Epidemiological update: Outbreaks of Zika virus and complications potentially linked to the Zika virus infection, 3 March 2016

Epidemiological update

​As of 3 March 2016, autochthonous cases of Zika virus infection have been reported from 38 countries and territories worldwide in the past two months. Forty-one countries and territories have reported autochthonous cases of Zika virus infection in the past nine months.

Page last updated: 4 March 2016

New developments since the last epidemiological update published on 25 February 2016

Since last week, New Caledonia confirmed the first autochthonous case in 2016 on 3 March 2016.
 
On 26 February 2016, the first autochthonous case of Zika was reported in an adult woman in Argentina, who has no travel history but had contact with a man who had travelled to Colombia.  
 
On 26 February 2016, a second sexually transmitted Zika case was reported from the US. 
 
According to media on 27 February 2016, the French authorities have reported a case of Zika virus due to sexual transmission in a woman who is not pregnant.
 
On 3 March 2016, the Ministry of Health of New Zealand announced that they are investigating a possible case of sexual transmission of Zika virus in New Zealand. A man became ill after visiting a country where Zika virus is currently being actively transmitted, and has tested positive for the virus. His female partner, who has not recently travelled to a Zika-affected country, has also tested positive for Zika.

Publications

A case–control study published in The Lancet provides evidence of Zika virus infection causing Guillain–Barré syndrome in French Polynesia during the Zika epidemic between October 2013 and April 2014.
 
On 3 March 2016, Eurosurveillance published a report of two cases of Guillain–Barré syndrome who had concomitant Zika virus viruria. This viruria persisted for longer than 15 days after symptom onset. The cases occurred on Martinique in January 2016, at the beginning of the Zika virus outbreak.
 
On 3 March 2016, PLoS Neglected Tropical Diseases published the outcome of the laboratory study on the susceptibility to Zika virus of Aedes aegypti and Aedes albopictus from the Americas.

Detailed epidemiological situation

As of 3 March 2016, autochthonous cases of Zika virus infection have been reported from 38 countries and territories worldwide in the past two months (see Table 1 and Figure 1). Forty-one countries and territories have reported autochthonous cases of Zika virus infection in the past nine months (see Table 1 and Figure 2).
 
Several countries in the Americas, Caribbean and the Pacific continue to report an increase in autochthonous cases of Zika virus infection.
 

Table 1. Countries and territories with reported confirmed autochthonous cases of Zika virus infection in the past two months, as of 3 March 2016

 Country and territories Affected in the past 2 months Affected in the past 9 months
American Samoa Increasing or widespread transmission Yes
Aruba Sporadic transmission Yes
Barbados Increasing or widespread transmission Yes
Bolivia Increasing or widespread transmission Yes
Brazil Increasing or widespread transmission Yes
Bonaire Sporadic 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 No Yes
French Guiana Increasing or widespread transmission Yes
Guadeloupe Increasing or widespread transmission Yes
Guatemala Increasing or widespread transmission Yes
Guyana Sporadic transmission Yes
Haiti Increasing or widespread transmission Yes
Honduras Increasing or widespread transmission Yes
Jamaica Sporadic transmission Yes
Marshall Islands Sporadic 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
Paraguay Increasing or widespread transmission Yes
Puerto Rico Increasing or widespread transmission Yes
Saint Martin Sporadic transmission Yes
Saint Vincent and the Grenadines Sporadic transmission Yes
Samoa Increasing or widespread transmission Yes
Sint Maarten Sporadic transmission Yes
Solomon Islands No Yes
Suriname Increasing or widespread transmission Yes
Thailand Sporadic transmission Yes
Tonga Increasing or widespread transmission Yes
Trinidad and Tobago Sporadic transmission Yes
Vanuatu No Yes
Venezuela Increasing or widespread transmission Yes
US Virgin Islands Increasing or widespread transmission Yes

EU/EEA and EU Outermost Regions and Territories 

As of 3 March, no autochthonous 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. As of 3 March 2016, ECDC has recorded 209 imported cases in 16 EU/EEA countries: Austria (1), Czech Republic (2), Denmark (1), Finland (2), France (81), Germany (26), Ireland (3), Italy (9), Malta (1), Netherlands (30), Portugal (7), Slovakia (1), Slovenia (1), Spain (32), Sweden (2), and the UK (10). Eleven of the imported cases are pregnant women. This list may not be exhaustive.
 
Thirty EU/EEA countries have issued travel advice for people travelling to Zika-affected areas. Of these, 28 have advised pregnant women to consider postponing travel to countries affected by the Zika epidemic.
 
Several Outermost EU Regions and territories continue to report autochthonous transmission.

Martinique: From December 2015 to 3 March 2016, 9 240 suspected cases have been reported, this is an increase of 1 710 suspected cases since the last update on 25 February 2016.

French Guiana: From December 2015 to 3 March 2016, 1 405 suspected and 118 laboratory-confirmed cases have been reported, an increase of 370 suspected and 14 laboratory-confirmed cases since the last update on 25 February 2016.

Guadeloupe: As of 3 March 2016, 474 suspected and 66 laboratory-confirmed cases have been reported, this is an increase of 85 suspected and 31 laboratory-confirmed cases since the last update on 25 February 2016.

Saint Martin: As of 3 March, 72 suspected and 17 laboratory-confirmed cases have been reported, this is an increase of 14 suspected and 6 laboratory-confirmed cases since the last update on 25 February 2016.
 

Figure 1.Countries and territories with reported confirmed autochthonous cases of Zika virus infection in the past two months, as of 3 March 2016

Note: the map does not indicate the extent of the autochthonous transmission in the countries.
 

Figure 2.Countries and territories with reported confirmed autochthonous cases of Zika virus infection in the past nine months, as of 3 March 2016

Note: the map does not indicate the extent of the autochthonous transmission in the countries.
 

Update on the observed increase of congenital malformations and other central nervous system complications

Brazil: According to the Ministry of Health, since October 2015 and as of 27 February 2016, there have been 5 909 suspected cases of microcephaly from 1 143 municipalities across 25 states in Brazil. This is an increase of 269 suspected cases since the last weekly update on 23 February (data as of 20 February). As of 27 February 2016, 641 of the cases have been confirmed to have microcephaly and/or other central nervous system findings suggestive of congenital infection. Of these cases, 82 have been confirmed positive for Zika virus by PCR.
 
There have been 139 intrauterine or neonatal deaths reported among children notified to have microcephaly and/or central nervous system malformations. Of these, 31 cases were investigated and confirmed to have microcephaly and/or central nervous system malformations. Ninety-six cases are still under investigation and 12 cases have been discarded.

Panama: On 2 March 2016, media, quoting the Ministry of Health, reported the first confirmed case of Guillain–Barré syndrome (GBS) possibly linked to Zika infection.
 
Additional information may be found in the latest ECDC Risk Assessment.