Confirmed Zika Transmission through Intercourse

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Update
Since my last writing on Zika, there have been new developments. Multiple cases of Zika have been diagnosed in the United States, all of which were imported into the country with the exception of one. This single case was transmitted to an individual by sexual contact in Dallas, TX.

During the investigation, it was found that the Zika virus can live in semen and transmitted to sexual partners through intercourse. This is the second case in the literature and the third person overall to have documented Zika virus found in semen. The virus can be found in semen even if the person is without symptoms or fully recovered from the acute illness. Zika virus has also been found in saliva and urine, though there have been no documented transmissions through exposure to these bodily fluids.

Because of the risk of transmission from intercourse, the CDC has issued additional protective measures. Males returning from areas where Zika is prevalent should either abstain from intercourse with a pregnant partner or use condoms for the duration of the pregnancy.

In addition to sexual transmission, there are now documented cases of Zika infections from blood transfusions. As a result, persons that have travelled within 28 days to countries that are known to have active Zika virus circulating are not allowed to donate blood products.

Background:
• Zika is a virus that is spread by mosquitoes that also transmit other diseases such as Dengue
and Yellow Fever.
• The majority of people infected with the Zika virus will not have any symptoms
• Patients normally complain of fevers, headache, joint pain, and a rash
• There is no vaccine or treatment for Zika
• Diagnosis is made using sophisticated analytic laboratory tests available only at the CDC and
certain state labs
• Pregnant women are at particular risk due to the effects on the developing fetus
• Women in any trimester are at risk of microencephaly in their fetus
• Zika can not be spread from person to person and there is no need for protection other than
standard PPE (gloves)

What Does EMS Need to Know
EMS Providers should be educated about what to look for in a Zika infected patient, though there are no immediate concerns and no isolation is required. Pregnant patients that are encountered should be asked about travel history in Zika infected areas during their pregnancy and any positive information should be relayed to the treating facility. Persons presenting to EMS with symptoms consistent with a Zika infection should be asked about their travel history and this information conveyed to hospital personnel.

More information can be found at the Centers for Disease Control and Prevention.