CDC COCA Call On Zika Virus - Webcast & Audio Online

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Last week the CDC held a COCA Call on the Zika Virus that was not well publicized in advance, and so many clinicians were unable to attend the live broadcast. Over the weekend they've posted the audio, transcript, and even a video of the web cast on their website - along with ancillary materials - which you can now access. 

Primarily of interest to clinicians and health care providers, COCA (Clinician Outreach Communication Activity) calls are designed to ensure that practitioners have up-to-date information for their practices. 

The details of this latest presentation are presented below.

Zika Virus — What Clinicians Need to Know

= Free Continuing Education

Date:Tuesday, January 26, 2016   

Presenter(s)

Ingrid Rabe, MBChB, MMed
Medical Epidemiologist
Division of Vector-Borne Diseases
Centers for Disease Control and Prevention

Dana Meaney-Delman, MD, MPH, FACOG
Medical Officer
National Center for Emerging and Zoonotic Infectious Diseases
Centers for Disease Control and Prevention

Cynthia A. Moore, MD, PhD
Director
Division of Birth Defects and Developmental Disabilities
National Center on Birth Defects and Developmental Disabilities
Centers for Disease Control and Prevention

Overview

Zika virus is a mosquito-borne flavivirus transmitted primarily by Aedes aegypti mosquitoes and an estimated 80% of persons infected with Zika virus are asymptomatic. Symptomatic disease is generally mild, with symptoms of fever, maculopapular rash, arthralgia, or nonpurulent conjunctivitis that typically last from several days to one week. Sporadic cases and outbreaks of Zika virus disease have occurred in countries in Africa and Southeast Asia. In 2015, the first local Zika virus transmission in the Americas was reported in Brazil and local transmission has now been in several countries or territories in the Americas. In the current outbreak in Brazil, a marked increase in the number of infants born with microcephaly has been reported and Zika virus infections have been confirmed in some infants with microcephaly. However, it is not known how many of the microcephaly cases are associated with Zika virus infection. Travelers to areas with ongoing outbreaks are at risk of becoming infected and spreading the virus to new areas, including the continental United States. During this COCA Call, participants will learn about the epidemiology and clinical manifestation of Zika virus disease and how early recognition and reporting of suspected cases can mitigate the risk of local transmission.

Objectives

At the conclusion of the session, the participant will be able to accomplish the following:

• Describe the epidemiology, clinical manifestations, management, and prevention of Zika virus disease
• Discuss diagnostic testing for Zika virus infection and interpretation of test results
• Articulate the importance of early recognition and reporting of cases
• State the recommendations for pregnant women and possible Zika virus exposure
• Discuss evaluation of infants with microcephaly and the relationship of Zika and microcephaly

Call Materials

• Slides:View Now
• Transcript:Read Now
• Audio:Listen Now
• Webcast:Watch Now

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Saudi MOH Announces A New MERS Case In Riyadh

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The Saudi MOH has announced  a new MERS case, this time in the capital of Riyadh involving a 43 year old expatriate male. This is the 8th case reported in 2016, and so far the authorities have not identified a known risk exposure.

While camel (or camel product) exposure has figured prominently in most of the recently reported community acquired cases, over the past 3 years the vast majority of these primary cases have unidentified risk exposures.


Last November, in EID Journal: Risk Factors For Primary MERS-CoV Infection, Saudi Arabia, we finally saw a small case-control study come out of KSA that found 33% of their subjects reported camel contact in the 14 days prior to falling ill vs. 15% in the control group.

While statistically significant, this obviously leaves a good many primary cases for whom camel contact does not appear to be a factor.

The authors of this study acknowledged these non-camel related cases, and wrote:

 
Other potential explanations of MERS-CoV illness in primary case-patients who did not have direct contact with dromedaries include unrecognized community exposure to patients with mild or subclinical MERS-CoV infection or exposure to other sources of primary MERS-CoV infection not ascertained in our study. 

A recent nationwide serosurvey from Saudi Arabia estimated that >44,000 persons might be seropositive for MERS-CoV and might be the source of infection to patients with confirmed primary MERS-CoV illness but with no dromedary exposure (8).

For more on the possibility of there being some limited `stealth’ transmission of the virus in the community see The Community Transmission Mystery and WHO Guidance On The Management Of Asymptomatic MERS Cases.

