What couples need to know about Zika

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by Sandee LaMotte, CNN

Story highlights

  • Pregnant women and their partners should take immediate precautions to avoid Zika
  • Couples trying to conceive must practice safe sex after exposure
  • Everyone can help by “avoiding the bite”

(CNN)You’ve doused yourself with repellent, donned long sleeves and pants, and done your best to swat any flying invaders. But if you live in or travel to a spot with active Zika transmission, how do you know for sure that you’ve not gotten the virus?

You probably wouldn’t feel the bite of the Aedes aegypti mosquito that gives you Zika; that pesky creature is so small, her nip is almost painless.

Since only one out of every five infected people has symptoms, you can’t be sure that you — or your sexual partner — didn’t catch it.

 

Which means you can’t be 100% sure that you won’t get the virus from sex. After all, the Centers for Disease Control just announced the first known case of a man who gave the virus to his female partner when he didn’t even know that he had it.

“I think this case is very important,” said Dr. John Brooks, a medical epidemiologist with the Centers for Disease Control, “because it reminds us that even though it might be less common than transmission from a person with active signs of Zika, it can still occur.”

So, just what is a person to do? The level of precautions you should take depends on your current baby-making status.

Pregnant women and their partners

Pregnancy is the most dangerous time to catch the Zika virus. It’s been linked to devastating neurological birth defects that destroy developing brain cells in the fetus, leading to a condition called microcephaly, which means “small head.” Babies with this disorder, if they live, often have seizures and difficulty lifting their heads, controlling their muscles or even feeding. The impact is lifelong, and care is expensive: The March of Dimes recently estimated the lifetime cost for one child with microcephaly at over $10 million.

 

But even if the baby escapes microcephaly, Zika has been known to cause brain calcifications, vision and hearing problems, and learning disabilities. Researchers are scrambling to find out just how widespread the damage can be.

Because of this danger, several South and Central American countries are encouraging their citizens to delay pregnancy until the outbreak is over, if possible.

The United States has not gone that far. Instead, the CDC recommends that pregnant women avoid travel to any areas where Zika is circulating. If that is unavoidable, use all known precautions to avoid a bite. And be sure to check in with your health care provider when you return for careful monitoring.

If a pregnant woman’s partner is the traveler, safe-sex precautions should be carefully and properly used for every sex act throughout the entire pregnancy, or sex should be avoided. That precaution applies to both male and female partners of the pregnant woman and includes male and female condoms, sex toys and dental dams for any vaginal, anal or oral sex.

Couples trying to conceive

If you and your partner are actively trying to conceive, you also need to take significant precautions. Because women can be pregnant for several weeks before they know it, it’s best to avoid travel to Zika-infested areas if possible.

“If you’re a couple and traveling to these areas,” said Brooks, “while you’re there, we recommend you consider using condoms, as you don’t know which of you might be bitten and transmit the disease, and then continue practicing safe oral, anal and vaginal sex for eight weeks.”

If the woman’s partner is the one who is traveling, safe sex should begin after the last known exposure.

“For most people, that’s the time they depart the area of risk,” Brooks said. “For others, it may be the last time they had a sexual exposure to someone. Regardless, it should continue for a full eight weeks, with one exception. Men who show signs of Zika, which include fever, rash, red eyes, headache, and joint or muscle pain, should practice safe sex for a full six months.”

Zika is known to hide in the male testes and reproduce, sometimes becoming more and more virulent for up to six months. At least, that’s the latest finding. With Zika, things change frequently.

Not making a baby anytime soon?

If you and your sexual partner have no plans for babies anytime soon, does that mean you’re off the hook? Not if you’re a good citizen.

Every person who brings the virus back into the United States and gets bitten by an Aedes aegypti mosquito could be starting a local outbreak. That’s exactly what’s happening now in Florida, in both the Miami and Tampa-St. Petersburg areas.

So taking precautions to “avoid the bite” is good for the community and the many pregnant women who are living happily around you, unaware that you could be soon turning their safe area into a new Zika hot zone.

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Then there’s a nasty neurological disorder that can attack anyone who gets Zika, including adults. It’s called Guillain-Barré, a disease in which your own immune system attacks your nerve endings, causing tingling and muscle weakness that can escalate into intense pain and total paralysis. It’s still pretty rare with this virus, but Puerto Rico, hard-hit by the Zika virus right now, has had nearly 40 cases and one death linked to Guillain-Barré.

And finally, there’s the problem of birth control. No method is 100% effective, and there is always a risk of exposure before the woman misses her menses.

 

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