Epidemiological update: Outbreaks of Zika virus and complications potentially linked to the Zika virus infection, 24 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.

This page was last updated on 25 November 2016
 
Since 2015 and as of 24 November 2016, 71 countries and territories have reported evidence of mosquito-borne transmission of the virus, while 28 countries or territories have reported microcephaly and other central nervous system malformations in newborns potentially associated with Zika virus infection.

Weekly Summary

The PHEIC regarding Zika virus infection, microcephaly and other neurological disorders was lifted on 18 November 2016. A sustained programme with dedicated resources will now be implemented to address the long-term nature of Zika virus infection and its associated consequences. In the USA, six new locally-acquired cases have been reported in Florida since the last CDTR and as of 22 November. In the ECDC map of countries and territories with autochthonous vector-borne transmission of Zika virus infection, the status of Pinellas County (Florida) changed to past transmission as no new cases have been reported in the past three months.

Update on the public health emergency of international concern

The fifth meeting of the Emergency Committee (EC) convened by the Director-General under the International Health Regulations (IHR) regarding Zika virus infection, microcephaly and other neurological disorders was held on 18 November 2016. The EC originally recommended a public health emergency of international concern (PHEIC) on 1 February 2016 on the basis of an extraordinary cluster of microcephaly and other neurological disorders reported in Brazil, following a similar cluster in French Polynesia and geographic and temporal association with Zika virus infection which required urgent and coordinated and research.

Because research has now demonstrated the link between Zika virus infection and microcephaly, the EC felt that a robust longer-term technical mechanism was now required to manage the global response and research agenda. Although Zika virus infection and its associated consequences remain a significant enduring public health challenge requiring intense action, it does no longer represent a PHEIC as defined under the IHR. The EC recommended that a sustained programme of work with dedicated resources should be implemented to address the long-term nature of the disease and its associated consequences. Based on this advice, the Director-General declared the end of the PHEIC.

Update on number of cases Worldwide

For the first time in the past week, no new country or territory reported mosquito-borne Zika virus infections.Since 2015 and as of 24 November 2016, 71 countries and territories have reported evidence of mosquito-borne transmission of the virus. Since February 2016 and as of 24 November 2016, 12 countries or territories have reported evidence of person-to-person transmission of the virus, probably via sexual route.

USA: In the USA, six new locally-acquired cases of Zika virus infection have been reported in Florida since the last CDTR and as of 22 November 2016. As of this date, 236 locally-acquired and 950 travel-related cases have been reported in Florida.

EU/EEA imported cases: Since June 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 1 996 travel-associated Zika virus infections through The European Surveillance System (TESSy). Over the same time period, eight EU/EEA Member States reported 99 Zika cases among pregnant women.

EU’s outermost regions and overseas territories: As of epidemiological week 46, the overall number of cases has been decreasing in the affected French overseas regions and collectivities, with about 20 suspected cases reported in Martinique, 45 in French Guiana, less than 25 in Guadeloupe, 10 in St Barthelemy and 50 in St Martin. 

Update on microcephaly and/or central nervous system malformations potentially associated with Zika virus infection: No new country or territory reported microcephaly and other central nervous system (CNS) malformations or Guillain-Barré syndrome (GBS) cases potentially associated with Zika virus infection for the first time in the past week.
As of 24 November 2016, 28 countries or territories have reported microcephaly and other CNS malformations in newborns potentially associated with Zika virus infection. Brazil reports the highest number of cases. As of 24 November 2016, 19 countries or territories have reported GBS potentially associated with Zika virus infection.

Web sources: ECDC Zika FactsheetPAHO | 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 25 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
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

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 25 November 2016