Dear SuzyKnew!, My boyfriend lives in Brazil and is coming to visit me next month in Washington, D.C.  I’m concerned about Zika virus.  Do I need to take any precautions when we are intimate?  He tells me not to worry because we are not looking to get pregnant.  Do you have any advice? 

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Dear Reader,

When Zika hit the news a few months ago it seemed like the only people who needed to worry were pregnant women living in or traveling to Brazil.  A few months into the outbreak, we have seen locally acquired Zika in 64 countries including Puerto Rico, the Caribbean (including the U.S. Virgin Islands), South America and Central America. We are seeing travelers to these regions return home to the U.S. and Europe with Zika.   Zika is a public health emergency.

Most important for you and our SuzyKnew! readers is that Zika cannot only be spread through the bite of an infected mosquito, but that it can also be spread through sexual contact.  Zika can live in semen and blood for an unknown amount of time, for weeks if not months, and can be transferred through oral, vaginal and anal sex.  But Zika is not just dangerous for pregnant women.  It has been linked to increased risk for Guillain-Barré syndrome, a very serious immunological disorder that attacks the nervous system.  Yes, you are correct to be concerned.

Would someone know if he or she was exposed to Zika? Not necessarily. Zika infection is primarily spread through the bite of the aedes aegypti mosquito.  For many people around the world, mosquito bites are just part of daily life.  Your boyfriend, his friends or family members, may have been exposed and not know it.  Symptoms are typically mild and may be confused with other illnesses.  They include: fever, muscle aches, headache, joint pain, and rash among others.  Zika can be spread before symptoms appear, while a person is asymptomatic and after symptoms have passed.

Is this a new disease?  No, Zika was first documented in the 1940’s in equatorial Africa and then in later outbreaks in the Pacific Islands.  In 2015 there was a cluster of cases of a “new” mosquito-borne illness in northern Brazil.  In February 2016 a cluster of Brazilian babies were born with abnormally small heads, called microcephaly, which is associated with defects in fetal brain development.   The microcephaly was associated with maternal infection with the Zika virus.  There are also increased cases of Guillain-Barré as a complication of Zika infection.

How can you protect yourself?  Because we now know that sexual transmission of Zika is possible, you should protect yourself by practicing safer sex, by using condoms correctly and consistently. You should have Emergency Contraception on hand in case you have unprotected sex so that you can avoid an unplanned pregnancy.

The Centers for Disease Control and Prevention (CDC) offers the following guidance for couples where a male partner has been exposed and or diagnosed with Zika:

• Couples who include a man who has been diagnosed with Zika or had symptoms of Zika should consider using condoms or not having sex for at least 6 months after symptoms begin.
• Couples who include a man who traveled to an area with Zika but did not develop symptoms of Zika should consider using condoms or not having sex for at least 8 weeks after their return.
• Couples who include a man who lives in an area with Zika but has not developed symptoms of Zika should consider using condoms or not having sex while there is Zika in the area.

What advice can you give your boyfriend?   Please advise him to protect himself from the mosquito. He should wear highly effective repellent, use treated mosquito nets and/or stay indoors.   If he has been exposed to Zika, he needs to tell a health care provider.  They can test for Zika, monitor symptoms, and provide contraceptive counseling, instructions on how to practice safer sex, and provide contraceptive supplies so that you avoid pregnancy.

Know your options.  If you have had unprotected sex and have been exposed to Zika, you have the option to use emergency contraception so that you can avoid an unplanned pregnancy.  All women and girls should have ready access to emergency contraception, including accurate information and counseling as well as affordable methods. If you are pregnant and have been exposed to Zika you also have the option to have an abortion.   A baby born with microcephaly or a related fetal brain defect is a tragedy.   Knowing and exercising your options is your best protection.

Take care.