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RESEP BATAGOR BANDUNG TAHU BAKSO IKAN GORENG

RESEP BATAGOR BANDUNG

Batagor adalah bakso tahu goreng, merupakan jajanan Bandung populer yang biasa disajikan bersama lumuran saus kacang sebagai khas bumbu batagor (batagor kering) atau disiram dengan kuah (batagor kuah). Resep batagor Bandung akan terasa lebih enak dan spesial gurih dengan ikan tenggiri sebagai bahan batagor yang dicampur dengan tepung kanji. Selain batagor tahu, terdapat juga batagor pangsit yang menggunakan kulit pangsit untuk variasi penyajiannya.

Persiapan Bahan Bumbu Batagor

Cara membuat batagor ikan tenggiri beserta bumbu kacang (sambal kacang) dapat diolah dengan mudah dan sederhana di rumah.

• 600 gram daging ikan tenggiri dihaluskan
• 400 gram tepung kanji/tapioka (sagu tani)
• 2 butir telur ayam
• 2 batang daun bawang diiris kecil-kecil
• 1,5 sdt lada/merica butir dihaluskan
• 8 butir bawang putih dihaluskan
• 1,5 sdt garam

Kombinasi jumlah tahu dan pangsit bisa sesuaikan selera :

• 11 buah tahu putih dibelah dua diagonal/bentuk segitiga
• 60 buah kulit pangsit
• minyak goreng secukupnya

Cara Membuat Batagor Bandung Ikan Tenggiri

1. Campurkan daging ikan tenggiri halus dengan semua bahan lainnya, gunakan sarung tangan plastik lalu uleni hingga merata dan kalis.
2. Tiap-tiap potongan tahu, korek sedikit tengahnya dan beri adonan ikan tadi. Sedangkan untuk setiap kulit pangsit, tuang 1 sendok teh adonan ikan lalu rekatkan menjadi bentuk bunga.
3. Panaskan minyak goreng yang banyak, kemudian goreng hingga matang dan berwarna kuning keemasan. Angkat dan tiriskan lalu sajikan dengan bumbu kacang.

Persiapan Bahan Bumbu Saus/sambal Kacang

• 200 gram kacang tanah
• 4 butir bawang merah
• 2 siung bawang putih
• 2 cm kencur
• 30 gram gula merah
• 50 ml air asam jawa
• 500 ml air
• 10 buah cabe merah keriting
• 1/2 sdt garam
• minyak goreng seperlunya

Cara Membuat Saus Kacang

1. Goreng kacang tanah hingga matang, angkat dan tiriskan dari minyak kemudian haluskan. Haluskan juga bawang merah, bawang putih, kencur dan cabe merah keriting.
2. Panaskan sedikit minyak dan tumis bumbu halus tadi hingga harum. Tuangkan air, masukkan kacang halus serta aduk rata. Masukkan juga gula merah, air asam jawa dan garam, lalu aduk rata dan masak hingga mendidih serta mengental.

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EID Journal: Zika's Evolution And Spread To The Western Hemisphere

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#10,949


The parallels between the evolution and progression of Zika and Chikungunya are nothing less than striking. 


Until the middle of the last decade both were relatively obscure, neglected tropical diseases, which were limited to sparking small low-impact outbreaks in east and central Africa. Both produced (generally mild) dengue-like symptoms, and both launched themselves on their respective world tours around the same time via the Indian Ocean/Pacific island route.

Chikungunya was the first out of the gate, making a surprise leap to the Indian Ocean island of Réunion in 2005. There, it infected nearly 1/3rd of the island’s 770,000 residents (see 2006 EID article Chikungunya Disease Outbreak, Reunion Island) in just a matter of months.

From there it quickly cut a swath across the Indian ocean, into southeast Asia, and into the Pacific.


It arrived on the  French Part of St. Martins in the fall of 2013, likely carried in by an infected tourist, and quickly spread across the Caribbean and into South and Central America. In the two years since it arrived in the Americas, it has likely infected more than 2 million people.


Zika appears to have arrived in Brazil in 2014, probably carried in by a viremic visitor from the South Pacific, where the virus had slowly been spreading since 2007 (see 2009 EID Journal Zika Virus Outside Africa by Edward B. Hayes).


As its symptoms are generally milder than both CHKV and Dengue, it wasn't until the summer of 2015 that Brazil recognized it was in the midst of a Zika epidemic.

But by October it was reported in Columbia, and over the next four months, it appeared in more than 2 dozen countries and territories across the Caribbean, South and Central America. It is likely already present in many other regions, but has yet to be picked up by surveillance. 

