Early Release
MMWR / February 5, 2016 / Vol. 65 5
loss, Zika virus RT-PCR and immunohistochemical staining
should be performed on fetal tissues, including umbilical cord
and placenta (1).
Sexual transmission of Zika virus can occur, although
there is limited data about the risk (20). The risk for sexual
transmission of Zika virus can be eliminated by abstinence
and reduced by correct and consistent use of condoms (21).
Given the potential risks of maternal Zika virus infection,
pregnant women whose male partners have or are at risk
for Zika virus infection should consider using condoms or
abstaining from sexual intercourse (21). Additional studies are
needed to characterize the risk for sexual transmission of Zika
virus; recommendations will be updated as more information
becomes available.
Special Considerations for Women of
Reproductive Age Residing in Areas of Ongoing
Zika Virus Transmission
CDC recommends that health care providers discuss preg-
reproductive age. Decisions regarding the timing of pregnancies
are personal and complex; reproductive life plans can assist in
making these decisions (22). Patient age, fertility, reproduc-
tive and medical history, as well as the values and preferences
discussions regarding pregnancy intentions and timing. In the
context of the ongoing Zika virus transmission, preconception
care should include a discussion of the signs and symptoms
and the potential risks associated with Zika virus infection.
Health care providers should discuss strategies to prevent
unintended pregnancy with women who do not want to
become pregnant; these strategies should include counseling on
family planning and use of contraceptive methods. Safety, effec-
tiveness, availability, and acceptability should be considered
when selecting a contraceptive method (23). Approximately
half of U.S. pregnancies each year are unintended (24); patients
should be counseled to use the most effective contracep-
tive method that can be used correctly and consistently. For
women desiring highly effective contraception, long acting
reversible contraception, including contraceptive implants
and intrauterine devices, might be the best choice (http://
www.cdc.gov/reproductivehealth/UnintendedPregnancy/
PDF/Contraceptive_methods_508.pdf). When choosing a
contraceptive method, the risk for sexually transmitted infec-
tions should also be considered; correct and consistent use of
condoms reduces the risk for sexually transmitted infections.
Strategies to prevent mosquito bites should be emphasized
for women living in areas with ongoing Zika virus transmission
who want to become pregnant. These strategies, including
wearing pants and long-sleeved shirts, using FDA-approved
insect repellents, ensuring that windows and doors have
screens, and staying inside air conditioned spaces when pos-
sible, can reduce the risk for Zika virus infection and other
vector-borne diseases. During preconception counseling visits,
the potential risks of Zika virus infection acquired during
Women of reproductive age with current or previous labora-
tory-confirmed Zika virus infection should be counseled that
there is no evidence that prior Zika virus infection poses a risk
for birth defects in future pregnancies (7). This is because the
viremia is expected to last approximately 1 week in patients
with clinical illness (2,25). There is no current evidence to sug-
gest that a fetus conceived after maternal viremia has resolved
would be at risk for fetal infection (7).
1
Epidemic Intelligence Service, CDC;
2
Division of Reproductive Health,
National Center for Chronic Disease Prevention and Health Promotion, CDC;
3
Division of Public Health Information Dissemination, Center for Surveillance,
Epidemiology, and Laboratory Services, CDC;
4
Arboviral Diseases Branch,
National Center for Emerging and Zoonotic Infectious Diseases, CDC;
5
Office
of the Director, National Center for Emerging and Zoonotic Infectious Diseases,
CDC;
6
Division of Birth Defects and Developmental Disabilities, National
Center on Birth Defects and Developmental Disabilities, CDC;
7
Division of
HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD,
and Tuberculosis Prevention, CDC.
References
1. Petersen EE, Staples JE, Meaney-Delman D, et al. Interim guidelines
for pregnant women during a Zika virus outbreak—United States, 2016.
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org/10.15585/mmwr.mm6502e1.
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http://dx.doi.org/10.3201/eid1509.090442.
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