Couples Exposed to Zika Should Wait on Pregnancy

From the WebMD Archives

March 25, 2016 -- Couples who are trying to have a baby should wait a few months to get pregnant if either partner has been exposed to the Zika virus through travel, the CDC said today.

That’s true whether they’ve had symptoms or not.

Women who’ve been to an area where mosquitos carry the virus and have had at least one symptom of Zika infection should wait for at least 2 months to conceive; men who’ve had Zika should wait for 6 months.

Even if they haven’t had any symptoms, men and women should wait at least 2 months to get pregnant, the new guidelines say.

Denise Jamieson, MD, co-lead of the CDC’s Pregnancy and Birth Defects Team, said experts had arrived at those time frames by taking the longest known survival of Zika virus in the body and tripling it out of caution.

“These recommendations are our best attempt to try to provide reasonable time frames based on how long the virus persists in the blood and how long the virus persists in semen,” Jamieson said. But she admitted that there was still a lot that was not known about how long the virus may stay in the body.

Symptoms of Zika infection include fever, rash, red eyes, and joint pain. Most people who are infected never have symptoms, though, so the CDC said a blood test that’s positive for Zika would be another reason people should put pregnancy plans on hold.

People catch the virus mainly through mosquito bites, but it can also be passed through sex.

For most people, the infection is mild and goes away after a week or so, but it can be very dangerous for pregnant women. Recent studies have strongly linked the virus to an increased risk for miscarriage, stillbirth and birth defects -- particularly microcephaly, where a baby is born with a smaller-than-normal head and brain.

In rare cases, Zika, like other infections, can trigger a rare disorder called Guillain-Barre syndrome (GBS), where the body turns on itself, attacking its own nerves. The condition causes paralysis, and patients may need months of care to fully recover. In at least one other person, the virus was linked to brain swelling that put an elderly man in a coma.

Continued

There have been at least six confirmed cases of sexual transmission in the U.S. So far, all these cases involved men who had traveled to tropical areas where mosquitos were infecting people.

There are still a lot of unanswered questions about the virus being spread through sex:

  • How long are men infectious? In at least one case, scientists found the virus in a man’s semen 62 days after his initial infection. So far, though, all the confirmed cases of sexual transmission have involved men who infected partners within 2 weeks of having symptoms.
  • Can men who don’t have any symptoms still pass Zika to others? About 4 out of 5 people who get the virus don’t have any symptoms.
  • Can women pass Zika to their sex partners? So far, that hasn’t happened.

The CDC is advising couples who don’t want to catch Zika to use condoms or avoid having sex if the man has recently traveled to or lives in an area where the virus is still being spread:

  • Men with pregnant partners should use condoms or avoid sex for the entire pregnancy.
  • Men who’ve had signs of a Zika infection should consider using condoms or avoid sex for at least 6 months.
  • Men who’ve traveled to Zika-affected areas, but have not had any symptoms of infection, should consider using condoms for 2 months.
  • Men who live in Zika-affected areas should consider using condoms or avoiding sex for as long as the outbreak lasts where they are.

The CDC also revealed more today about the need for better birth control options for women in Puerto Rico, the island that’s expected to be ground zero for Zika infections in the United States.

The CDC estimates that 138,000 women in Puerto Rico -- many in their teens -- don’t want to get pregnant right now, but are at risk for an unplanned pregnancy because they lack access to effective birth control. About two-thirds of pregnancies on the island are unplanned.

The CDC is working with local doctors and health insurers to make hormonal implants and IUDs available for free to women who want them. These types of birth control are the most effective, but they’re also the most expensive, costing up to $1,500 each for the device and its insertion. Federal laws that were supposed to guarantee insurance coverage for these options haven’t helped everyone.

In Puerto Rico, most women of childbearing age are covered by Medicaid. The Medicaid program there has put restrictions on the most popular long-acting contraceptives, making them hard for doctors to prescribe if women ask for them. The government is working on a plan to provide more birth control options.

WebMD Health News Reviewed by Hansa D. Bhargava, MD on March 25, 2016

Sources

SOURCES:

Morbidity and Mortality Weekly Report, March 25, 2016.

Telebriefing, CDC.

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