ZIKV disease symptoms include: fever, arthralgia, maculopapular rash, and conjunctivitis. Less frequently, observed symptoms include digestive problems (abdominal pain, diarrhea,and constipation), mucous membrane ulcerations (aphthae), and pruritus (Refs. 16, 17). In addition, neurological manifestations and congenital anomalies have been temporally and spatially associated with ZIKV disease outbreaks (Ref. 17). Association of ZIKV infection with GuillainBarré syndrome cases has been reported during outbreaks in Polynesia (Ref. 18) and in Brazil (Ref. 19). In Brazil, there has also been a marked increase in the incidence of microcephaly in regions most affected by the ZIKV epidemic (Refs. 19, 20). Sexual transmission of ZIKV has been reported (Refs. 4, 5). The two reported cases involved transmission of the virus through sexual contact. In a separate report, ZIKV was isolated from semen at least two weeks and possibly up to 10 weeks after illness onset (Ref. 21). The duration
of persistence of ZIKV in semen remains unknown. Data are currently not available regarding the presence of ZIKV in vaginal fluids. Sexual transmission of ZIKV from infected women to
their sexual partners has not been reported. Two instances of possible transfusion-transmission have been described in media announcements in Campinas, Brazil (Refs. 20, 22). In French Polynesia, 3% of samples from asymptomatic blood donors contained detectable ZIKV RNA during the outbreak in French Polynesia in 2013- 14, indicating the likelihood of transmission by blood transfusion (Refs. 9, 23, 24). For these
reasons, measures should be taken to prevent transfusion-transmission.