Zika emergence in the French Territories of America and description of first confirmed cases of Zika virus infection on Martinique, November 2015 to February 2016

Abstract

Following of the emergence of Zika virus in Brazil in 2015, an epidemiological surveillance system was quickly implemented in the French overseas Territories of America (FTA) according to previous experience with dengue and chikungunya and has detected first cases of Zika. General practitioners and medical microbiologists were invited to report all clinically suspected cases of Zika, laboratory investigations were systematically conducted (RT-PCR). On 18 December, the first autochthonous case of Zika virus infection was confirmed by RT-PCR on French Guiana and Martinique, indicating introduction of Zika virus in FTA. The viral circulation of Zika virus was then also confirmed on Guadeloupe and Saint-Martin. We report here early findings on 203 confirmed cases of Zika virus infection identified by RT-PCR or seroneutralisation on Martinique Island between 24 November 2015 and 20 January 2016. All cases were investigated. Common clinical signs were observed (maculopapular rash, arthralgia, fever, myalgia and conjunctival hyperaemia) among these patients, but the rash, the foundation of our case definition, may be absent in a significant proportion of patients (16%). These results are important for the implementation of a suspected case definition, the main tool for epidemiological surveillance, in territories that may be affected by ZIKV emergence, including Europe.

Travel-associated and autochthonous Zika virus infection in mainland France, 1 January to 15 July 2016

“…The number of imported cases steadily increased in 2016, reflecting the epidemic in the French departments of the Americas [1,8] (Figure 3), as observed during the chikungunya virus outbreak in 2014 [9]. …”

“…d The numbers are based on cases reported by a sentinel network of general practitioners and are then extrapolated [1,8]. …”

“…Since 2015, ZIKV has spread rapidly throughout the Americas, including the French departments and collectivities [8], and revealed new ways of transmission and severe complications [10-12], including sexual transmission, congenital malformations [13,14] and neurological syndromes [15]. By 5 August 2016, 43 countries and territories had confirmed local, vector-borne transmission of ZIKV in South and Central America since 2015 [16,17].…”

Simple reverse genetics systems for Asian and African Zika viruses

“…ZIKV re-emerged in the Pacific Ocean islands in 2013, causing outbreaks in French Polynesia4, which was followed by a series of ZIKV outbreaks affecting numerous Pacific Ocean islands56. Recently, ZIKV invaded the Americas causing large outbreaks in many territories of South and Central America78910. Prior to the French Polynesian outbreak, ZIKV human infections were described as mild and self-limiting.…”

Note from the editors: Articles on Zika preparedness

“…Both draw on lessons learnt from earlier arbovirus epidemics (chikungunya and dengue) that had considerable impact on the health of citizens and put a strain on the public health systems. Daudens-Vaysse et al share experiences and results from the epidemiological surveillance set up in the FTA at the beginning of the epidemic, covering the period from November 2015 to February 2016 [7]. They highlight challenges associated with the chosen case definition, namely the absence of rash, the foundation of their case definition, in a significant proportion of patients.…”