Fourteen women — some of them pregnant — may have contracted the Zika virus in the United States through sexual contact, federal health officials said Tuesday.
The Centers for Disease Control and Prevention said the new cases suggest the virus may be more easily contracted through unprotected sex than originally believed. That presents new challenges in preventing spread of the mosquito-borne virus, linked to a severe birth defect.
The Atlanta-based agency reissued an advisory Tuesday reminding pregnant women not to have unprotected sex with men who have been to regions in Latin America and the Caribbean impacted by Zika.
In three of the new U.S. cases, the infected were women whose only known risk factor was sexual contact with men who'd recently traveled to regions with active outbreaks. Several of the women were pregnant. Dr. Jennifer McQuiston, of the CDC, declined to say exactly how many pregnant women may have been affected and said the cases were spread out across the nation. Seven of the cases are still being investigated.
“We knew going in the virus could be sexually transmitted, but we have been a little surprised by the numbers,” McQuiston told The Atlanta Journal-Constitution on Tuesday. ” We were concerned enough by the numbers that we wanted to remind people we have guidelines out there (regarding sexual activity) and they should follow it.”
Zika is linked to microcephaly, a birth defect that causes cognitive disorders and unusually small heads in newborns. It is also a suspect behind the increasing number of Guillain-Barre syndrome cases that have appeared in areas where Zika has flourished. Guillain-Barre is a virus that attacks the nervous system causing paralysis and, in some cases, death.
Since early last year Zika has spread across Latin and South America primarily through mosquito bites. Initially, it can be something of a stealth virus; four out of five people don’t get the telltale symptoms of Zika: conjunctivitis, joint pain, fever and rash. An infection is usually over in a week but the virus can persist in semen. Scientists haven’t figured out for how long.
For a pregnant woman, however, scientists suspect the virus can prove devastating to her fetus, which is why the CDC is reiterating its guidelines issued earlier this month regarding sexual contact. CDC researchers are racing to figure out exactly how Zika may affect a pregnancy and at what stage of a pregnancy a Zika infection is most dangerous. The agency now has a team in Brazil conducting a case-control study with women and children who have had the virus, and those who have not, to determine exactly how the virus might cause birth defects or if other factors may be at play. It could be months before the results of that study are known.
McQuiston said while Zika is believed to be spread primarily through mosquitoes, sexual transmission of the disease may have been masked in countries with active Zika outbreaks. Because the U.S. currently has no active mosquito-borne flare-ups, the cases involving sexual transmission may be easier to detect, she said.
McQuiston said the 14 new cases should still be considered travel related because the women may have gotten the virus by having sex with men who had been in the affected areas. The cases came to the attention of the CDC after the agency released their initial guidelines regarding sexual activity earlier this month.
The CDC continues to advise that pregnant women not have unprotected sex — vaginal, oral or anal — with any male partner who has returned from one of the regions. A couple should either use latex condoms or abstain from sex for the duration of the pregnancy, the agency said.
Dr. Jane Ellis, a gynecologist, at Grady Hospital in Atlanta, said so far she hasn’t had many questions about Zika from women seeking treatment.
“Maybe with this additional attention we will get more,” Ellis said.
Until today, the CDC had only confirmed one U.S. case of Zika being sexually transmitted. In that instance, a Texas man who had recently returned from Venezuela, passed the virus to his female partner. While it wasn’t the first time Zika has been passed along sexually in the U.S., it was the first documented case during this current outbreak. The first known sexual transmission of the virus here was eight years ago in Colorado. A researcher who contracted the disease while working in Africa wound up passing the virus to his wife once he came home.
Georgia had its first case of travel-related Zika this month when an unidentified person returning from Colombia tested positive for exposure to the virus. State health officials are also waiting on test results from at least three other people who may have contracted the virus while traveling. Currently the CDC does all Zika testing for state and regional health departments at its facility in Colorado. In the coming weeks, however, the agency is expected to provide testing kits to some state health agencies, including Georgia's, so tests can be turned around faster. People who think they have been exposed to the virus would first have to be examined by their primary care physician who would then contact the Georgia Department of Public Health to arrange for testing.
U.S. health officials say the nation should expect the virus to spread here as mosquito season arrives. The Obama administration has asked Congress for $1.8 billion to prevent and fight the spread of disease which is proving difficult to contain.
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