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CDC: Women with Zika symptoms should postpone pregnancy for 8 weeks
Women with symptoms of Zika virus should wait at least 8 weeks after symptom onset before attempting to become pregnant, and men should abstain from unprotected sex for at least 6 months after the onset of their symptoms, according to new guidelines issued by the CDC.
The recommendations came as the number of confirmed Zika cases in the United States — all of them either travel-related or sexually transmitted — reached 273, according to Denise Jamieson, MD, of the CDC’s Division of Reproductive Health.
Denise Jamieson
“In making these recommendations, we consider the longest known risk period for these categories. We then allowed for three times the known period of time that the virus persisted,” Jamieson said during a teleconference.
The CDC also recommended that men and women who do not exhibit symptoms of Zika but who had possible viral exposure from recent travel or sexual contact wait at least 8 weeks before trying to conceive to minimize their potential risks.
The guidelines, issued in two separate reports by researchers, came amid mounting evidence that Zika is linked to microcephaly and other grave outcomes associated with pregnancy, such as miscarriage and stillbirth. Jamieson said men and women who live in areas with active Zika virus transmission need “clear guidance” about timing pregnancies.
“These are very complex, deeply personal decisions, and we are communicating the potential risks of pregnancy for people who have had Zika and for those who live in areas with active transmission,” she said. “We are encouraging health care providers to have conversations with couples about pregnancy planning and their individual circumstances and to discuss strategies to prevent unintended pregnancies.”
CDC guidelines for preventing sexual transmission
The CDC continues to recommend that men who live in or have traveled to an area with active Zika transmission should either abstain from having sex with their pregnant partners for the duration of the pregnancy or correctly use a condom from start to finish every time they have vaginal, anal or oral sex.
The agency updated several other guidelines according to available information about how long the virus remains in semen and the risks associated with Zika based on whether men were symptomatic. It recommends that:
- couples with men use condoms or abstain from having sex for at least 6 months in cases where a man has confirmed Zika or symptoms of Zika;
- couples with men consider using condoms or abstaining from sex for 8 weeks after a man returns from an area with Zika, even if the man does not have symptoms of the virus; and
- couples with men who live in an area with Zika but have not developed symptoms should consider abstaining from sex while there is active Zika transmission in the area.
Access to contraception in Puerto Rico
A third report by CDC researchers estimated that approximately 138,000 women in Puerto Rico are at risk for unintended pregnancies — indicating a potential unmet need for access to birth control in the hardest-hit area of any U.S. state or territory.
Puerto Rico reported 258 laboratory-confirmed cases of Zika as of March 28, including 258 locally acquired cases, according to the CDC. Jamieson said the CDC has “identified considerations and challenges in reducing unintended pregnancies in areas with active Zika transmission.”
In those areas, she said, “women and their partners who do not want to get pregnant now should be advised about the range of effective birth control methods and counseled that correct and consistent use of these methods is important if they do not want to become pregnant.”
The Department of Health and Human Services is working to leverage existing programs that currently provide resources or access to contraception in Puerto Rico, according to the CDC. The agency said the HHS also is coordinating with federal, local and private partners to identify additional resources to support increased access to the most effective forms of contraception.
Thomas R. Frieden
CDC Director Thomas R. Frieden, MD, MPH, previously said that fighting Zika in Puerto Rico is an “uphill battle” and that he fears infections in the country could number in the hundreds of thousands by the end of the year, including thousands of pregnant women. – by Gerard Gallagher
References:
Petersen EE, et al. MMWR Morb Mortal Wkly Rep. 2016;doi:10.15585/mmwr.mm6512e2er.
Oster AM, et al. MMWR Morb Mortal Wkly Rep. 2016;doi:10.15585/mmwr.mm6512e3er.
Tepper NK, et al. MMWR Morb Mortal Wkly Rep. 2016;doi:10.15585/mmwr.mm6512e1er.
Disclosure: The researchers report no relevant financial disclosures.