Men, Mosquitos, Sex & Zika

This series of questions from a dad and answers from Dr. Greene explore the issues important to couples when they consider sex in a post Zika world.

Q: I just returned from a trip to a tropical location. There are confirmed cases of Zika in the area and there were definitely mosquitos where I was staying. Sadly, I got a few bites – nothing crazy, but I did get a few. The CDC recommendation is to avoid sex or use condoms for six months post traveling in a Zika zone.

My wife and I are not trying to have another child right now, but my wife is not on any form of birth control.

What is your recommendation to us regarding sex to avoid any chance of my wife contracting Zika?

Dr. Greene: I agree with the CDC guidance that men who have had Zika exposure, whether symptomatic or not, should wait at least 6 months before unprotected sex.

Q: Is there any risk if she were to get it that it could be passed on to our baby via breast milk?

Dr. Greene: Effective transmission of Zika through breast feeding has NOT been reported. Having said that, the Zika virus has been detected in breast milk – but it appears to be deactivated in the acid of the child’s stomach. ACOG recommends that women with known Zika continue to breast feed because

  • It’s never been shown to cause Zika in babies, and
  • When babies do get Zika from other means, it’s mild and no developmental complications have ever been reported in otherwise healthy kids

Q: Is there a test available to see if someone is infected. Is that correct?

Dr. Greene: There is indeed a Zika test (a couple actually).

Q: And if we can get me tested, are the tests conclusive or is there a chance of being infected and the virus not showing up on a test?

Dr. Greene: The current recommendation is that there is no role for Zika testing in asymptomatic people (who aren’t pregnant). Because there is a small chance that the virus may be present even with a negative test, the 6-month recommendation still holds. If you didn’t get mosquito bites, I’d take a negative test more seriously, because the prior probability of exposure is so much lower. Because you did have bites, even with a negative test, the prudent course is no unprotected sex for 6 months.


Published on: July 10, 2017
About the Author
Photo of Alan Greene MD
Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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