2015–16 Zika virus epidemic

From Wikipedia, the free encyclopedia
Jump to: navigation, search
2015–16 Zika virus epidemic
Zikamain 051916 880.jpg
Countries and territories with active transmission of the Zika virus
as of 19 May 2016[1]
Date April 2015 (2015-04) – present

As of mid-2016, a widespread epidemic of Zika fever, caused by the Zika virus, is ongoing in the Americas and the Pacific.[2] The outbreak began in early 2015 in Brazil, then spread to other parts of South and North America; it is also affecting several islands in the Pacific. In January 2016, the World Health Organization (WHO) said the virus was likely to spread throughout most of the Americas by the end of the year.[3]

In February 2016, WHO declared the outbreak a Public Health Emergency of International Concern as evidence grew that Zika can cause birth defects as well as neurological problems.[4][5] The virus can be transmitted from an infected pregnant woman to her fetus, then can cause microcephaly and other severe brain anomalies in the infant.[6][7][8] Zika infections in adults can result in Guillain–Barré syndrome.[8] Prior to this outbreak, Zika was considered a mild infection, as most Zika virus infections are asymptomatic, making it difficult to determine precise estimates of the number of cases.[9] In approximately one in five cases, Zika virus infections result in Zika fever, a minor illness that causes symptoms such as fever and a rash.

The virus is spread mainly by the Aedes aegypti mosquito, which is commonly found throughout the tropical and subtropical Americas. It can also be spread by the Aedes albopictus ("Asian tiger") mosquito, which is distributed as far north as the Great Lakes region in North America.[10] Men infected with Zika can transmit the virus to their sexual partners.[5][11][12][13]

A number of countries have issued travel warnings, and the outbreak is expected to reduce tourism significantly.[5][14] Several countries have taken the unusual step of advising their citizens to delay pregnancy until more is known about the virus and its impact on fetal development.[15] Furthermore the outbreak has raised concerns regarding the safety of athletes and spectators at the upcoming 2016 Summer Olympics in Rio de Janeiro.[16][17][18]

Epidemiology[edit]

As early as August 2014, physicians in Natal in northeastern Brazil began to investigate an outbreak of illness characterized by a flat pinkish rash, bloodshot eyes, fever, joint pain and headaches. While the symptoms resembled dengue fever, testing ruled out this and several other potential causes. By March 2015, the illness had spread to Salvador, Bahia and had appeared in three different states.[72] Then, in May 2015, researchers from the Federal University of Bahia and the Evandro Chagas Institute determined, using the RT-PCR technique, that the illness was an outbreak of Zika virus.[73][74]

The Zika virus was first isolated in 1947, in a rhesus monkey in a forest near Entebbe, Uganda.[75] Although serologic evidence indicated additional human exposure during subsequent decades in parts of Africa and Asia,[76] before the 2007 Yap Islands Zika virus outbreak, only 14 cases of human Zika virus disease had been documented.[75]

Researchers generally believe the virus was brought to Brazil by an infected traveler who had been exposed to the virus in French Polynesia, who was then bitten by a mosquito that then infected others.[77][78][79] Phylogenetic analysis of the first Brazilian infections have strongly indicated that the circulating virus is the Asian, rather than African, strain of the virus, and was genetically similar to the virus found in the outbreak in French Polynesia.[78][79] It appears Zika's route – from Africa and Asia to Oceania and then the Americas – may mirror that of chikungunya and dengue, both of which are now endemic in a large portion of the Americas.[80]

The specific event that brought the virus to Brazil was uncertain until March 2016. Brazilian researchers had suggested that the Zika virus arrived during the 2014 FIFA World Cup tournament.[77] French researchers speculated the virus arrived shortly afterwards, in August 2014, when canoeing teams from French Polynesia, New Caledonia, Easter Island, and the Cook Islands, which had been or were experiencing Zika outbreaks, attended the Va'a World Sprint Championships in Rio de Janeiro.[72][78] However, the outbreak in French Polynesia is known to have peaked and declined precipitously by February 2014, lending doubt to the suggestion the virus arrived later that year in Brazil with spectators and competitors.[81] In March 2016, a study published in Science, which developed a "molecular clock" based on the count of virus mutations in a relatively small sample, suggested Zika virus arrived in the Americas (most likely in Brazil) from French Polynesia between May and December 2013, well before the World Cup and Va'a Championships.[81] In the Science article, Faria and colleagues managed to trace the origins of the virus strain that is circulating in Brazil and found out that this strain has little genetic variability when compared to the strain of French Polynesia; after relating the number of travellers arriving in Brazil from French Polynesia with the cases reported and the events happening in that year, the team was able to deduce that the virus arrived in Brazil in 2013 during the Confederation Cup, when Tahiti's team played against other teams in a few Brazilian cities, which attracted many tourists from both places.[82] Zika virus usually has very mild, or no symptoms, so it took almost a year for Brazil to confirm the first case of the disease. By then the outbreak was already widespread. Factors associated with the rapid spread of Zika virus in Brazil include the non-immune population, high population density, tropical climate and inadequate control of Aedes mosquitoes in the country.[83]