It has only been since November that suspicions have been raised that Zika infection might not be quite as benign as previously believed (see WHO To Convene IHR Emergency Committee Meeting On Zika).

This rapid spread, and possible shift in virulence, has led to speculation that the Zika virus has changed somehow from its milder African version; transmitting more efficiently via mosquitoes or perhaps replicating more efficiently in human hosts.  

Nearly two months ago, in Paper: Zika Adaptations To Humans Helped Spark Global Spread, we looked at a study - yet to be peer reviewed - by researchers at the University of Sao Paulo and the Pasteur Institute of Dakar (Senegal) who believe they have uncovered genetic changes in the Zika virus that occurred after the virus reached the South Pacific in 2007, that may make it better adapted to human physiology.


While we've yet to see any definitive proof that such a change has occurred, in the past few days the subject has come up repeatedly in the media.

A few days ago the Harvard University School of Public Health ran an article called Zika virus in Brazil may be mutated strain while the New Scientist recently carried a report called Did Zika’s recent mutations let it explode as a global threat?

Today, a report from the Anadolu Agency also touches on this idea, with an interview with a Ugandan researcher who believes the virus has adapted to humans during its trek across the Pacifc.

Uganda virus expert says Zika adapting to humans

A top scientist at the Uganda-based facility that first identified the Zika virus has told Anadolu Agency that the bug is multiplying and becoming more adaptable to humans.

Dr. Julius Lutwama, senior principal research officer at the Uganda Virus Research Institute, said the virus outbreak in the Americas can only be reduced by supportive treatment and through controlling disease-carrying mosquitoes.

“There are two strains of the Zika virus, which include the African Zika virus and the Asian strain, which are slightly different,” he said.

“The strain that is causing problems in the Americas comes from Asia, went to Micronesia, Polynesia and moved to South America.” 

(Continue . . . )

Again, all of this is far from settled science, but it is worth noting that CHKV appears to have benefited from a mutation in the middle of the last decade that allowed it to spread more  efficiently by the Aedes Albopictus mosquito (see A Single Mutation in Chikungunya Virus Affects Vector Specificity and Epidemic Potential).

We have, quite frankly, very little research in the literature on Zika - at least when you compare it to what's available for Dengue, Chikungunya, or West Nile Virus.  That will change over time, now that Zika is viewed as potentially more dangerous than previously believed, but good research takes time. 

Below you'll find an early example, via the CDC's EID Journal. A letter reviewing the expansion of Zika out of Africa (and its similarities to CHKV), along with phylogenic analysis of early samples collected in the Americas.

It doesn't answer the question as to whether the virus has recently `adapted' to humans or mosquitoes, but it does find the Zika virus has evolved into 3 distinct genotypes (East Africa, West Africa, and Asia) and that the Asian genotype is the one that has arrived in the Americas.

Follow the link to read:

Volume 22, Number 5—May 2016

Letter

Phylogeny of Zika Virus in Western Hemisphere, 2015

To the Editor: Zika virus (ZIKV) belongs to the genus Flavivirus, family Flaviviridae, and is transmitted by Aedes spp. mosquitoes. Clinical signs and symptoms of human infection with ZIKV include fever, headache, malaise, maculopapular rash, and conjunctivitis.
ZIKV was first isolated in 1947 from the blood of a febrile sentinel rhesus monkey during a study of yellow fever in the Zika Forest of Uganda (1). During the next 20 years, ZIKV isolates were obtained primarily from East and West Africa during arbovirus surveillance studies in the absence of epidemics. During those 20 years, cases of ZIKV infection were detected sporadically; however, given the clinical similarity of ZIKV and dengue virus infections and the extensive cross-reactivity of ZIKV antibodies with dengue viruses, it is possible that ZIKV was associated with epidemics that were incorrectly attributed to dengue viruses. Beginning in 2007, substantial ZIKV outbreaks were reported first in Yap Island (Federated States of Micronesia), then in French Polynesia, and then in other Pacific Islands (2–4).

Genetic studies have revealed that ZIKV has evolved into 3 distinct genotypes: West African (Nigerian cluster), East African (MR766 prototype cluster), and Asian. It has been postulated that the virus originated in East Africa and then spread into both West Africa and Asia ≈50–100 years ago (5). In early 2015, cases of ZIKV infection were detected in Rio Grande State, northern Brazil, and limited sequence analyses revealed that the virus was most closely related to a 2013 ZIKV from French Polynesia, within the Asian clade (6).

