WHO issues advice on the prevention of sexual transmission of Zika virus

The World Health Organization (WHO) has issued a press release which advised on the prevention of sexual transmission of Zika virus.

WHO states that a total of 17 studies or reports have been published on sexual transmission of Zika virus.

Based on the research findings, WHO advises members of the public to have protected sexual intercourse or abstinence for six months, which was longer than 8 weeks period it had announced before.

It said that this change in the advisory is caused by a new finding based on men in Italy who had visited Haiti in January and February. When a test of reverse transcription polymerase chain reaction (RT-PCR) was conducted on the men, an equal viral permanence was detected and the longer shedding of the Zika virus in semen was documented. The findings noted that the virus can still be found after 181 days of infection.

WHO recommends health programmes in regions with active Zika virus transmission, should ensure that :

• All people (male and female) with Zika virus infection and their sexual partners (particularly pregnant women) should receive information about the risks of sexual transmission of Zika virus.
• Men and women also get counselling on safer sexual practice, and should be offered condoms. The consistent use of condoms is essential to prevent sexually transmitted infections, including human immunodeficiency virus (HIV), and unwanted pregnancy.
• Sexually active men and women should be correctly counselled and offered a full range of contraceptive methods to be able to make an informed choice about whether and when to become pregnant, to prevent possible adverse pregnancy and fetal outcomes.
• Women who have had unprotected sex and do not wish to become pregnant due to concerns about Zika virus infection have ready access to emergency contraceptive services and counselling.
• Pregnant women should practice safer sex or abstain from sexual activity for at least the whole duration of the pregnancy. Their partners should also be informed about this recommendation.

While for regions with no active Zika virus transmission, WHO advises health programmes to ensure that:

• Men and women returning from areas where transmission of Zika virus is known to occur should adopt safer sex practices or consider abstinence for at least 6 months upon return to prevent Zika virus infection through sexual transmission.
• Couples or women planning a pregnancy, who are returning from areas where transmission of Zika virus is known to occur, are advised to wait at least 6 months before trying to conceive to ensure that possible Zika virus infection has cleared.
• Sexual partners of pregnant women, returning from areas where transmission of Zika virus is known to occur, should be advised to practice safer sex or abstain from sexual activity for at least the whole duration of the pregnancy.

WHO spokeswoman, Nyka Alexander, advised couples to wait six months to provide a margin of safety on Tuesday (6 September). She also referred to the wording meant “delaying until we have more answers, more evidence, more science” which was published by WHO in early June and said, “Last time, our guidance was quite confusing. We want it to be unmistakable that we are not counseling anybody toward delay.”

WHO and the Centers for Disease Control and Prevention (CDC) have repeatedly said they would not advise women to delay pregnancy.

Dr James Kiarie, the coordinator of the W.H.O. human reproduction team, said “While directive counselling may be appealing, it is not supported by evidence.” However, they urge countries to make contraception available. One of the examples is solicited corporate donations for birth control devices and pills for use in Puerto Rico, which is fighting a spreading Zika epidemic, is provided by CDC.

However, health officials in several countries have asked female citizens to delay pregnancy if they can. The countries including Brazil, Colombia, El Salvador, Jamaica, and health secretary of Puerto Rico.

On the situation of the Zika infection in Singapore, the Ministry of Health (MOH) stated that there were another 17 new cases of locally transmitted Zika virus infection confirmed as of 12 pm, 6 September, which brought the numbers to 275 cases.