Sexually acquired Zika virus: a systematic review

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ZIKAV may be a sexually transmitted disease, and can be transmitted from asymptomatic and  female carriers.

There have been Zika virus outbreaks in 69 countries and territories since 2015. Although the WHO has recently downgraded it from a Public Health emergency of International Concern, Zika does remain a significant challenge.

Mosquito-transmission of the virus is most common but the magnitude of non-mosquito transmission is unclear, so this SR summaries the current evidence about sexual transmission, and the shedding of Zika virus in genital fluids.

18 studies reported 27 probable or confirmed episodes of person-to-person transmission through sexual intercourse, of which 15 studies reported male to female transmission in 25 couples, 1 reported male to male, and 1 reported female to male transmission. Of the 27 cases which reported timing of symptom onset, intercourse occurred before symptom onset in 5 cases, during in 7 cases, and after in 1 case. Shedding of zika virus in genital fluids was recorded in 21 studies:  ZIKV RNA was detected in semen as late as 188 days following symptom onset though only viable up to 69 days after symptom onset; the detection times in other body fluids were all much shorter than for genital fluids. Limited databases were searched (not including LILACS or SceiLO).

 

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