Last reviewed: September 2018
Last updated: August  2018

CDC shortens waiting period for conception after Zika exposure

The Centers for Disease Control and Prevention (CDC) have issued new guidance that recommends men with possible Zika virus exposure who are planning to conceive with their partner need only wait for 3 months after symptom onset or their last possible exposure (if asymptomatic) - rather than the previously recommended 6 months - before engaging in unprotected sex. The recommendation for women to wait at least 2 months after possible exposure before trying to conceive remains unchanged.

The change follows a review of latest evidence on the risk of sexual transmission of Zika virus infection. It found that the longest period from symptom onset in a man to sexual transmission to a partner was between 32-41 days. The longest period after symptom onset at which potentially infectious virus has been detected in semen was 69 days.

It is worth noting that the World Health Organization still currently recommends a 6-month waiting period for both men and women.

See Prevention

Original source of update

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • fever
  • maculopapular rash
  • arthralgia
  • conjunctivitis
  • features of congenital Zika syndrome (infants)
  • features of Guillain-Barre syndrome

Other diagnostic factors

  • other constitutional symptoms
  • gastrointestinal symptoms
  • retro-orbital pain
  • oedema of lower limbs
  • transient hearing loss in adults

Risk factors

  • residence in/travel from endemic area
  • mosquito bites in endemic area
  • unprotected sexual contact with infected individual
  • blood transfusion from infected individual
  • sperm donation from infected individual
  • exposure to other infected body fluids
  • exposure to infected human cells/tissues

Diagnostic investigations

1st investigations to order

  • reverse transcriptase-polymerase chain reaction (RT-PCR) on serum and urine
  • serology
  • testing for other arboviruses
Full details

Investigations to consider

  • antenatal ultrasound
  • amniocentesis
  • head circumference measurement (newborn)
  • newborn further evaluation
  • CT/MRI head (newborn)
  • tests for Guillain-Barre syndrome
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Clinical Director

Microcephaly Working Group

Instituto de Medicina Integral Professor Fernando Figueira (IMIP)

Recife

Brazil

Disclosures

GF declares that he has no competing interests.

Coordinator Obstetrics/Gynecology

Microcephaly Working Group

Instituto de Medicina Integral Professor Fernando Figueira (IMIP)

Recife

Brazil

Disclosures

AS declares that she has no competing interests.

Peer reviewers VIEW ALL

Chief

Division of Infectious Diseases and International Health

University of Virginia

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

Director

Institute of Clinical Pathology and Medical Research

Pathology West

Westmead Hospital

Sydney

Australia

Disclosures

DD is a member of Advisory Boards for bioCSL and GSK in antivirals and vaccines.

Assistant Professor

Division of Infectious Diseases

Northwestern University Feinberg School of Medicine

Chicago

IL

Disclosures

CA declares that he has no competing interests.

Assistant Professor of Medicine

TravelWell Center

Division of Infectious Diseases

Atlanta

GA

Disclosures

HW declares that he has no competing interests.

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