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Epidemiological update: Outbreaks of Zika virus and complications potentially linked to the Zika virus infection

08 Jul 2016

New developments since the last epidemiological update

 
As of 7 July 2016, WHO has reported 62 countries and territories with mosquito-borne transmission since 2015. There is now a scientific consensus that Zika virus is a cause of microcephaly and Guillain-Barré syndrome. 

During the past week, the Netherlands confirmed an imported case of Zika virus infection on the island of Saba and the first autochthonous case of Zika virus on the island of St Eustatius. Both islands have a special status as municipalities of the Netherlands.  

Three cases of Zika virus infection have been detected in Guinea-Bissau on the island of Bubaque, in the archipelago of Bijagos. Guinea-Bissau becomes the second country in West Africa affected by the virus since 2015 (after Cape Verde).  

 

EU/EEA imported cases 

Since week 45/2015, fourteen countries (Austria, Belgium, Czech Republic, Denmark, Finland, France, Italy, Luxembourg, Malta, Norway, Slovenia, Spain, Sweden and the UK) reported 862 travel-associated Zika virus infections through The European Surveillance System.  
 
As of 7 July 2016, ECDC has detected 1 028 imported cases through epidemic intelligence activities. This information is aggregated from official EU/EEA public health authorities websites but is not based on a systematic reporting surveillance system hence cannot be considered exhaustive. 
 

EU’s Outermost Regions and Territories

 
As of 7 July 2016: 

  • Guadeloupe: 20 070 suspected cases have been detected, an increase of 2 650 suspected cases since last week. The weekly number of cases is not decreasing yet.
  • French Guiana: 8 715 suspected cases have been detected, an increase of 260 since last week. The weekly number of cases has been increasing compared to the previous three weeks.
  • Martinique: 32 400 suspected cases have been reported, an increase of 640 since last week. The weekly number of cases has been stable over the last four weeks.
  • St Barthélemy: 185 suspected cases have been detected, an increase of 55 suspected cases since last week. The weekly number of cases is still increasing.
  • St Martin: 1 260 suspected cases have been detected, an increase of 165 suspected cases since last week. The weekly number of cases has decreased compared to the previous week.  

Update on microcephaly and/or central nervous system (CNS) malformations potentially associated with Zika virus infection

 As of 6 July 2016, microcephaly and other central nervous system (CNS) malformations associated with Zika virus infection or suggestive of congenital infection have been reported by thirteen countries or territories. In the EU, Spain (2) and Slovenia (1) reported congenital malformations associated with Zika virus infection after travel in the affected areas. Cases have also been detected in the EU’s Outermost Regions and Territories in Martinique, French Guiana and French Polynesia.
 
Fifteen countries and territories worldwide reported an increased incidence of Guillain-Barré syndrome (GBS) and/or laboratory confirmation of a Zika virus infection among GBS cases.
 
Brazil: Between October 2015 and 7 July 2016, Brazil reported 8 301 suspected cases of microcephaly and other nervous system disorders suggestive of congenital infection; this is an increase of 136 cases since the last update; 1 656 are confirmed cases of microcephaly, 255 of which are laboratory-confirmed for Zika virus infection, according to the Brazilian Ministry of Health. However, the Ministry of Health, reports that this figure does not adequately represent the total number of cases related to the virus. 
 
 

WHO recommends that infants born to mothers with suspected, probable or confirmed Zika virus infection, or who reside in or have travelled to areas of ongoing Zika virus transmission, should be fed according to normal infant feeding guidelines. In light of the evidence available, the benefits of breastfeeding for the infant and mother outweigh any potential risk of Zika virus transmission through breast milk. 

Web sources: ECDC Zika Factsheet | PAHO |  Colombian MoH |  Brazilian MoH | Brazilian microcephaly case definition |SAGE MOH Brazil

ECDC assessment

The spread of the Zika virus epidemic in the Americas is likely to continue as the vectors (Aedes aegypti and Aedes albopictus mosquitoes) are widely distributed there. The likelihood of travel-related cases in the EU is increasing. A detailed risk assessment is available here. As neither treatment nor vaccines are available, prevention is based on personal protection measures. Pregnant women should consider postponing non-essential travel to Zika-affected areas.

Table 1. Countries and territories with reported confirmed autochthonous cases of Zika virus infection in the past three months, as of 1 July 2016 

Countries Last case since 3 months
American Samoa Widespread transmission
Argentina Widespread transmission
Aruba Widespread transmission
Barbados Widespread transmission
Belize Widespread transmission
Bolivia Widespread transmission
Bonaire Widespread transmission
Brazil Widespread transmission
Cape Verde Widespread transmission
Colombia Widespread transmission
Costa Rica Widespread transmission
Curaçao Widespread transmission
Dominica Widespread transmission
Dominican Republic Widespread transmission
Ecuador Widespread transmission
El Salvador Widespread transmission
Fiji Widespread transmission
French Guiana Widespread transmission
Guadeloupe Widespread transmission
Guatemala Widespread transmission
Haiti Widespread transmission
Honduras Widespread transmission
Jamaica Widespread transmission
Martinique Widespread transmission
Mexico Widespread transmission
Micronesia, Federated States of Widespread transmission
Nicaragua Widespread transmission
Panama Widespread transmission
Paraguay Widespread transmission
Peru Widespread transmission
Puerto Rico Widespread transmission
Saint Lucia Widespread transmission
Saint Martin Widespread transmission
Saint Vincent and the Grenadines Widespread transmission
Saint-Barthélemy Widespread transmission
Samoa Widespread transmission
Sint Maarten Widespread transmission
Suriname Widespread transmission
Thailand Widespread transmission
Tonga Widespread transmission
Trinidad and Tobago Widespread transmission
US Virgin Islands Widespread transmission
Venezuela Widespread transmission
Vietnam Widespread transmission
Anguilla Sporadic transmission
Grenada Sporadic transmission
Indonesia Sporadic transmission
Philippines Sporadic transmission
Sint Eustatius Sporadic transmission

 

Figure 1. Countries or territories with reported confirmed autochthonous cases of Zika virus infection in the past three months, as of 29 June 2016

Zika map, 8 July
 

All ECDC maps with information on countries or territories with reported confirmed autochthonous cases of Zika virus infection can be found here.

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