Epidemiological update: Outbreaks of Zika virus and complications potentially linked to the Zika virus infection, 21 July 2016
New developments since the last epidemiological update
Page last updated: 22 July 2016
New developments since the last epidemiological update
On 15 July, the island of Saba in the Caribbean reported its first local mosquito-borne Zika virus transmission. On 15 July 2016, the first suspected female-to-male sexual transmission of Zika virus was reported by the US CDC . Since 18 July, the CDC has been supporting the investigation of a new case of Zika virus infection in a Utah resident who took care of a previously infected case who died in late June. Both cases were laboratory confirmed for Zika virus infection. This new case had not travelled to any affected areas and had not had sex with someone infected with Zika. Investigators are now trying to determine how this second resident became infected. In the USA, Florida health officials are investigating possible non-travel-related cases of Zika virus in Miami-Dade County and Broward County. On 21 July, the media reported that the first Zika vaccine has been approved by Health Canada and the US Food and Drug Administration to begin Phase I clinical trials in humans. In Brazil, on 21 July the Ministry of Health confirmed that further studies are needed to clarify the possible link between Zika virus and Culex mosquitoes following recent unpublished research by the Oswaldo Cruz Foundation (Fiocruz) which detected Zika virus in samples collected from Culex quinquefasciatus (the popular muriçoca or house mosquito) in the city of Recife. The preliminary results of field research identified the presence of Culex quinquefasciatus naturally infected with Zika virus in three of the 80 pools of mosquitoes analysed to date.
EU/EEA imported cases
Since week 45/2015, 18 countries (Austria, Belgium, the Czech Republic, Denmark, Finland, France, Ireland, Italy, Luxembourg, Malta, the Netherlands, Norway, Portugal, Romania, Slovenia, Spain, Sweden and the UK) have reported 1048 travel-associated Zika virus infections through The European Surveillance System (TESSy).
EU’s Outermost Regions and Territories
As of 21 July 2016:
- Guadeloupe: 23 330 suspected cases have been detected, an increase of 1 230 suspected cases since last week. The weekly number of cases is slightly decreasing.
- French Guiana: 9 090 suspected cases have been detected, an increase of 120 since last week. The weekly number of cases has been decreasing over the past three weeks.
- Martinique: 33 460 suspected cases have been reported, an increase of 530 since last week. The weekly number of cases is stable compared to the previous week.
- St Barthélemy: 270 suspected cases have been detected, an increase of 45 suspected cases since last week. The virus is still actively circulating.
- St Martin: 1 580 suspected cases have been detected, an increase of 160 suspected cases since last week. The weekly number of cases remains stable compared to the previous week.
Update on microcephaly and/or central nervous system (CNS) malformations potentially associated with Zika virus infection
As of 20 July 2016, microcephaly and other central nervous system (CNS) malformations associated with Zika virus infection or suggestive of congenital infection have been reported by 13 countries or territories. Brazil has reported the highest number of cases. Between October 2015 and 20 July 2016, Brazil reported 8 571 suspected cases of microcephaly and other nervous system disorders suggestive of congenital infection. This represents an increase of 120 cases since the last update; 1 709 are confirmed cases of microcephaly, 267 of which are laboratory-confirmed for Zika virus infection, according to the Ministry of Health.
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.
Web sources: ECDC Zika Factsheet | PAHO | Colombian MoH | Brazilian MoH | Brazilian microcephaly case definition |SAGE MOH Brazil
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 22 July 2016
|Country||Last case since 3 months|
|American Samoa||Widespread transmission|
|Cape Verde||Widespread transmission|
|Costa Rica||Widespread transmission|
|Dominican Republic||Widespread transmission|
|El Salvador||Widespread transmission|
|French Guiana||Widespread transmission|
|Micronesia, Federated States of||Widespread transmission|
|Puerto Rico||Widespread transmission|
|Saint Lucia||Widespread transmission|
|Saint Martin||Widespread transmission|
|Saint Vincent and the Grenadines||Widespread transmission|
|Sint Eustatius||Sporadic transmission|
|Sint Maarten||Widespread transmission|
|Trinidad and Tobago||Widespread transmission|
|US Virgin Islands||Widespread transmission|
Figure 1. Countries or territories with reported confirmed autochthonous cases of Zika virus infection in the past three months, as of 22 July 2016
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