(SNIP)

As reported by Musso et al. (8), the phylogeny and movement of ZIKV and chikungunya virus are strikingly similar. Each virus is grouped into 3 genotypes of very similar geographic distribution: East Africa, West Africa, and Asia. For both viruses, it also seems that viruses from East Africa moved into Asia ≈50–100 years ago and evolved into a unique Asian genotype (9,10). In addition, the similarity with respect to the recent movement of these viruses from Asia into the Pacific Islands and then into the New World (9) is noteworthy. It seems that similar ecologic and/or human social factors might be responsible for the movement of chikungunya virus and ZIKV into the New World at approximately the same time. 

Further studies might elucidate the exact mechanism of this transcontinental movement, leading to effective prevention strategies.

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Pondering The Great Zika Unknowns

PAHO - Zika Spread Epi Week 4

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It is practically an axiom of infectious disease blogging that the first details you get on any emerging disease outbreak are nearly always wrong, or at least misleading. Rarely are all of the pieces to the puzzle immediately available, and the media's narrative is often geared more to boosting circulation than presenting the facts.

As a result, I only sparingly use media accounts in this blog and try to use official releases of information where I can.   Of course, those are often wrong (or biased), as well.

I've called it the `fog of flu'  before - borne of situations where there are alarming but ambiguous reports of something `bad' breaking out - but very little real information.  We deal with it every winter, as we try to parse out the avian H5N1, H5N6 and H7N9 cases from the yearly cascade of seasonal flu and other respiratory outbreaks in places like Egypt and China.


Since November we've been aware of reports of elevated cases of microcephaly in Brazil which the local authorities have tentatively linked to the arrival of Zika last spring. The case numbers have been alarming, the stories of its impact tragic, and we've seen strong warnings issued by our own CDC regarding travel to the region by pregnant women.

But despite all of that, it is far from clear what is going on with Brazil's rates of microcephaly, or even if Zika is responsible.

Overnight both Crof and Dr. Ian Mackay have weighed in on this topic, and I encourage you to read both of their efforts.

First Crof, whose excellent analysis of the (admittedly sketchy) numbers to date (see Is microcephaly surging in Brazil, or just  efforts to find it?), was inspired by Declan Butler's Nature News & Comment article Report questions size of surge in Brazil's microcephaly cases.

Ian took a hard look at this week's  MMWR report Possible Association Between Zika Virus Infection and Microcephaly — Brazil, 2015, and finds it wanting in:

Microcephaly in Brazil: is it occurring in greater numbers than normal or not?

A paper came out yesterday (AEST) from Morbidity and Mortality Weekly Report (MMWR) with the heading...

Possible Association Between Zika Virus Infection and Microcephaly — Brazil, 2015

Reads as though some great data may finally show us a hint of an association between Zika virus (ZIKV) infection and microcephaly disease. Right? 

Nope. There are none. At least none that could approach satisfying that title which highlights that it is not just the popular media who can generate misleading titles (headlines in their case).

(Continue. . .)

This lack of evidence doesn't mean the evidence won't be found, or that a problem doesn't exist.  Only that there are an awful lot of questions yet to be answered.

CIDRAP Director Dr. Michael Osterholm, on the other hand, already finds the evidence compelling. He looks at the rise in mosquito-borne threats in the Americas - due in large part to the cutbacks in mosquito control efforts over the past couple of decades - in:

How Scared Should You Be About Zika?

By MICHAEL T. OSTERHOLM JAN. 29, 2016

Zika, or perhaps co-infection (or sequential infection) with Zika and other similar arboviruses (DENV, CHKV), may very well turn out to be responsible for increased rates of microcephaly, spikes in Guillain-Barré syndrome (GBS), or other serious outcomes.

Other viral infections have produced similar impacts, so it is certainly plausible.  But until we know for sure, it is important not ignore other possibilities.

While it may be overstated, I find it hard to believe Brazil's reported surge in microcephaly is due entirely to observational bias, even granting that the base line numbers are suspect and most of the cases are still only suspected.  Something certainly seems amiss.

But that's what epidemiological investigations are for . . . to find out. 

There are other issues, other unknowns, including determining exactly what species of mosquitoes can (and cannot) transmit the virus, that will need to be nailed down by scientists before we can accurately gauge the impact Zika will have on North America.

