Epidemiological update: Outbreaks of Zika virus and complications potentially linked to the Zika virus infection, 8 September 2016

Since 1 February 2016, Zika virus infection and the related clusters of microcephaly cases and other neurological disorders constitute a public health emergency of international concern (PHEIC).

Since 2015, and as of 2 September 2016, there have been 63 countries and territories reporting mosquito-borne transmission. According to WHO and as of 8 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.

New developments since the last epidemiological update

The USA

Nine new autochthonous cases have been reported in Florida since the last CDTR, bringing the number of locally transmitted cases to 56. As of 7 September, the number of autochthonous cases reported in Florida state is as follows: 49 cases in Miami-Dade, one in Broward, three in Palm Beach and one in Pinellas. The department is conducting an investigation into the other two cases to determine where exposure occurred. The Florida Department of Agriculture and Consumer Services has detected Zika in three mosquito samples from a small area in Miami Beach.

Malaysia

On 2 September, the Ministry of Health in Malaysia reported the first local transmission of Zika virus infection in a 61-year-old male.

Singapore

Following the detection of a case of Zika virus infection on 27 August 2016, the Ministry of Health reports 267 locally-acquired cases including two cases diagnosed in pregnant women.

Philippines

On 6 September, the Department of Health reported a case of locally-acquired Zika virus infection in a woman from Iloilo City. This is the first locally-acquired case reported in 2016 and the sixth case reported in the country since 2012.

WHO

On 6 September, WHO published updated interim guidance on the prevention of sexual transmission of Zika virus. WHO recommends that both women and men who are returning from Zika-affected areas abstain or practice safe sex for six months, even if they are not trying to conceive and regardless of symptoms.

Publications

Cell published 'Zika Virus Infection in Mice Causes Panuveitis with Shedding of Virus in Tears'. In addition, Clinical Infectious Diseasespublished 'Fetal infection by Zika virus in the third trimester'.

 

EU/EEA imported cases

Since week 45/2015, 19 countries (Austria, Belgium, the Czech Republic, Denmark, Finland, France, Ireland, Italy, Luxembourg, Malta, the Netherlands, Norway, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and the UK) have reported 1 557 travel-associated Zika virus infections through The European Surveillance System (TESSy). Over the same time period, seven EU countries reported 79 Zika cases among pregnant women.

Zika virus infections through The European Surveillance System (TESSy). Over the same time period, seven EU countries reported 79 Zika cases among pregnant women.

EU’s Outermost Regions and Territories

As of 8 September 2016:

Martinique: 35 795 suspected cases have been reported, an increase of 225 since last week. The weekly number of cases is stable. 

French Guiana: 9 630 suspected cases have been detected, an increase of 77 cases since last week. The weekly number has been slightly increasing during the past week.

Guadeloupe: 29 460 suspected cases have been detected, an increase of 385 suspected cases since last week. The weekly number of cases continues to decrease.

St Barthélemy: 630 suspected cases have been detected, an increase of 36 suspected cases since last week. The weekly number of cases has been decreasing during the past two weeks.

St Martin: 2 165 suspected cases have been detected, an increase of 80 suspected cases since last week. The weekly number of cases is stable.

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.

Since February 2016, 11 countries have reported evidence of person-to-person transmission of Zika virus, probably via a sexual

route.

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 9 September 2016  

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.

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Figure 1. Countries or territories with reported confirmed autochthonous cases of Zika virus infection in the past three months, as of 9 September 2016

All latest ECDC maps with information on countries or territories with reported confirmed autochthonous cases of Zika virus infection

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