In light of the recent news that Zika virus could stay in semen for more than six months ― twice as long as scientists previously though the virus could be detected ― it's time for the United States to ramp up its focus on the major mechanism for Zika virus transmission after mosquitos: sex.
“For the public health community, Zika represents an unprecedented emergency,” Tom Frieden, director of the Centers for Disease Control and Prevention, wrote in the Journal of the American Medical Association in August.
“Never before, to our knowledge, has a mosquito-borne virus been associated with human birth defects or been capable of sexual transmission,” Frieden wrote. “The effects of brain damage due to microcephaly and consequences of other Zika-related birth defects are likely devastating, lifelong, and costly.”
As Zika virus spreads, with at least 55 countries and territories reporting local transmissions, according to the CDC, and the United States reporting two areas of active transmission in Florida, health officials like Frieden have called for increased safe-sex messaging, even for people outside active Zika zones.
New York City is ramping up its public health messaging on sexually transmitted infections to include Zika virus in coming weeks, The New York Times reports. The campaign will feature posters, fliers, radio and television ads, in addition to deploying community health workers to communicate the risks of sexually transmitted Zika in person.
Florida's sex ed blunder
But not everyone is making public health a priority. In Florida's Broward County, which is adjacent to Miami-Dade County, where active Zika transmissions are occurring, abstinence-only rhetoric is trumping public safety ― at least for now.
According to Miami news station WSVN 7News, Broward County removed two AIDS Healthcare Foundation billboards that featured unrolled condoms reminding people that safe sex “prevents Zika transmissions.”
The Fort Lauderdale mayor's office and tourism board pressured the company to take down the signs, Michael Kahane, a spokesman for the foundation, told the station. “They felt, I guess, that they could impact tourism,” Kahane said. “I find it completely disgusting.”
Still, neither the mayor's office nor the tourism board is taking credit for the sign's removal, so it's unclear who is behind the billboard takedown.
We still don't know enough to write strong health policies
Using condoms is key to curbing sexually transmitted infection, including Zika virus, but health experts cautioned against overstating Zika's sexual transmission risk compared to the larger risk of transmission via mosquitos.
Travel-related Zika virus is a major concern. The CDC currently recommends that pregnant women avoid traveling to areas with active Zika transmissions and use condoms or abstain from sex if their partner has traveled to a Zika outbreak area in the last six months.
Dr. Federico Laham, the medical director of infectious disease at Arnold Palmer Hospital for Children in Orlando stressed that it's also important for doctors to ask pregnant patients about their travel histories, regardless of whether or not the Aedes aegypti mosquito is present in their areas of practice.
One major challenge for health officials trying to curb sexually transmitted Zika in their respective cities is that it's difficult to craft definitive public health and safe sex recommendations, because no one knows for sure how long Zika virus can stay active ― or remain capable of transmitting infection ― in men's semen.
That information is “very important if you are trying to craft a prevention method to your community,” Laham told The Huffington Post. “Any couple expecting a child will live with a lot of anxiety. It's important for health officials to deliver a clear message.”
Zika isn't the only STI that can hurt unborn babies
For Dr. Jeffrey Klausner, a professor of medicine in the infectious disease and global health divisions at the University of California Los Angeles, focusing on sexually transmitted Zika and the risk it poses to pregnant women misses the point.
“Zika is important, but we need a much broader holistic approach to address infections in pregnant women,” Klausner said.
He cited congenital syphilis ― when a pregnant woman infected with the disease passes it to her child ― as a more common STI, with equally grave consequences. Indeed, congenital syphilis can cause severe illness, miscarriage, stillbirth and early infant death, as well as blindness, nervous system damage and deformity if left untreated.
“When things are common and they occur regularly people forget about them,” Klausner said. “We need to remind people of the day-to-day risks.”
There were 12 cases of congenital syphilis per 100,000 live births in 2014, an increase from 8 per 100,000 live births in 2012, according to the CDC.
Klausner believes defunded health departments and communicable disease programs in the wake of the 2008 recession is making it even harder to address issues like congenital syphilis and Zika virus.
He's also frustrated by Congress, which failed to pass a Zika bill before leaving for summer vacation this year.
“You can't trade the health of one population because of ideological views,” he said. “When Congress does come back, it's going to be important for local constituents to demand a response.”
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