Impact of the 2016 Ecuador Earthquake on Zika Virus Cases

Abstract

Objectives. To evaluate the impact of the April 2016 7.8-magnitude earthquake in Ecuador on the incidence of Zika virus (ZIKV) cases.Methods. We used the national public health surveillance system for reportable transmissible conditions and included suspected and laboratory-confirmed ZIKV cases. We compared the number of cases before and after the earthquake in areas closer to and farther from the epicenter.Results. From January to July 2016, 2234 patients suspected of having ZIKV infection were reported in both affected and control areas. A total of 1110 patients had a reverse transcription-polymerase chain reaction assay, and 159 were positive for ZIKV. The cumulative incidence of ZIKV in the affected area was 11.1 per 100 000 after the earthquake. The odds ratio of having ZIKV infection in those living in the affected area was 8.0 (95% CI = 4.4, 14.6; P < .01) compared with the control area and adjusted for age, gender, province population, and number of government health care facilities. METHODSWe included all confirmed ZIKV cases in areas affected by the earthquake and in control areas that are similar in elevation, average temperature, proximity to the coast, and population size. We also included suspected ZIKV cases to evaluate the geographic relationship between these cases and those confirmed by laboratory.The epicenter of the 2016 earthquake was 17 miles south-southeast of Muisne, Esmeraldas, in the northeastern part of the country. The Manabí and Esmeraldas provinces had the most earthquake-related damage, with 705 and 420 destroyed buildings, respectively.7 Before the earthquake, Manabí had 199 health centers and 15 hospitals. After the earthquake, 7 hospitals had major damage and were inoperative. 8,9Almost all earthquake-related deaths in Ecuador were reported in Manabí; the earthquake affected larger urban centers in Manabí than in Esmeraldas, Guayas, and Los Ríos. Definitions of EarthquakeAffected AreasWe defined the earthquake-affected area as the province of Manabí, which is 30 miles south of the epicenter. The rationale for using only this province was that the roads to Esmeraldas province and the health care facilities most proximal to the epicenter were completely destroyed, 10,11 preventing the collection of any confirmatory samples, whereas several facilities in nearby Manabí remained partially operational and accessible by car. Manabí has larger urban areas and more health care facilities and transportation infrastructure than Esmeraldas. To better evaluate the relationship between earthquake-related damage and ZIKV incidence, we also collected data at the county Correspondence should be sent to Denisse C. Pareja, MD, MSPH, Department of Veterans Affairs, Bruce W. Carter VA Medical Center, 1201 NW 16th Street, 207G, Miami, FL 33125-1693 (denpareja@gmail.com). Reprints can be ordered at http://www. ajph.org by clicking the "Reprints" link.

Post-earthquake Zika virus surge: Disaster and public health threat amid climatic conduciveness

“…Our preliminary research had already suggested an increase in post-earthquake incident ZIKV cases in Ecuador during the period January-July 2016 44 . A later study confirmed this observation 45 . However, neither of these studies controlled for socioeconomic and climatic variables nor did they evaluate the impact of climatic context on this phenomenon, which might confound the observed associations.…”

Condiciones sociodemográficas post terremoto relacionadas a los Conocimientos, Actitudes y Prácticas de Zika, Nuevo Pedernales - Ecuador.

“…(4) Las ETV aumentaron a raíz de los desastres naturales en regiones de Sudamérica y Centroamérica. (5) . Ningún otro continente notificó brotes de ZIKV en magnitud similar a lo observado en Sudamérica, donde los cambios meteorológicos de "El Niño" fueron considerados los desencadenantes iniciales de la epidemia en Brasil.…”

“…Ningún otro continente notificó brotes de ZIKV en magnitud similar a lo observado en Sudamérica, donde los cambios meteorológicos de "El Niño" fueron considerados los desencadenantes iniciales de la epidemia en Brasil. (5) La mayor transmisión de ZIKV a nivel mundial se produjo a inicios del año 2016, posterior a lo cual disminuyó considerablemente. (6,7) Sin embargo, el calentamiento global y las características poblacionales de pobreza produjeron una segunda oleada de transmisión de ZIKV en Ecuador, Perú y Argentina durante el primer semestre del año 2017.…”

“…(6,7) Sin embargo, el calentamiento global y las características poblacionales de pobreza produjeron una segunda oleada de transmisión de ZIKV en Ecuador, Perú y Argentina durante el primer semestre del año 2017. (5) A finales del año 2017 la tasa de incidencia de infección por ZIKV a nivel mundial fue de 80 por 100.000 personas. (7,8) En Ecuador, según el Ministerio de Salud Pública (MSP) el mayor pico de casos confirmados de ZIKV se produjo a mediados del año 2016, después del terremoto de magnitud 7,8 Mw del 16 de abril del 2016.…”

Psychological Distress and Zika, Dengue and Chikungunya Symptoms Following the 2016 Earthquake in Bahía de Caráquez, Ecuador

“…There were 660 reported fatalities, 4605 people with injuries, 30,223 people displaced, 9738 buildings damaged/destroyed and roughly 720,000 people requiring humanitarian assistance [ 1 ]. The earthquake triggered a major epidemic of Zika virus (ZIKV) [ 2 ], a major health concern due to the complications associated with infection, such as Guillain-Barre Syndrome and congenital syndrome [ 3 ]. Following the earthquake, the cumulative number of ZIKV cases in Ecuador increased from 103 cases in epidemiological week 14 of 2016 to 1275 cases in epidemiological week 25 of 2016, with 85% of all ZIKV cases in 2016 reported from Manabí Province, near the epicenter ( Figure 1 and Figure 2 ) [ 4 ].…”