Zika virus infection epidemiology and demographics

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

Sexually transmitted diseases Main Page
Zika virus infection Microchapters
Home
Patient Information
Overview
Historical Perspective
Pathophysiology
Causes
Classification
Differentiating Zika Virus Infection from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications, and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Evaluation of Pregnant Women
Evaluation of Infants
Collection and Submission of Fetal Tissues
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Guidelines for Pregnant Women
Travel Notice
Blood Donation
Sexual transmission
Secondary Prevention
CDC Response Planning Tips
Risk-based Preparedness for States
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Zika virus infection epidemiology and demographics On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Zika virus infection epidemiology and demographics All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Zika virus infection epidemiology and demographics
CDC on Zika virus infection epidemiology and demographics
Zika virus infection epidemiology and demographics in the news
Blogs on Zika virus infection epidemiology and demographics
Directions to Hospitals Treating Zika virus infection
Risk calculators and risk factors for Zika virus infection epidemiology and demographics

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.

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.
• 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.

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). 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.
• 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).

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.

Gender

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