Incidence of Zika Virus Disease by Age and Sex — Puerto Rico, November 1, 2015–October 20, 2016

Lozier, Matthew; Adams, Laura; Febo, Mitchelle Flores; Torres-Aponte, Jomil; Bello-Pagán, Melissa; Ryff, Kyle; Muñoz‐Jordán, Jorge L.; Garcı́a, Myriam; Rivera, Aidsa; Read, Jennifer S.; Waterman, Stephen H.; Sharp, Tyler M.; Rivera-García, Brenda

doi:10.15585/mmwr.mm6544a4

Cited by 64 publications

(58 citation statements)

References 8 publications

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“…26,27 Although serosurveys will be ultimately necessary to properly quantify the level of population immunity in Thailand, the observed similarity between the agespecific incidence patterns in Thailand as compared with those in Colombia and Puerto Rico, where Zika virus has only recently emerged, suggest limited population immunity. 20,28 Thus, our findings from Thailand suggest that Zika virus might have found a middle ground-sufficient transmission to maintain itself but not at high enough levels to result in Our findings are also consistent with agespecific differences in symptomatic infection risk or health seeking behaviour. We find a reduced risk of being infected with Zika virus among individuals older than 50 years, and an increased risk in individuals aged 21-30 years.…”

Section: Discussionsupporting

confidence: 79%

“…Similar patterns have been described in the American outbreak. 20,28 Our findings highlight the key insight that phylogenetic approaches provide, even with only a handful of sequences. Although we cannot rule out that the individual sequences represent the recent offspring from independent introductions into the country, this would necessitate a diverse viral reservoir in the wider region, which has not been observed.…”

Section: Discussionmentioning

confidence: 69%

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Long-term circulation of Zika virus in Thailand: an observational study

Ruchusatsawat

Wongjaroen

Posanacharoen

et al. 2019

The Lancet Infectious Diseases

107

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Background Little is known about the historical and current risk of Zika virus infection in southeast Asia, where the mosquito vector is widespread and other arboviruses circulate endemically. Centralised Zika virus surveillance began in Thailand in January, 2016. We assessed the long-term circulation of Zika virus in Thailand. MethodsIn this observational study, we analysed data from individuals with suspected Zika virus infection who presented at hospitals throughout the country and had biological samples (serum, plasma, or urine) tested for confirmation with PCR at the National Institute of Health laboratories in Bangkok. We analysed the spatial and age distribution of cases, and constructed time-resolved phylogenetic trees using genomes from Thailand and elsewhere to estimate when Zika virus was first introduced. FindingsOf the 3089 samples from 1717 symptomatic individuals tested between January, 2016, and December, 2017, 368 were confirmed to have Zika virus infection. Cases of Zika virus infection were reported throughout the year, and from 29 of the 76 Thai provinces. Individuals had 2·8 times (95% CI 2·3-3·6) the odds of testing positive for Zika virus infection if they came from the same district and were sick within the same year of a person with a confirmed infection relative to the odds of testing positive anywhere, consistent with focal transmission. The probability of cases being younger than 10 years was 0·99 times (0·72-1·30) the probability of being that age in the underlying population. This probability rose to 1·62 (1·33-1·92) among those aged 21-30 years and fell to 0·53 (0·40-0·66) for those older than 50 years. This age distribution is consistent with that observed in the Zika virus epidemic in Colombia. Phylogenetic reconstructions suggest persistent circulation within Thailand since at least 2002.Interpretation Our evidence shows that Zika virus has circulated at a low but sustained level for at least 16 years, suggesting that Zika virus can adapt to persistent endemic transmission. Health systems need to adapt to cope with regular occurrences of the severe complications associated with infection.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 69%

Long-term circulation of Zika virus in Thailand: an observational study

Ruchusatsawat

Wongjaroen

Posanacharoen

et al. 2019

The Lancet Infectious Diseases

107

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“…Studies conducted in Puerto Rico, Brazil, and El Salvador showed that ZVD has a higher incidence among women than among men, and the highest rates are reported among women aged 20–49 years, which corresponds to women of childbearing age [18,19,20]. …”

