Epidemiological update: Outbreaks of Zika virus and complications potentially linked to the Zika virus infection, 28 April 2016
Since last week, on 25 April 2016 the Canadian health authorities reported the first sexual transmission of Zika in Canada.
New developments since the last epidemiological update published on 22 April 2016
Since last week: On 25 April 2016 the Canadian health authorities reported the first sexual transmission of Zika in Canada. On 28 April 2016 Saint-Barthélemy reported the first locally acquired Zika virus infection.
Table 1. Countries and territories with reported confirmed autochthonous cases of Zika virus infection in the past two months, as of 29 April 2016
|Country/Territory||Current Zika transmission||Zika transmission in the past nine months|
|American Samoa||Increasing or widespread transmission||Yes|
|Aruba||Increasing or widespread transmission||Yes|
|Barbados||Increasing or widespread transmission||Yes|
|Bolivia||Increasing or widespread transmission||Yes|
|Brazil||Increasing or widespread transmission||Yes|
|Cape Verde||Increasing or widespread transmission||Yes|
|Colombia||Increasing or widespread transmission||Yes|
|Costa Rica||Increasing or widespread transmission||Yes|
|Curaçao||Increasing or widespread transmission||Yes|
|Dominican Republic||Increasing or widespread transmission||Yes|
|Ecuador||Increasing or widespread transmission||Yes|
|El Salvador||Increasing or widespread transmission||Yes|
|Fiji||Increasing or widespread transmission||Yes|
|French Guiana||Increasing or widespread transmission||Yes|
|Guadeloupe||Increasing or widespread transmission||Yes|
|Guatemala||Increasing or widespread transmission||Yes|
|Guyana||Increasing or widespread transmission||Yes|
|Haiti||Increasing or widespread transmission||Yes|
|Honduras||Increasing or widespread transmission||Yes|
|Marshall Islands||Increasing or widespread transmission||Yes|
|Martinique||Increasing or widespread transmission||Yes|
|Mexico||Increasing or widespread transmission||Yes|
|New Caledonia||Sporadic transmission||Yes|
|Nicaragua||Increasing or widespread transmission||Yes|
|Panama||Increasing or widespread transmission||Yes|
|Papua New Guinea||Sporadic transmission||Yes|
|Puerto Rico||Increasing or widespread transmission||Yes|
|Saint Lucia||Sporadic transmission||Yes|
|Saint Martin||Increasing or widespread transmission||Yes|
|Saint Vincent and the Grenadines||No||Yes|
|Samoa||Increasing or widespread transmission||Yes|
|Sint Maarten||Sporadic transmission||Yes|
|Suriname||Increasing or widespread transmission||Yes|
|Tonga||Increasing or widespread transmission||Yes|
|Trinidad and Tobago||Increasing or widespread transmission||Yes|
|US Virgin Islands||Increasing or widespread transmission||Yes|
|Venezuela||Increasing or widespread transmission||Yes|
|Vietnam||Increasing or widespread transmission||Yes|
The classification of countries above is based on: 1) number of reported autochthonous confirmed cases; 2) number of affected areas in the country; 3) duration of the circulation.
EU/EEA and EU Outermost Regions and Territories
As of 29 April, no autochthonous vector-borne Zika virus transmission has been reported in the continental EU. ECDC is collecting data regarding imported cases through the media and official government communication lines. ECDC has recorded 452 imported cases in 17 EU/EEA countries. Twenty-three of the imported cases are pregnant women. In addition, one confirmed case was published following diagnosis in a Slovenian hospital. The number of imported cases reported is not based on systematic reporting surveillance systems hence cannot be considered exhaustive.
EU’s Outermost Regions and Territories
- Martinique: As of 28 April 2016, 20 980 suspected cases have been reported, an increase of 1 600 since last week. Since the beginning of the outbreak to 28 April 2016, two microcephaly cases and one additional congenital abnormality have been reported with confirmed Zika virus infection. Additionally, 14 cases with neurological complications have been detected in Zika virus confirmed cases.
- French Guiana: As of 28 April 2016, 4 860 suspected cases have been reported, an increase of 300 since last week. Three cases with neurological complications have been identified since the beginning of the outbreak.
- Guadeloupe: As of 28 April 2016, 2 099 suspected and 412 laboratory-confirmed cases have been reported, an increase of 418 suspected and 72 laboratory-confirmed cases since last week. One case with neurological complications has been reported since the beginning of the outbreak.
- St Martin: As of 28 April 2016, 212 suspected and 61 laboratory-confirmed cases have been reported, an increase of 29 suspected and 7 laboratory-confirmed cases since last week. One case with neurological complications has been reported; however, this could not be directly attributed to Zika.
- St Barthélemy: As of 28 April 2016, one case has been confirmed.
Figure 1. Countries or territories with reported confirmed autochthonous cases of Zika virus infection in the past three months, as of 29 April 2016
Figure 2. Countries and territories with reported confirmed autochthonous cases of Zika virus infection in the past nine months, as of 29 April 2016
Update on the observed increase of congenital Zika syndrome and other neurological complications
Congenital zika syndrome and GBS:
Microcephaly and other foetal malformations potentially associated with Zika virus infection or suggestive of congenital infection have been reported in Brazil (1 198 cases), Cape Verde (two cases), Colombia (seven cases), French Polynesia (eight cases), Martinique (three cases), Marshall Islands (one case) and Panama (five cases). Two additional cases, each linked to a stay in Brazil, were detected in Slovenia and the United States of America. One more case was reported in the US in a returning traveller from the affected countries.
In the context of Zika virus circulation, 13 countries or territories have reported an increased incidence of Guillain-Barré syndrome (GBS) and/or laboratory confirmation of a Zika virus infection among GBS cases.
Brazil Between October 2015 and as of 23 April 2016, Brazil reported 7 228 suspected cases of microcephaly from 1 359 municipalities in all states and in the Federal District. Of these cases, 1 198 are reported as confirmed cases of microcephaly with 194 having laboratory confirmation of Zika virus infection. Of the remaining cases, 2 320 were investigated and discarded as they did not fit the case definition, while 3 710 cases are still under investigation.
Among the 7 228 suspected cases of microcephaly, 251 intrauterine or neonatal deaths were reported. Of these, 54 cases were investigated and confirmed (microcephaly and/or central nervous system malformations).
Additional information may be found in the latest ECDC Risk Assessment.
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