Epidemiological update: Outbreaks of Zika virus and complications potentially linked to the Zika virus infection, 17 November 2016

epidemiological update

​Since 2015, and as of 10 November 2016, there have been 71 countries and territories reporting mosquito-borne transmission of the virus. According to WHO and as of 9 November 2016, 26 countries or territories have reported microcephaly and other central nervous system (CNS) malformations in newborns potentially associated with Zika virus infection.

Since 2015, and as of 10 November 2016, there have been 71 countries and territories reporting mosquito-borne transmission of the virus. According to WHO and as of 9 November 2016, 26 countries or territories have reported microcephaly and other central nervous system (CNS) malformations in newborns potentially associated with Zika virus infection.

Weekly Summary

In the USA, 15 new locally-acquired cases have been reported in Florida since the last CDTR. Additionally, 19 cases have been reported, following a change in the CDC national Zika case definition on 9 November.

Montserrat has been designated as high risk for Zika transmission on the Public Health England website and has been added to the ECDC map.

On 8 November, Palau reported the first autochthonous Zika case.

ECDC Zika map: Montserrat and Palau have been displayed on the map as countries with sporadic transmission. In addition, Turks and Caicos Islands and British Virgin Islands have changed the status to widespread transmission.

Epidemiological Summary

1. Update on number of cases

USA: In the USA, 15 new locally-acquired cases have been reported in Florida since the last CDTR. Additionally, 19 cases have been reported, following a change in the CDC national Zika case definition on 9 November. To date, 222 locally-acquired and 915 imported cases of Zika have been reported in Florida.

EU/EEA imported cases Since July 2015 (week 26), 20 countries (Austria, Belgium, the Czech Republic, Denmark, Finland, France, Hungary, Ireland, Italy, Luxembourg, Malta, the Netherlands, Norway, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and the United Kingdom) have reported 1 967 travel-associated Zika virus infections through The European Surveillance System (TESSy). Over the same time period, eight EU countries reported 95 Zika cases among pregnant women. EU’s Outermost Regions and Territories As of epidemiological week 42, the overall number of cases has been decreasing in all the French Outermost Territories with 40 suspected cases reported in Martinique, 30 in French Guiana, 50 in Guadeloupe, 30 in St Barthelemy, 40 in St Martin. Since February 2016, 12 countries have reported evidence of person-to-person transmission of Zika virus, probably via a sexual route. 2. Update on microcephaly and/or central nervous system (CNS) malformations potentially associated with Zika virus infection As of 10 November 2016, microcephaly and other central nervous system (CNS) malformations associated with Zika virus infection or suggestive of congenital infection have been reported by 26 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. 

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

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 28 October 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 11 November 2016

Countries Region Last case since 3 months
American Samoa Widespread transmission
Anguilla Widespread transmission
Antigua and Barbuda Widespread transmission
Aruba Widespread transmission
Bahamas Widespread transmission
Barbados Widespread transmission
Belize Widespread transmission
Bolivia Widespread transmission
Bonaire Widespread transmission
Brazil Widespread transmission
British Virgin Islands (UK) Widespread transmission
Cayman Islands Widespread transmission
Colombia Widespread transmission
Costa Rica Widespread transmission
Cuba Sporadic 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
Grenada Widespread transmission
Guadeloupe Widespread transmission
Guatemala Widespread transmission
Haiti Widespread transmission
Honduras Widespread transmission
Jamaica Widespread transmission
Malaysia Sporadic transmission
Maldives Sporadic transmission
Martinique Widespread transmission
Mexico Widespread transmission
Micronesia, Federated States of Widespread transmission
​Montserrat ​Sporadic transmission
Nicaragua Widespread transmission
​Palau ​Sporadic transmission
Panama Widespread transmission
Paraguay Widespread transmission
Peru Widespread transmission
Philippines Widespread transmission
Puerto Rico Widespread transmission
Saba Sporadic transmission
Saint Kitts and Nevis Widespread transmission
Saint Lucia Widespread transmission
Saint Martin Widespread transmission
Saint-Barthélemy Widespread transmission
​Saint Vincent and the Grenadines ​Widespread transmission
Singapore Widespread transmission
Sint Eustatius Widespread transmission
Sint Maarten Widespread transmission
​Solomon Islands ​Sporadic transmission
Suriname Widespread transmission
Thailand Widespread transmission
Trinidad and Tobago Widespread transmission
​Turks and Caicos ​Widespread transmission
United States of America Miami-Dade Widespread transmission
United States of America Palm Beach Sporadic transmission
US Virgin Islands Widespread transmission
Venezuela Widespread transmission
Vietnam Widespread transmission
United States of America Pinellas 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 11 November 2016