Richard A. Watson, MD, explains why urologists need to be prepared to deal with men’s questions and recommend preventive steps related to Zika virus transmission.
National Report-The Centers for Disease Control and Prevention recently reported that the mosquito-borne Zika virus can also be transmitted via sexual intercourse. A man whose semen silently harbors the virus is capable of infecting his sexual partner and endangering the outcome of her pregnancy. Urologists, therefore, need to be prepared to deal with men’s questions and recommend preventive steps related to virus transmission.
The World Health Organization now warns that neonatal microcephaly, as well as other illnesses caused by Zika virus, constitute a “public health emergency of international concern.” Since the first case was reported in Brazil in May 2015, the spread of Zika has escalated “from a mild threat to one of alarming proportions,” WHO Director General Margaret Chan, MD, said in a BBC News article.
In addition to microcephaly and mental retardation, premature birth and serious congenital eye defects are now linked to this virus, according to the CDC. Furthermore, people infected by Zika may later develop Guillain-Barré syndrome, acute demyelinated encephalomyelitis, and other neurologic infections within the brain and spinal cord, recent reports from WHO, the American Academy of Neurology, and other sources indicate.
The most common symptoms are fever, rash, joint pain, or conjunctivitis (red eyes). Other common symptoms include muscle pain and headache. However, most people infected with Zika virus will have no symptoms at all. Even when the Zika virus is present in semen and urine, there are no accompanying signs of prostatitis or other lower urinary tract symptoms. The CDC says it may be possible for a man to be carrying the Zika virus and to transmit it to his partner through sexual contact, without his knowing that he is infected. The virus can stay in semen longer than in blood. Currently, there is no practical screening process for detecting whether or not men are carrying Zika virus in their semen.
Commercial testing for Zika virus is just now becoming available on a limited basis. Meanwhile, requests for testing still entail a complex, time-consuming application process, mediated through government agencies, which may vary from state to state.
Because of the link between Zika and serious birth defects, steps should be taken to prevent sexual transmission of infection, especially during pregnancy.
The CDC has issued the following warning:
The CDC maintains a website with more complete, updated information: Zika and Sexual Transmission.
These CDC recommendations are preliminary. Answers are based on relatively scant, short-term experience. Many additional critically important questions remain unanswered, and men may soon be asking their urologist:
Anne Schuchat, MD, principal deputy director of the CDC, admits that the type of mosquito in which the virus is carried is present in more U.S. states than was originally estimated-30 states, rather than just 12. Over 500 cases are already present in Puerto Rico. “Everything we look at about the virus is scarier than we initially thought,” she told a White House press briefing.
On a more sanguine note, Congress is now voting on a $1.9 billion package to combat Zika virus here. Other nations are following suit. A commercially available blood test should be available imminently, and there is hope that an initial anti-Zika vaccine will be available for testing by the end of this year.
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