Epidemiological update: Outbreaks of Zika virus and complications potentially linked to the Zika virus infection, 28 April 2016

Epidemiological update

​Since last week, on 25 April 2016 the Canadian health authorities reported the first sexual transmission of Zika in Canada.

​New developments since the last epidemiological update published on 22 April 2016

Since last week: On 25 April 2016 the Canadian health authorities reported the first sexual transmission of Zika in Canada. On 28 April 2016 Saint-Barthélemy reported the first locally acquired Zika virus infection.

Table 1. Countries and territories with reported confirmed autochthonous cases of Zika virus infection in the past two months, as of 29 April 2016

Country/Territory Current Zika transmission Zika transmission in the past nine months
American Samoa Increasing or widespread transmission Yes
Aruba Increasing or widespread transmission Yes
Barbados Increasing or widespread transmission Yes
Belize Sporadic transmission Yes
Bolivia Increasing or widespread transmission Yes
Bonaire Sporadic transmission Yes
Brazil Increasing or widespread transmission Yes
Cape Verde Increasing or widespread transmission Yes
Colombia Increasing or widespread transmission Yes
Costa Rica Increasing or widespread transmission Yes
Cuba Sporadic transmission Yes
Curaçao Increasing or widespread transmission Yes
Dominica Sporadic transmission Yes
Dominican Republic Increasing or widespread transmission Yes
Ecuador Increasing or widespread transmission Yes
El Salvador Increasing or widespread transmission Yes
Fiji Increasing or widespread transmission Yes
French Guiana Increasing or widespread transmission Yes
Guadeloupe Increasing or widespread transmission Yes
Guatemala Increasing or widespread transmission Yes
Guyana Increasing or widespread transmission Yes
Haiti Increasing or widespread transmission Yes
Honduras Increasing or widespread transmission Yes
Jamaica Sporadic transmission Yes
Kosrae  Sporadic transmission Yes
Marshall Islands  Increasing or widespread transmission Yes
Martinique Increasing or widespread transmission Yes
Mexico Increasing or widespread transmission Yes
New Caledonia Sporadic transmission Yes
Nicaragua Increasing or widespread transmission Yes
Panama Increasing or widespread transmission Yes
Papua New Guinea Sporadic transmission Yes
Paraguay No Yes
Philippines Sporadic transmission Yes
Puerto Rico Increasing or widespread transmission Yes
Saint Lucia Sporadic transmission Yes
Saint Martin Increasing or widespread transmission Yes
Saint Vincent and the Grenadines No Yes
Saint-Barthélemy Sporadic transmission Yes
Samoa Increasing or widespread transmission Yes
Sint Maarten Sporadic transmission Yes
Suriname Increasing or widespread transmission Yes
Thailand No Yes
Tonga Increasing or widespread transmission Yes
Trinidad and Tobago Increasing or widespread transmission Yes
US Virgin Islands Increasing or widespread transmission Yes
Venezuela Increasing or widespread transmission Yes
Vietnam Increasing or widespread transmission Yes

The classification of countries above is based on: 1) number of reported autochthonous confirmed cases; 2) number of affected areas in the country; 3) duration of the circulation.
 

EU/EEA and EU Outermost Regions and Territories

As of 29 April, no autochthonous vector-borne Zika virus transmission has been reported in the continental EU. ECDC is collecting data regarding imported cases through the media and official government communication lines. ECDC has recorded 452 imported cases in 17 EU/EEA countries. Twenty-three of the imported cases are pregnant women. In addition, one confirmed case was published following diagnosis in a Slovenian hospital. The number of imported cases reported is not based on systematic reporting surveillance systems hence cannot be considered exhaustive.

EU’s Outermost Regions and Territories

  • Martinique: As of 28 April 2016, 20 980 suspected cases have been reported, an increase of 1 600 since last week. Since the beginning of the outbreak to 28 April 2016, two microcephaly cases and one additional congenital abnormality have been reported with confirmed Zika virus infection. Additionally, 14 cases with neurological complications have been detected in Zika virus confirmed cases.
  • French Guiana: As of 28 April 2016, 4 860 suspected cases have been reported, an increase of 300 since last week. Three cases with neurological complications have been identified since the beginning of the outbreak.
  • Guadeloupe: As of 28 April 2016, 2 099 suspected and 412 laboratory-confirmed cases have been reported, an increase of 418 suspected and 72 laboratory-confirmed cases since last week. One case with neurological complications has been reported since the beginning of the outbreak.
  • St Martin: As of 28 April 2016, 212 suspected and 61 laboratory-confirmed cases have been reported, an increase of 29 suspected and 7 laboratory-confirmed cases since last week. One case with neurological complications has been reported; however, this could not be directly attributed to Zika.
  • St Barthélemy: As of 28 April 2016, one case has been confirmed.

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

Figure 2. Countries and territories with reported confirmed autochthonous cases of Zika virus infection in the past nine months, as of 29 April 2016

Update on the observed increase of congenital Zika syndrome and other neurological complications 

 
Congenital zika syndrome and GBS:

Microcephaly and other foetal malformations potentially associated with Zika virus infection or suggestive of congenital infection have been reported in Brazil (1 198 cases), Cape Verde (two cases), Colombia (seven cases), French Polynesia (eight cases), Martinique (three cases), Marshall Islands (one case) and Panama (five cases). Two additional cases, each linked to a stay in Brazil, were detected in Slovenia and the United States of America. One more case was reported in the US in a returning traveller from the affected countries.
 
In the context of Zika virus circulation, 13 countries or territories have 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 as of 23 April 2016, Brazil reported 7 228 suspected cases of microcephaly from 1 359 municipalities in all states and in the Federal District. Of these cases, 1 198 are reported as confirmed cases of microcephaly with 194 having laboratory confirmation of Zika virus infection. Of the remaining cases, 2 320 were investigated and discarded as they did not fit the case definition, while 3 710 cases are still under investigation.
Among the 7 228 suspected cases of microcephaly, 251 intrauterine or neonatal deaths were reported. Of these, 54 cases were investigated and confirmed (microcephaly and/or central nervous system malformations).

Additional information may be found in the latest ECDC Risk Assessment.