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Patient Counseling

People Planning to Conceive

Planning Travel

Healthcare providers should counsel [PDF – 173 KB] women and men who are trying to conceive about travel to areas with risk of Zika virus infection. This conversation should address the potential consequences of becoming infected with Zika around the time of conception or during pregnancy as well as the patient’s individual circumstances and risk tolerance.

Timeframes to Wait after Possible Zika Exposure before Trying to Conceive

Patients with Known Infection or Recent Exposure to Areas with CDC Zika Travel Notices

For women and men who have been diagnosed with Zika virus infection or had exposure to an area with a CDC Zika travel notice, eCDC recommends that healthcare providers counsel patients that a person can be infected and contagious even if they have no symptoms and advise

  • If a woman is exposed, the couple should wait at least 8 weeks after her symptoms started or last possible Zika virus exposure before trying to get pregnant.
  • If a man is exposed, the couple should wait at least 6 months after his symptoms started or last possible Zika virus exposure before trying to conceive.
  • If a woman and man travel together and both are exposed, the couple should wait at least 6 months after their symptoms started or last possible Zika virus exposure before trying to conceive.
  • During the waiting periods after their possible exposure, couples should also be counseled to correctly and consistently use condoms for vaginal, anal, oral sex, and the sharing of sex toys, in addition to their chosen method of birth control, or to not have sex.

Given the limited data available on how long Zika virus can persist in the body, men and women with possible Zika virus exposure might choose to wait longer than the recommended time period to conceive, depending on individual circumstances and risk tolerance.

Patients with Recent Exposure to Areas with Risk of Zika but No Travel Notice

The level of risk for Zika virus infection in these areas is unknown but some risk of being bitten by an infected mosquito may exist. For this reason and because information is limited about the risk of infection around the time of conception, healthcare providers should counsel women and men who are trying to conceive about travel to these areas and their risk of Zika virus infection. This conversation should address the potential consequences of becoming infected with Zika around the time of conception in the context of the couple’s plans to have children, their individual circumstances, and risk tolerance.

Zika virus testing is indicated for non-pregnant women and men who have exposure to these areas and who experience symptoms of Zika virus disease. Those who test positive for Zika should follow the suggested timeframes above before trying to conceive.

Patients with Ongoing Exposure to Areas with a CDC Zika Travel Notice

Ongoing exposure means living in or frequently traveling to (e.g., daily or weekly) an area with a  CDC Zika travel notice. Given the ongoing possible exposure to Zika, healthcare providers should counsel women and men about how they can protect themselves against Zika, the potential consequences of becoming infected with Zika around the time of conception and during pregnancy, and their individual circumstances.

  • Symptomatic non-pregnant women and men: Zika virus testing is indicated for non-pregnant women and men who live in or frequently travel to areas with a CDC Zika travel notice and who have symptoms of Zika. Those who test positive for Zika should follow the suggested timeframes above before trying to conceive.
  • Asymptomatic women planning to conceive: Preconception Zika IgM testing can be considered for asymptomatic women planning to become pregnant in the near future, who live in or frequently travel to areas with a CDC Zika travel notice. Testing shortly before pregnancy can provide information that may help interpret test results in the future if a woman is exposed to Zika later during the pregnancy. Positive IgM test results before pregnancy should not be used to determine if it is safe for a woman to become pregnant because the test results could have multiple interpretations. Positive test results could mean a recent infection with Zika; recent infection with a similar type of virus such as dengue, a false positive result, or a past infection with Zika.

People Not Planning to Conceive

Men and women should use condoms correctly and consistently for vaginal, anal, and oral sex and while using sex toys in addition to their chosen birth control method, or abstain from sex if they are concerned about the possibility of transmitting Zika virus to their sex partners. People who live in or travel to areas with risk of Zika should be informed that Zika can be passed through sex, even if the infected person does not have symptoms at the time. The virus may also be passed through sex by a person who has been infected with the virus but never develops symptoms.

Patients should be counseled about contraceptive methods, including the availability and effectiveness of different contraceptive methods and how to use these methods. The decision about what type of contraceptive method to use is a personal decision and should be made by the person or couple in consultation with their healthcare provider.

Persistence of Zika in Semen

CDC is aware of reports of Zika virus RNA detected in semen more than 90 days after symptoms began, with the longest report at 188 days. However, it’s unknown whether Zika virus RNA in the semen represents infectious virus. To date, Zika virus has been cultured (shown to be infectious) from semen collected within 3 months after symptoms started. There have also been reports of men without symptoms who are infected with Zika transmitting Zika virus to their partners through sex. Without definitive data showing a difference in the risk for men with and without symptoms to spread Zika through sex, the recommendations are the same for both groups.

Given the limited information available at this time and the potential for severe birth defects from congenital Zika infection, CDC recommends men wait 6 months before attempting pregnancy with their partner. This recommendation will be updated as new data become available.

Recommendations by Geographic Location

Clinician Resources

Preconception Counseling Guide for Men and Women Living in Areas with a CDC Zika Travel Notice Who are Interested in Conceiving

Counseling Travelers: Women and Men of Reproductive Age

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