I certainly have no inside information or special insight into all of this - but considering the potential impacts to individuals, to families, and to society - it seems only prudent to regard Zika as the most likely culprit - at least until proven otherwise.

Which means, until we know different, the smart money will be on preparing to deal with an enhanced mosquito threat this summer, and likely for many years to come.


Because if it isn't Zika, there's always WNV, Dengue, CHKV, and EEE out there, and they can all ruin your entire day.

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CDC Guidance For People Exposed To Birds Carrying Avian Flu Viruses

CREDIT CDC Avian Flu

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With so many new and emerging avian flu viruses popping up in poultry and wild birds, both in the United States and around the world, I suppose it was only a matter of time before a new term would appear describing them:

 Avian Influenza Viruses Of Public Health Concern.

The list, which started off with H5N1, and a couple of H7 viruses, has grown rapidly over the past several years, and now includes H5N1, H7N9, H10N8, H5N6, H7N8, H5N2, H5N8, H5N9, H7N7, H7N2, H7N3, H9N2 . . . among others.

Only a handful of these avian viruses are known to infect humans, and of those, all but a few (H5N1, H5N5, H7N9, H10N8) usually produce mild, self-limiting influenza-like symptoms.  

Unless you work with live poultry, purchase birds from a live market, or are involved in the culling of infected birds, your odds of exposure right now are pretty slim. But, in the words of the CDC:

Avian influenza virus infections in humans are of public health concern, not only because of the illness they may cause, but because of their pandemic potential.

Some avian influenza viruses have been associated with greater numbers of human infections and more serious illnesses in people and therefore may pose a greater known public health risk. Avian influenza viruses of particular public health concern include (1) those viruses which are known to have caused severe disease in humans, such as highly-pathogenic avian influenza (HPAI) A (H5N1) virus and low-pathogenic avian influenza (LPAI) A (H7N9) virus.

Also, (2) avian influenza viruses that are related to viruses known to cause severe disease in humans are of concern because of their perceived potential to cause severe disease in people. These include HPAI A (H5) and A (H7) viruses identified in birds in the United States during 2015 and 2016. Finally, (3) other avian influenza viruses may be deemed to be of public health concern based on specific circumstances.

This week the CDC has published guidance for those who may be exposed to birds that may be carrying avian flu. Again, this is primarily for those who work in the poultry industry who have been exposed to flocks determined to be infected with avian flu.

Information for People Exposed to Birds Infected with Avian Influenza Viruses of Public Health Concern

Available as a PDF[142 KB, 3 pages] 

 

You are being given this information and these instructions because you were recently around poultry or wild birds found to be infected with avian influenza viruses (“bird flu”) of public health concern. Some avian influenza viruses have caused rare, sporadic infections in people, resulting in human illness ranging from mild to severe. These viruses are of public health concern because of their ability to cause human illness and also because of their potential to cause a pandemic.

Infected birds shed bird flu virus in their saliva, mucous and feces. Human infections with bird flu viruses are rare, but they can happen when enough virus gets into a person’s eyes, nose or mouth, or is inhaled. This can happen when virus is in the air (in droplets or possibly dust) and a person breathes it in, or when a person touches something that has virus on it and then touches their mouth, eyes or nose. Most often these infections have occurred after unprotected contact with infected birds or surfaces contaminated with avian influenza viruses. However, some infections have been identified where direct contact was not known to have occurred.

Because human infections with these viruses are possible, all people with exposure to birds infected with avian influenza viruses of public health concern and people with exposure to surfaces contaminated with these viruses should be monitored for illness for 10 days after their last exposure. State and local health departments are helping to monitor people’s health and you should contact your health department if you get any of the symptoms listed on this fact sheet during the 10 days after your last exposure. By following the instructions below, you can help ensure that you receive prompt medical evaluation, possible testing and appropriate treatment if you become ill with signs and symptoms that could be due to bird flu.

Please follow these instructions carefully:

1. Monitor your health for symptoms of avian influenza virus infection.
During and then immediately after your last exposure to infected birds or contaminated surfaces, monitor yourself daily for any of these signs and symptoms for 10 days:

You should observe your health daily even if you carefully followed all guidelines and instructions for properly putting on and taking off personal protective equipment (PPE) and maintaining biosecurity precautions.  

Re-start your 10-day monitoring period from Day 1 if you are around sick birds again.

