Dear Editor,

We read the publication on ‘The challenge given by Zika virus’ with a great interest.1Rodriguez and Sebastian mentioned that ‘No sexual transmission of Zika virus from infected women to their partners and from infected people without symptoms has been reported’.1Indeed, sexual transmission is a possible mode of Zika virus transmission.2Either homosexual or heterosexual contact might be the starting point of pathogenic virus transmission.3Regarding female-to-male sexual transmission of Zika virus, there are some reports on this problem. Davidson et al first reported a suspected female-to-male sexual transmission of Zika Virus from New York city in 2016.4This case report had several laboratory evidences showing the possibility of disease transmission.4After that,there are many reports on this issue.5As noted by Sherley and Ong, ‘Unusually for a mosquito-borne virus, sexual spread has also been reported; with cases of male-to-female, female-tomale and male-to-male sexual transmission all now published in the scientific literature’.5According to the summative analysis by Moreira et al on sexual transmission of Zika virus, female-to-male transmission is detected in 3.7%.6Nevertheless, the common difficulty for diagnosis of a male-to-female or female-to-male sexual transmission of Zika virus is the ruling out of the chance of mosquito transmission, mosquito bite, of the two partners.7The diagnosis requires both clinical epidemiological molecular laboratory investigations for final confirmation.7

Beuy Joob,1Viroj Wiwanitkit2

1Sanitation 1, Medical Academic Center, Bangkok,Thailand

2Department of Community Medicine, Dr DY Patil Vidyapeeth University, Pune, India

Correspondence toDr Beuy Joob;beuyjoob@ hotmail. com

ContributorsBoth authors have contributed equally.

FundingThe authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interestsNone declared.

Patient consent for publicationNot required.

Provenance and peer reviewNot commissioned;internally peer reviewed.

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? Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

To citeJoob B, Wiwanitkit V. Fam Med Com Health 2019;7:e000183.

Received 25 May 2019

Revised 12 June 2019

Accepted 17 June 2019

Published Online First 8 July 2019

Fam Med Com Health 2019;7:e000183.doi:10.1136/fmch-2019-000183

ORCID iDBeuy Joob http:// orcid. org/ 0000- 0002- 5281- 0369