May (date cited).
  5. Musso D, Roche C, Robin E, Nhan T, Teissier A, Cao-Lormeau VM. Potential sexual transmission of Zika virus. Emerg Infect Dis. 2015 Feb (date cited).

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