2. Call your state/local health department immediately if you develop any illness signs or symptoms during the 10-day observation period.
Your health department will help you determine what to do next.

Remember: 

• Most of the signs and symptoms of bird flu overlap with those of other respiratory illnesses (like seasonal flu).
• If you develop any of the signs or symptoms listed on this fact sheet, immediately call the health department of the state you are in at the time. Your health department wants to hear from you, even if it turns out to be a ‘false alarm’.  
• Your health department may contact you by phone, email or text while you are observing your health.
• If you have symptoms, your health department may give you instructions and ask you to get tested for avian influenza virus infection.  
• To test for avian influenza virus, a doctor or nurse will collect a sample from you by swabbing your nose and/or throat.
• If you become sick while you are observing your health, a doctor may prescribe you an antiviral medication that is used for treatment of influenza.  It is important to follow the directions for taking the medication. (CDC recommends that clinicians prescribe antiviral medications for treatment of ill persons who had exposure to avian influenza viruses of public health concern.)

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UK PHE Warns On Potential Sexual Transmission Of Zika

#10,946


There is a great deal we still don't know about the Zika virus, but given its suspected link to profound birth defects, public health agencies around the globe are faced with a difficult decision:

Do you wait for irrefutable proof of harm, or do you warn people based on the available (and often anecdotal) evidence, in hopes of preventing needless tragedies?

Given the devastating effects that microcephalic birth defects have on families and society, most health agencies would prefer to be proactive, even if it risks raising some degree of alarm. 

In this regard, this week the UK's PHE (Public Health England) has issued some specific advice to sexually active men who have recently returned from regions where Zika has been reported, based on limited reports that the virus may be sexually transmitted.

The notion that Zika might be transmitted direct contact first came to light in 2011 when the EID Journal carried a dispatch on the first Probable Non–Vector-borne Transmission of Zika Virus, Colorado, USA, involving two researchers infected in Africa, one of whom returned to the Untied States and passed the virus (presumably via sexual contact) on to his wife. 

This was the first instance where sexual transmission of an Arbovirus was suspected, the author’s writing:

Results also support ZIKV transmission from patient 1 to patient 3. Patient 3 had never traveled to Africa or Asia and had not left the United States since 2007. ZIKV has never been reported in the Western Hemisphere. Circumstantial evidence suggests direct person-to-person, possibly sexual, transmission of the virus.

A second clue came a year ago, when the CDC's EID journal carried a dispatch called:

Potential Sexual Transmission of Zika Virus

Didier Musso , Claudine Roche, Emilie Robin, Tuxuan Nhan, Anita Teissier, and Van-Mai Cao-Lormeau

Abstract

In December 2013, during a Zika virus (ZIKV) outbreak in French Polynesia, a patient in Tahiti sought treatment for hematospermia, and ZIKV was isolated from his semen. ZIKV transmission by sexual intercourse has been previously suspected. This observation supports the possibility that ZIKV could be transmitted sexually.

Even if sexual transmission is possible, this would be a minor route of infection compared to the mosquito-vectored virus.  But as we've seen with Ebola in West Africa, some viruses can persist in the host long after they have physically recovered, and so this potential route of infection must be considered.


In addition to providing Zika virus: travel advice for pregnant women, this week the UK government updated their detailed guidance -  The characteristics, symptoms, diagnosis and epidemiology of Zika - with the following advice on sexual transmission of the virus.

Sexual transmission

Sexual transmission of Zika virus has been recorded in a limited number of cases, and the risk of sexual transmission of Zika virus is thought to be very low. However, if a female partner is at risk of getting pregnant, or is already pregnant, condom use is advised for a male traveller :

• for 28 days after his return from a Zika transmission area if he had no symptoms of unexplained fever and rash
  
• for 6 months following recovery if a clinical illness compatible with Zika virus infection or laboratory confirmed Zika virus infection was reported
  

This is a precaution and may be revised as more information becomes available. Individuals with further concerns regarding potential sexual transmission of Zika virus should contact their GP for advice.

The data is very limited, and the risks of sexual transmission are likely very low.  But there is still much we still don't know about how the Zika virus affects the human body, how it is shed, and the potential for non–vector-borne transmission of the virus.


For another look on how the Zika virus is shed from the human body, earlier today Dr. Ian Mackay looked at the detection of Zika virus in urine, in his VDU blog:

Zika virus disease samples...don't pass urine (by)..

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