A group of French scientists have raised the possibility that Zika could be transmittable through oral sex and maybe even deep kissing, according to a recent letter to the editor detailing the account of a likely case of Zika transmission through sexual contact published in The New England Journal of Medicine.
The case relayed in NEJM involves a 24-year-old French woman who became infected with Zika after engaging in seven sexual encounters with a 46-year-old man who had recently traveled to Brazil. The man had experienced symptoms related to the virus while in Brazil, but they had dissipated when he reached France. After the woman became sick, both were tested for Zika.
The man had high levels of the virus in his urine and semen, but not in his blood or saliva. The virus was detected in the woman's urine and saliva, and antibodies generated by the virus were also detected in her blood. Indications of the virus were not detected on a vaginal swab. During their seven sexual interactions the two engaged in vaginal sex without ejaculation and oral sex with ejaculation.
The study's authors write, "These data support the hypothesis of sexual transmission (either oral or vaginal)...we cannot rule out the possibility that transmission occurred not through semen but through other biologic fluids, such as pre-ejaculate secretions or saliva exchanged through deep kissing."
William Schaffner, MD, head of preventive medicine at Nashville, Tenn.-based Vanderbilt University Medical School, told The New York Times he agreed with the assessment that the most likely method of transmission in this case was oral sex, but stated, "I don't think this changes anything, but it shows you how elaborate the number of avenues of possible transmission can be."
John T. Brooks, MD, an epidemiologist at the CDC studying sexual transmission of the Zika virus, told the Times he wasn't surprised to see likely transmission of the virus through oral sex, but countered that transmission through kissing wasn't likely.
Dr. Brooks said, "Casual kissing has got to be safe because, if it weren't, don't you think we'd see a lot more Zika? Every mom who kissed her baby would pass it on...to be sure, we'd have to look for deep kissing in the absence of sexual contact, and that's hard to find."
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