Section: Discussionmentioning

confidence: 99%

Knowledge, Attitudes, and Practices about the Prevention of Mosquito Bites and Zika Virus Disease in Pregnant Women in Greece

Mouchtouri

Papagiannis

Katsioulis

et al. 2017

IJERPH

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A survey among 573 pregnant women in Greece was conducted through self-completion of a questionnaire in July 2016. Traveling abroad the last six months was declared by 10.5% and 13.0% of pregnant women and their male sex partners, respectively, while 77.4% (441/570) had heard about Zika virus disease (ZVD). A lack of knowledge about sexual transmission of ZVD was identified in 63.3% of pregnant women, and 24.1% of responders did not know the risks to the fetus and baby. Approximately 73% of responders believed that the mosquito bites can affect their fetus and baby and 18% did not take measures to prevent mosquito bites routinely. Multivariable logistic regression models showed that traveling abroad the last six months by pregnant women correlated with correctly answering the question about the transmission of ZVD through bites of infected mosquitoes (Odds Ratio, OR = 10.47, 95% CI = 1.11–98.41). Traveling abroad with a male sex partner over the last six months correlated (OR = 2.05, 95% CI = 0.99–4.23) with responding correctly to the four key questions about the transmission of ZVD through mosquito bites, the risk of microcephaly, and the risks of traveling to the affected countries. A score of ≥5 for the nine responses given to questions of knowledge and attitudes was associated with a Bachelor of Science degree (OR = 1.54, 95% CI = 1.09–2.18), antenatal care at a public hospital (OR = 2.26, 95% CI = 1.28–3.98), being a civil servant as occupation (OR = 1.96, 95% CI = 1.10–3.48), and having gotten information about ZVD from the public health sector (OR = 2.04, 95% CI = 1.05–3.98). In conclusion, we found considerable knowledge gaps related to ZVD among Greek pregnant women. These study results are useful in targeting pregnant women for the prevention of potential Zika virus infections.

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“…It did not take long to reach other countries in South (WHO, 2015; Pacheco et al, 2016) and Central America (Lozier et al, 2016), accompanied by an epidemic of GBS cases (Dos Santos et al, 2016) and microcephaly (Cuevas et al, 2016). Patients infected with ZIKV began to be identified in the U.S., initially imported from South and Central American countries (McCarthy, 2016; Hamer et al, 2017).…”

Section: Emergence and Spread Of Zikv Infectionmentioning

confidence: 99%

Zika in the Americas, year 2: What have we learned? What gaps remain? A report from the Global Virus Network

et al. 2017

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In response to the outbreak of Zika virus (ZIKV) infection in the Western Hemisphere and the recognition of a causal association with fetal malformations, the Global Virus Network (GVN) assembled an international taskforce of virologists to promote basic research, recommend public health measures and encourage the rapid development of vaccines, antiviral therapies and new diagnostic tests. In this article, taskforce members and other experts review what has been learned about ZIKV-induced disease in humans, its modes of transmission and the cause and nature of associated congenital manifestations. After describing the make-up of the taskforce, we summarize the emergence of ZIKV in the Americas, Africa and Asia, its spread by mosquitoes, and current control measures. We then review the spectrum of primary ZIKV-induced disease in adults and children, sites of persistent infection and sexual transmission, then examine what has been learned about maternal-fetal transmission and the congenital Zika syndrome, including knowledge obtained from studies in laboratory animals. Subsequent sections focus on vaccine development, antiviral therapeutics and new diagnostic tests. After reviewing current understanding of the mechanisms of emergence of Zika virus, we consider the likely future of the pandemic.

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Incidence of Zika Virus Disease by Age and Sex — Puerto Rico, November 1, 2015–October 20, 2016

Cited by 64 publications

References 8 publications

Long-term circulation of Zika virus in Thailand: an observational study

Long-term circulation of Zika virus in Thailand: an observational study

Knowledge, Attitudes, and Practices about the Prevention of Mosquito Bites and Zika Virus Disease in Pregnant Women in Greece

Zika in the Americas, year 2: What have we learned? What gaps remain? A report from the Global Virus Network

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