infectious diseases
Zika Virus (ZV) Infections
Prevention of Zika Virus Infections
If possible, pregnant women should NOT travel to areas with ongoing Zika virus outbreaks (see alsoCDC: Pregnant Women and Zika). If traveling to such areas, pregnant women should talk with their obstetric clinician about risks of Zika virus infection and precautions to be taken to avoid mosquito bites during the trip. There is currently no vaccine to prevent Zika virus infection. Prevention of Zika virus infection depends on control ofAedesmosquitoes and prevention of mosquito bites when traveling to countries with ongoing Zika virus transmission. Control ofA. aegyptihas been very difficult; however, 2 approaches are being field-tested currently: Release of genetically altered males or sterilized males that mate with wild females whose larval offspring then do not mature or whose eggs are infertile Release of femaleA. aegyptimosquitoes infected withWolbachiabacteria that block susceptibility to Zika virus in the infected mosquitoes and their offspring To prevent mosquito bites, the following precautions should be taken (see also the CDC'sProtection against MosquitoesandZika virus: Prevention and Transmission): Wear long-sleeved shirts and long pants. Stay in places that have air conditioning or that use window and door screens to keep mosquitoes out. Sleep under a mosquito bed net in places that are not adequately screened or air-conditioned. Use Environmental Protection Agency–registered insect repellents with ingredients such as DEET (diethyltoluamide) or other approved active ingredients on exposed skin surfaces. Treat clothing and gear withpermethrininsecticide (do not apply directly to the skin). For children, the following precautions are recommended: Do not use insect repellent on infants < 2 months. Do not use products containing oil of lemon eucalyptus (para-menthane-diol) on children < 3 years. For older children, adults should spray repellent on their hands and then apply it to the children's skin. Dress children in clothing that covers their arms and legs, or cover the crib, stroller, or baby carrier with mosquito netting. Do not apply insect repellent to the hands, eyes, mouth, or cut or irritated skin of children. RNA of the Zika virus has been detected in semen up to 281 days after the onset of symptoms ( Prevention reference ). However, detection of viral RNA does not necessarily indicate the presence of infectious virus. In one study, infectious virus was detected in a few individuals 30 days after illness onset but, in general, shedding of infectious Zika virus appeared to become much less common with time and was limited mainly to the first few weeks after illness onset; however, there is still a possibility of later transmission. Because Zika virus can be transmitted via semen, people should use condoms or practice abstinence if one or both partners live in or have traveled to an area with current or past Zika virus transmission. This recommendation applies whether or not people have symptoms because most Zika virus infections are asymptomatic, and when symptoms do develop, they are usually mild. Man with pregnant partner: Abstain from sexual activity, or use condoms and avoid sharing sex toys for the duration of the pregnancy Man who traveled to area at risk of Zika with or without female partner: Abstain from sexual activity or use condoms for 3 months after return (or the start of symptoms) Woman who traveled to area at risk of Zika without male partner: Abstain from sexual activity or use condoms for 2 months after return (or the start of symptoms) If using condoms, they should be used from start to finish every time during vaginal, anal, and oral sex. Although no cases of woman-to-woman sexual transmission have been reported, the CDC recommends that all pregnant women who have a female sex partner who has traveled to or resides in an area with Zika use barrier methods every time during vaginal, anal, and oral sex, or abstain from sex during the pregnancy, and avoid sharing sex toys. See alsoCDC: Zika: People Trying to Conceive. 1.Mead PS, Duggal NK, Hook SA, et al: Zika Virus Shedding in Semen of Symptomatic Infected Men.N Engl J Med378(15):1377-1385, 2018. doi:10.1056/NEJMoa1711038 