Epidemiological update: Outbreaks of Zika virus and complications potentially linked to the Zika virus infection, 15 Sept 2016
According to WHO and as of 15 September 2016, 20 countries or territories have reported microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection or suggestive of congenital infection.
Since 1 February 2016, Zika virus infection and the related clusters of microcephaly cases and other neurological disordersconstitute a public health emergency of international concern (PHEIC). Since 2015, and as of 15 September 2016, there have been 64 countries and territories reporting mosquito-borne transmission. According to WHO and as of 15 September 2016, 20 countries or territories have reported microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection or suggestive of congenital infection.
Update on the number of cases
The USA
Twenty-two new locally acquired cases have been recorded in Florida over the past week. To date, 78 locally-acquired and 650 imported cases of Zika have been reported in Florida. The distribution of the locally-acquired cases is as follow: 71 in Miami-Dade, five in Palm beach, one in Pinellas and one in Broward.
Malaysia
Six cases have been reported by national authorities between 1 and 13 September.
Singapore
As of 15 September 2016, the Singapore National Environment Agency (NEA) records 355 locally-acquired ZIKV cases, an increase of 88 cases since the last CDTR. To date, ZIKV has been confirmed in eight pregnant women.
Thailand
As of 15 September 2016 and according to media quoting the Ministry of Health, Thailand records about 200 cases since the beginning of the year in 16 provinces. Five provinces are under active control: Bangkok, Chiangmai, Buengkarn, Phetchaboon, Chantaburi.
Publication
The Lancet published the preliminary findings of a case-control study confirming the association between microcephaly and inutero Zika virus infection.
EU/EEA imported cases
Since week 45/2015, 19 countries (Austria, Belgium, Czech Republic, Denmark, Finland, France, Ireland, Italy, Luxembourg, Malta, Netherlands, Norway, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, United Kingdom) have reported 1 614 travel-associated Zika virus infections through The European Surveillance System (TESSy). This corresponds to an increase of 57 cases since the last update. Since week 45/2015, seven EU countries reported 80 Zika cases among pregnant women.Zika virus infections through The European Surveillance System (TESSy).
EU’s Outermost Regions and Territories
As of 15 September 2016:
Martinique: 36 100 suspected cases have been reported, an increase of 305 since last week. The weekly number of cases is stable.
French Guiana: 9 710 suspected cases have been detected, an increase of 86 cases since last week. The weekly number of cases is stable.
Guadeloupe: 29 850 suspected cases have been detected, an increase of 380 suspected cases since last week. The weekly number of cases is stable.
St Barthélemy: 675 suspected cases have been detected, an increase of 45 suspected cases since last week. The weekly number of cases is stable.
St Martin: 2 265 suspected cases have been detected, an increase of 100 suspected cases since last 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 8 September 2016, microcephaly and other central nervous system (CNS) malformations associated with Zika virus infection or suggestive of congenital infection have been reported by 20 countries or territories. Brazil reports the highest number of cases. Eighteen 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. 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 16 September 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 |
| Barbados | Widespread transmission | |
| Belize | 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 | |
| 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 |
| Philippines | | Sporadic transmission |
| Saba | 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.
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.