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CDC updates Zika guidance on postponing pregnancy

The Centers for Disease Control and Prevention (CDC) on Friday updated guidance on Zika, recommending that couples postpone trying to become pregnant for at least six months if an asymptomatic male partner has possibly been exposed to the virus, The Hill reports (Ferris, The Hill, 9/30).

Background

The Zika virus is not easily diagnosed, and it does not have a cure or vaccine. It is linked to microcephaly, a sometimes fatal anomaly in which a fetus develops an abnormally small head and brain. The virus is most commonly transmitted by a bite from an infected mosquito, but it can also be spread through sexual activity.

In September, Congress cleared a short-term spending bill that includes $1.1 billion in funds for Zika response efforts (Women's Health Policy Report, 9/29). President Obama signed the bill on Thursday (Fabian, The Hill, 9/29).

In March, CDC said a woman infected with Zika or displaying symptoms of the virus should delay attempts to conceive for at least eight weeks after she first presented with symptoms. Men who have been infected or present with symptoms should wait at least six months after the initial symptoms appear before having sex without protection, the agency said.

CDC also advised that men and women who have traveled to Zika-infected regions but who have not been infected or displayed symptoms should postpone trying to conceive by eight weeks. In addition, the agency recommended that people who live in Zika-infected regions discuss the risks of a Zika infection with their physicians, but did not advise such women to postpone pregnancy (Women's Health Policy Report, 3/29).

In addition, CDC in July issued guidance recommending that physicians ask pregnant women whether she or her sex partner has traveled to an area affected by Zika. In addition, according to the agency, pregnant women who have potentially been exposed to Zika should be tested for the virus up to two weeks after they first experience symptoms. In addition, CDC recommends that all pregnant women who have traveled to or live in a Zika-affected area abstain from sex or use condoms for the remainder of their pregnancy. The recommendation applies regardless of the sex of the pregnant woman's sexual partner (Women's Health Policy Report, 7/26).

Latest developments

On Friday, CDC said for couples who live in an area where Zika is not actively spreading, women should postpone trying to become pregnant for six months if their asymptomatic partner has been exposed to the Zika virus, increasing the agency's prior recommendation of an eight-week delay.

In areas where there is active transmission, the agency recommended that women and men get tested for the virus if they present symptoms. If they test positive, CDC advised that men wait six months before a couple tries to conceive and that women wait eight weeks. Individuals who test negative should discuss their conception plans with a physician, assessing factors such as age and fertility (Stein, "Shots," NPR, 9/30).

According to The Hill, CDC's recommendation applies to men who have been possibly exposed to the virus who do not present with symptoms. CDC did not alter its guidance advising women with possible exposure to the virus. According to the agency, such women are still advised to postpone trying to become pregnant for eight weeks. However, CDC reiterated that it would continue to update its guidance as research develops on the virus.

The agency said the latest recommendation stems from "the accumulating evidence, expert opinion, and knowledge about risks associated with other viral infections around the time of conception" (The Hill, 9/30). Specifically, the agency cited evidence suggesting that Zika can remain in semen for longer than previously thought and can be transmitted by men who do not present with symptoms. According to CDC, the extended time period is "expected to minimize the risk of sexual transmission around the time of conception and prevent possible early fetal exposure to the Zika virus" ("Shots," NPR, 9/30).

CDC updates Zika count

In related news, CDC said as of Sept. 22, there have been 3,625 laboratory-confirmed cases of Zika in the United States. Of those, 59 cases were transmitted via mosquitoes in Florida and 30 were transmitted via sexual activity.

The agency noted that the cases reported in the United States include 808 pregnant women. According to the agency, 21 infants have been delivered with anomalies linked to the virus, and five women have lost pregnancies that presented Zika-related fetal anomalies.

In U.S. territories, CDC said it has received reports of 22,069 cases of Zika, including 21,609 cases in Puerto Rico. According to the agency, the overall total of Zika cases in U.S. territories includes 21,988 locally transmitted cases and 1,490 cases involving pregnant women. There has been one instance of an infant born with Zika-related anomalies (Punke, Becker's Hospital Review, 9/30).