Epidemiological update: Outbreaks of Zika virus and complications potentially linked to the Zika virus infection, 4 August 2016

 Page last updated: 5 August 2016

Since 1 February 2016, Zika virus infection and the related clusters of microcephaly cases and other neurological disorders constitute a public health emergency of international concern (PHEIC). Since 2015, and as of 4 August 2016, WHO has reported 65 countries and territories with mosquito-borne transmission. There is now a scientific consensus that Zika virus is a cause of microcephaly and Guillain-Barré syndrome. As of 3 August 2016, 14 countries or territories have reported microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection or suggestive of congenital infection.

On 1 August, the Florida Department of Health in US confirmed four autochthonous Zika virus cases through local mosquitoes in Miami-Dade and Broward counties. As of 4 August, the Florida Department of Health (DOH) has identified 15 locally-acquired Zika cases in Florida who likely acquired the infection through a mosquito bite. The DOH believes that active transmission of the Zika virus is still only occurring in one small area of Miami-Dade County. Among the 15 cases, six are asymptomatic and were identified as a result of the door-to-door community survey that the DOH is conducting. ​

 

New developments since the last epidemiological update

 

The US CDC has issued travel advice for people who live in or travelled to Wynwood in Miami any time after 15 June. Pregnant women have been advised not to travel to this neighbourhood. 

In addition, the US CDC has published an official health advisory on guidance for 'Travel and Testing of Pregnant Women and Women of Reproductive Age for Zika Virus Infection Related to the Investigation for Local Mosquito-borne Zika Virus Transmission in Miami-Dade and Broward Counties, Florida'. The CDC is also recommending Zika testing for all pregnant women in the continental United States at prenatal visits in their first and second trimesters. 

On 3 August, the Ministry of Health in Cuba reported two cases of locally-acquired Zika in the city of Hoguin. 

In Vietnam, the Ministry of Health reported one case of locally-acquired Zika virus in Phu Yen Province. 

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 1 136 travel-associated Zika virus infections through  The European Surveillance System (TESSy). 

EU’s Outermost Regions and Territories

 

As of 4 August 2016: 

Guadeloupe: 26 520 suspected cases have been detected, an increase of 1 060 suspected cases since last week. The weekly number of cases has decreased compared to the previous week.

 

French Guiana: 9 330 suspected cases have been detected, an increase of 110 since last week. The weekly number of cases is decreasing compared to the previous week. 

 

Martinique: 34 310 suspected cases have been reported, an increase of 415 since last week. The weekly number of cases is declining. 

 

St Barthélemy: 370 suspected cases have been detected, an increase of 60 suspected cases since last week. The virus is still actively circulating.

 

St Martin: 1 835 suspected cases have been detected, an increase of 105 suspected cases since last week. The weekly number of cases has decreased slightly compared to the previous week. 

 

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

 As of 3 August 2016, microcephaly and other central nervous system (CNS) malformations associated with Zika virus infection or suggestive of congenital infection have been reported by 14 countries or territories. Brazil has reported the highest number of cases. 

Fifteen countries and territories worldwide have reported an increased incidence of Guillain-Barré syndrome (GBS) and/or laboratory confirmation of a Zika virus infection among GBS cases. 

Since February 2016, 11 countries have reported evidence of person-to-person transmission of Zika virus, probably via a sexual route. 

In the EU, Spain (2) and Slovenia (1) have 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. 

 

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 5 August 2016  

 

The classification of countries above is based on: 1) number of reported autochthonous confirmed cases; 2) number of countries who report a zika virus transmission or a country’s transmission status changes; 3) duration of the circulation.

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Figure 1. Countries or territories with reported confirmed autochthonous cases of Zika virus infection in the past three months, as of 5 August 2016

All ECDC maps with information on countries or territories with reported confirmed autochthonous cases of Zika virus infection

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