Zika virus in saliva—New challenges for prevention of human to human transmission

The ongoing Zika virus (ZIKV) outbreak in South and Central America has rapidly focused global attention due to its association with clusters of congenital malformations such as microcephaly, and neurological disorders and impending 2016 Olympic Games in Rio, Brazil [ ]. It was declared a global emergency by the World Health Organization and the ensuing flurry of research is defining the complexity of the epidemiology and pathogenesis of ZIKV. The main mode of transmission to humans is through the bite of an infected Aedes spp. mosquito. However, the unexpected rapid spread and transmission of the ZIKV has raised questions as to whether secondary human-to-human transmission can occur after primary infection. ZIKV has been detected in bodily fluids such as serum, urine, and semen. ZIKV has been detected and isolated in cell culture from semen samples of patients and cases of sexual transmission of ZIKV infection from males to their female partners have been documented [ ]. Oral-genital contact can transmit a number of sexually transmitted infections (STIs) including human immunodeficiency virus (HIV) [ ]. Even though oral sex carries a lower risk of HIV transmission than other sexual activities, the risk is not zero. It is difficult to measure the exact risk because people who practice oral sex may also practice other forms of sex during the same encounter (http://www.cdc.gov/hiv/risk/oralsex.html).