Zika virus infection epidemiology and demographics

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Zika as global threat - Source: Source: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0660-0

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D., Luke Rusowicz-Orazem, B.S., Serge Korjian M.D., Yamuna Kondapally, M.B.B.S[2], Tarek Nafee, M.D. [3], Shivani Chaparala M.B.B.S [4]

Overview

In 2015, Zika virus infection outbreaks rose dramatically, particularly in Brazil, as was observed by the manifestation of a correlated complication, microcephaly, in infants born to mothers with Zika virus infection at an incidence of approximately 100 per 100,000 infants. The majority of Zika virus infection cases are reported in South Africa and tropical Asia. As of 2014, Zika Virus infection outbreaks have also become more common in South America. Cases reported in other regions of the world are attributed to travel from areas with outbreaks. Zika virus infection affects all age groups, with newborn infants particularly vulnerable due to risk of transmission from the mothers upon birth.

Epidemiology

  • Only 1 in 5 people with Zika virus infection usually becomes symptomatic, and symptoms are generally mild, thus it is hard to establish a clear incidence of the infection.
  • The incidence of Zika virus infection is often correlated to one of its commonly associated complications, neonatal microcephaly.
  • As of November 2015, it is estimated that 99.7/100,000 live births of infants displaying microcephaly may be attributed to Zika virus.
  • This is a twenty-fold increase from 2010's report of 5.7/100,000 cases.[1]

2017 India reported cases

  • Between February 2016 and January 2017, 3 laboratory confirmed cases were discovered in India.
  • The 3 cases were 1 male and 2 pregnant females.[2]
  • The 3 cases did not give any history of recent travels.
  • The 2 pregnant women gave birth to fully healthy babies and the male recovered without any complications.
  • The government in India has been discrete about the cases and this attitude has been widely critisizesd.[3]

Worldwide Distribution

  • According to WHO regional office for Americas, 75 countries and territories have confirmed indigenous vector-borne transmission of Zika virus in the region of Americas.(most recent update December 15, 2016).[4] The following world map shows the workdwide distribution of Zika as of December 2016:
Source: http://www.who.int/en/




















Sexually transmitted Zika

The following table demonstrates the worldwide distribution of confirmed sexually transmitted Zika cases:

Region Countries Number of Cases
Americas Argentina, Canada, Chile, Peru, USA 5
Euro France, Germany, Italy, Netherlands, Portugal, Spain, UK, Northern Ireland 7
Western Pacific New Zealand 1


North America

  • Mexico: Showing downward trend on number of confirmed cases.
  • United States of America: Zika transmission continues to expand.
  • Florida: No new local transmission cases were reported since 7 December 2016. On 9 December, Miami beach area was declared clear of any ongoing active Zika transmission.
  • Texas: Five additional cases of suspected locally transmitted Zika virus disease cases were detected in Cameron County.The cases were identified as part of the followup to state’s first case of Zika likely transmitted by mosquito, announced on 28 November, 2016.

Central America

  • Central America has decreasing trend of cases except in Panama, where there has been increasing trend of cases since the beginning of outbreak.
  • Between late 2015 and early 2016, there was greatest increase in Zika cases in Central America.

Caribbean

  • The Caribbean countries are showing decreasing trends expect in Anguilla where, there has been an increasing trend in cases. In Saint Martin, a French oversea territory, the epidemic continues to decline erratically with a recent increase in the number of visits to emergency services.

South America

  • All countries of South America are showing decreasing trends except in Paraguay and Peru,particularly in the city of Iquitos,where an increasing tendency is observed.

Africa

  • Cape Verde is the only African country with confirmed active Zika transmission since 2015. 9 cases of Zika-associated microcephaly or CNS manifestations have been reported.

Southeast Asia

  • On May 15 2017, the WHO has reported 3 confirmed cases of Zika virus in pregnant women in India.

Pacific Islands

  • Countries in the pacific islands region with active transmission since 2015 include American Samoa, Kosrae/Micronesia, Fiji, Marshall Islands, New Caledonia, Palau, Papua New Guinea, Samoa, and Tonga.

Singapore

  • According to the Centers for Disease Control and Prevention (CDC), the first local transmission of Zika virus infection (Zika) was reported in Singapore in August 2016. As of December 2016, Singapore is reported to be clear of active Zika transmission.

United States

  • There have been cases of local level transmission within the continental United States.[5]
  • By December 22,2016 - 215 locally-acquired cases have been reported in the United States (100% in Florida) and 34,463 in U.S. territories.
  • 4541 travel associated cases have been reported in the United States and 131 in U.S. territories.


The following map demonstrates the distribution of zika virus infections in the United States:

Source: https://www.cdc.gov/

Travel Associated cases of ZIKV

Source: https://www.cdc.gov/



Locally Acquired cases of ZIKV

Locally acquired cases of ZIKV infection
State or Territory Number of Cases
Puerto Rico 33,487
U.S Virgin Islands 862
Florida 210
American Samoa 114
Texas 5
Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory (as of December 22, 2016).[5]













Congenital syndrome associated with Zika virus infection

  • To date, 22 countries and territories in the Americas have reported confirmed cases of congenital syndrome associated with Zika virus infection. Since the Zika Epidemiological Update of 1 December 2016, Nicaragua has been added to the list of countries that have reported a case of congenital syndrome associated with Zika virus infection for the first time.

Guillain-Barre syndrome (GBS) and other neurological disorders

  • Since the Zika Epidemiological Update of 1 December 2016, no new country or territory has reported for the first time cases of Guillan-Barré syndrome (GBS) associated with Zika virus infection.
Countries and territories in the Americas with GBS in the context of Zika virus circulation
Increase in GBS with Zika virus lab confirmation in at least one case of GBS Zika virus infection laboratory confirmation in at least one case of GBS Increase in GBS with no Zika virus lab confirmation in any of the cases
Brazil Bolivia Paraguay
Colombia Costa Rica Saint Vincent and the Grenadines
Dominican Republic Grenada
El Salvador Haiti
French Guiana Mexico
Guadeloupe Panama
Guatemala
Honduras
Jamaica
Martinique
Puerto Rico
Suriname
Venezuela

Demographics

Age

  • Zika virus infection may affect individuals of all age groups.[1][6]

Gender

  • Men and women are equally affected by Zika virus infection.

References

  1. 1.0 1.1 "Epidemiological Alert: Neurological Syndromes, Congenital Malformations, and Zika Virus Infection. Implications for Public Health in the Americas". Pan American Health Organization. Pan American Health Organization. December 1, 2015. Retrieved December 11, 2015.
  2. "WHO | Zika virus infection – India".
  3. "Did India hide its first cases of Zika virus? - BBC News".
  4. WHO http://www.paho.org/hq/index.php?option=com_content&id=11599&Itemid=41691 (September 8, 2016) Accessed on September 15, 2016
  5. 5.0 5.1 Reported cases http://www.cdc.gov/zika/intheus/maps-zika-us.html (December 22, 2016) Accessed on December 27, 2016
  6. "Zika Virus: Geographical Distribution". CIDRAP Center for Infectious Disease Research and Policy. University of Minnesota. December 1, 2015. Retrieved December 14, 2015.