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Health Protection Surveillance Centre guidance for preventing the sexual transmission of Zika virus infection

09 November 2016
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Dear Colleagues,

As you are aware, the epidemic of Zika virus infection is continuing, with an increasing number of countries and territories affected. The major complication of this flaviviral infection is that of foetal microcephaly, which affects single figure percentages of births when the mother is infected in early pregnancy. Initially transmission with Aedes mosquitoes had been the only identified mode of transmission but now sexual and other methods of transmission have been identified.

Sexual transmission is particularly relevant in countries like Ireland that have not the climatic conditions to propagate Aedes mosquitoes and the Zika SAC Committee in HPSC has devised a series of guidance documents to support clinical and public health decision making, particularly in relation to minimising the potential for sexual transmission (and subsequent potential threat of microcephaly) within Ireland.

In our guidance in order to minimise risk of sexual transmission we had devised guidance that had recommended that:

"Men returning from affected areas should follow the advice on preventing sexual transmission by using condoms and their partner should delay pregnancy as follows:

  • A man who was ill with Zika should delay pregnancy with their partner for 6 months.
  • A man who travelled to an affected area but was not ill with Zika should delay pregnancy with their partner for 8 weeks after return to Ireland.

Were a woman to become ill with Zika during or following her return, she should wait 8 weeks after her symptoms subside before trying to become pregnant."

A number of international agencies including the World Health Organization, the US's Centers for Disease Control and Prevention (CDC) and most recently the European Centre for Disease Prevention and Control (ECDC) have produced updated guidance in this area. 

The Zika SAC Committee has reviewed these latest pieces of guidance and have amended Ireland's national guidance so that we are now completely aligned with that of both CDC and ECDC. In future, the recommended intervals of abstinence/practising safe sex for symptomatic and asymptomatic men and women are changed thus:

Group/Guidance Old Guidance New Guidance
Males (Symptoms) 6 months 6 months
Males (No Symptoms) 8 weeks 6 months
Females (Symptoms) 8 weeks 8 weeks
Females (No Symptoms) 8 weeks 8 weeks

 
In other words, the recommended intervals of abstinence/practising safe sex for asymptomatic men has been extended to six months and is now the same as the period recommended for symptomatic men.

These changes have been updated in all relevant guidance documentation in the Zika virus section of the HPSC website.

Health Protection Surveillance Centre

Email: library@icgp.ie, Tel: 01 6763705, Fax: 01 6765850