Epidemiological update: Outbreaks of Zika virus and complications potentially linked to the Zika virus infection, 13 October 2016

Epidemiological update

​Since July 2015 (week 26), 19 countries (Austria, Belgium, the Czech Republic, Denmark, Finland, France, Ireland, Italy, Luxembourg, Malta, Netherlands, Norway, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and the United Kingdom) have reported 1 918 travel-associated Zika virus infections through The European Surveillance System (TESSy). Over the same time period, seven EU countries reported 92 Zika cases among pregnant women.

Weekly summary

Since 2015, and as of 14 October 2016, there have been 69 countries and territories reporting mosquito-borne transmission of the virus. According to WHO and as of 13 October 2016, 22 countries or territories have reported microcephaly and other central nervous system (CNS) malformations in newborns potentially associated with Zika virus infection.

  • In the USA, 14 new locally-acquired cases have been reported in Florida since the last CDTR, bringing the cumulative number of locally-acquired cases to 155.
  • In Mexico, the Ministry of Health has reported the first five cases of Guillain-Barré syndrome linked to Zika virus infection. The cases are reported from the South of Mexico: Tabasco, Chiapas, Guerrero and Quintana Roo States. Three of the cases are males and the mean age is 18 years.
  • In ECDC map, the status of Argentina and Fiji has changed to ‘past transmission’ as no new cases have been reported in the last three months.
  • ECDC is preparing the ninth update of the rapid risk assessment to be published on 19 October.

Update on number of cases

The USA

Fourteen locally-acquired cases have been recorded in Florida over the past week. To date, 155 locally-acquired and 736 imported cases of Zika have been reported in Florida. The distribution of the locally-acquired cases is as follows: 145 in Miami-Dade, seven in Palm beach, one in Pinellas and one in Broward. The other case is a Broward County resident and investigation is ongoing to determine where exposure occurred.
 
EU/EEA imported cases:

Since July 2015 (week 26), 19 countries (Austria, Belgium, the Czech Republic, Denmark, Finland, France, Ireland, Italy, Luxembourg, Malta, Netherlands, Norway, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and the United Kingdom) have reported 1 918 travel-associated Zika virus infections through The European Surveillance System (TESSy). Over the same time period, seven EU countries reported 92 Zika cases among pregnant women.
 
EU’s Outermost Regions and Territories

As of 6 October 2016:

Martinique: 36 445 suspected cases have been reported, an increase of 90 since the previous week. The weekly number of cases has been decreasing.

French Guiana: 9 790 suspected cases have been detected, an increase of 20 cases since the previous week. The weekly number of cases decreased. According to the regional situation report, the epidemic is over.

Guadeloupe: 30 590 suspected cases have been detected, an increase of 90 suspected cases since the previous week. The weekly number of cases has been decreasing.

St Barthélemy: 770 suspected cases have been detected, an increase of 30 suspected cases since the previous week. The weekly number of cases is stable.

St Martin: 2 595 suspected cases have been detected, an increase of 60 suspected cases since the previous week. The weekly number of cases is stable.
 
Since February 2016, 12 countries have reported evidence of person-to-person transmission of Zika virus, probably via a sexual route.
 

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

As of 13 October 2016, microcephaly and other central nervous system (CNS) malformations associated with Zika virus infection or suggestive of congenital infection have been reported by 22 countries or territories. Brazil reports the highest number of cases. Nineteen 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.
 
 

ECDC assessment

The spread of the Zika virus in the Americas and Asia 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 was published on 30 August 2016. 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.

 

Countries and territories with reported confirmed autochthonous cases of Zika virus infection in the past three months, as of 14 October 2016  

Countries affected in past 3 months Areas (non-tropical countries only) Type of transmission
American Samoa   Widespread transmission
​​Anguilla ​Widespread transmission
Argentina Tucumán Province Widespread transmission
​Antigua and Barbuda ​Widespread transmission
​Barbados ​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
​Philippines​​ ​​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
​Singapore ​Widespread transmission
Sint Maarten   Widespread transmission
Suriname   Widespread transmission
Thailand   Widespread transmission
Trinidad and Tobago   Widespread transmission
US Virgin Islands   Widespread transmission
United States of America ​​Florida (Miami-Dade county) ​Widespread transmission
​​​United States of America ​Florida (Broward, Palm Beach and Pinellas  counties) ​Sporadic transmission
​​​​Venezuela ​Widespread transmission
Antigua and Barbuda   Sporadic transmission
​Bahamas ​Sporadic transmission
​British Virgin Island (UK) ​Sporadic transmission
​Cayman Islands ​Sporadic transmission
​Cuba ​Sporadic transmission
Grenada   Sporadic transmission
Guinea-Bissau   Sporadic transmission
​Malaysia Sporadic transmission​
Saba   Sporadic transmission
​Saint Kitts and Nevis   Sporadic transmission
​Sint Eustatius ​Sporadic transmission
Turks and Caicos Islands   Sporadic transmission
​Vietnam ​Sporadic transmission

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. 

Countries or territories with reported confirmed autochthonous cases of Zika virus infection in the past three months, as of 14 October 2016