CFAS Communication on Zika

Revised April 6, 2016

Please be advised that in light of the recent changes to Health Canada Zika virus recommendations, the CFAS has updated its advisory.

On February 29th, Health Canada released an advisory indicating that women and couples wanting to conceive should avoid trying to become pregnant for at least two months after returning from an area with confirmed transmission of Zika virus or after potential exposure through sexual contact.

On March 24th, Health Canada updated its advisory with the recommendation that men should use a condom for six months after returning from an area with confirmed transmission of Zika virus.

Key points from Government of Canada are reproduced below. A link to the full document is provided at the end along with links to other useful resources:

• The Canadian recommendations for the prevention and treatment of Zika virus (ZIKV) were developed by a working group of the Committee to Advise on Tropical Medicine and Travel (CATMAT). Recommendations are based on a literature review and clinical judgement; they were not developed using an evidence-based medicine methodology.
• A large outbreak of ZIKV is occurring predominantly in the Americas. This outbreak has been associated with an increased rate of microcephaly in newborns in Brazil. The strength of the association between ZIKV infection and congenital abnormalities has previously been very poorly described. However, recent evidence suggests that ZIKV infection during pregnancy is frequently associated with serious neurologic consequences to the fetus.
• Infection with ZIKV also has also been associated with neurologic complications such as Guillain-Barré syndrome (GBS).
• Sexual transmission (male to female) of ZIKV has been documented, including in travellers.
• Much remains unknown about ZIKV. For example, the likelihood of infection among travellers to ZIKV-infected areas, the probability of vertical transmission from mother to fetus, the likelihood of sexual transmission (from symptomatic or asymptomatic partners), and the likelihood of serious ZIKV-associated sequelae among travellers.
• CATMAT recommends that pregnant women avoid travel to areas of ongoing risk of ZIKV outbreak. Women planning a pregnancy should consult with their health care provider and consider postponing travel to risk areas.
• Other travellers, based on risk tolerance, values and preferences may wish to consider deferring travel to ZIKV-infected areas (e.g. males who are trying to impregnate their partner). Travellers should use personal protective measures against mosquito bites. These include skin repellents and protection of living areas against mosquito entry.
• Health care providers should take a travel history from their pregnant patients including relevant information related to the travel history of their partner(s). Any patient who indicates that they or their partner have recently travelled (i.e. during or just prior to the pregnancy) to a risk area should be further evaluated.
• Women should avoid becoming pregnant during travel and for two months after return from a risk area. After a male partner returns from an area of risk, it is reasonable to delay trying to become pregnant for six months.
• To minimize the risk of sexual transmission, CATMAT recommends abstinence or use of condoms for the duration of pregnancy by male partners who have travelled in areas of risk

The CFAS will continue to pass on information as it becomes available. In the meantime, here are some helpful links.