Confirmed cases have been reported in 39 countries or territories in South America, North America, and the Caribbean,[84] as well as 16 in the western Pacific and one in Africa since the beginning of 2015 (see table).

Many countries with no cases of mosquito transmission have reported travel-related Zika cases: people who moved or came home from a Zika-affected region before they showed symptoms (see table).

Transmission[edit]

See also: Zika virus § Transmission
Adult Aedes aegypti mosquito, a vector or carrier of the Zika virus

Zika is a mosquito-borne disease. Zika can also be sexually transmitted from a man to his sex partners.[85] The resurgence of Aedes aegypti's worldwide distribution over the past 2–3 decades makes it one of the most widely distributed mosquito species.[86] In 2015, Aedes albopictus was present in tropical, subtropical, and temperate regions of the Americas, reaching as far north as the Great Lakes of North America and, internationally, living alongside Aedes aegypti in some tropical and subtropical regions.[10]

The Aedes aegypti mosquito usually bites in the morning and afternoon hours, and can be identified by the white stripes on its legs.[87] The mosquito species (Aedes aegypti, mainly, and Aedes albopictus) that can spread Zika virus can also spread dengue, chikungunya, and yellow fever.[88]

Sexual transmission of Zika has been documented in nine countries—Argentina, Canada, Chile, France, Italy, New Zealand, Peru, Portugal, and the United States—during this outbreak.[89]

Zika is transmitted from pregnant women to the fetus ("vertical transmission"), and causes microcephaly and other severe brain anomalies in infants born of women infected with the virus.[6][8]

A baby with microcephaly (left) compared to a baby with a typical head size

Zika infections in adults can cause Guillain–Barré syndrome.[8]

Diagnosis[edit]

Main article: Zika fever
Symptoms of Zika virus
Symptoms of Zika virus[90]

Symptoms are similar to other flaviviruses such as dengue fever or the alphavirus that causes chikungunya,[91] but are milder in form and usually last two to seven days.[5] It is estimated that 80% of cases are asymptomatic.[11] The main clinical symptoms in symptomatic patients are low-grade fever, conjunctivitis, transient joint pain (mainly in the smaller joints of the hands and feet) and maculopapular rash that often starts on the face and then spreads throughout the body.[91]

It is difficult to diagnose Zika virus infection based on clinical signs and symptoms alone due to overlaps with other arboviruses that are endemic to similar areas.[92] The methods currently available to test for Zika antibodies cross-react with dengue antibodies. An IgM-positive result in a dengue or Zika ELISA test can only be considered indicative of a recent flavivirus infection. Plaque-reduction neutralization tests (PRINT) can be performed and may be specific.[93] The Zika virus can be identified by RT-PCR in acutely ill patients.[5]

RT-PCR testing of serum and tissue samples can be used to detect the presence of the Zika virus. However, the RT-PCR test with serum is only helpful while the virus is still in the blood which is generally within the first week of the illness. After this period other methods should be used to determine if the virus is still present in the body. A test for IgM antibodies has seen to be effective over longer periods of time, as these antibodies can be present starting 4 days after the beginning of the illness and up to 12 weeks after that. However, it is suggested that a PRINT test be performed following a test for IgM antibodies to help eliminate false positives resulting from other flaviviruses. The PRINT test looks for viral-specific neutralizing antibodies. However, this test can still produce false positive results, for Zika, in individuals who have received immunization for or had previously been exposed to other flaviviruses.[94]

Containment and control[edit]

Americas[edit]

Several countries, including Colombia, Ecuador, El Salvador, and Jamaica, advised women to postpone getting pregnant until more was known about the risks.[15][95] Plans were announced by the authorities in Rio de Janeiro, Brazil, to try to prevent the spread of the Zika virus during the 2016 Summer Olympics in Rio.[96] The health ministry of Peru installed more than 20,000 ovitraps during the 2015 dengue outbreak. The same ovitraps will be used to monitor a potential Zika outbreak in tropical regions of Peru.[97]

symptoms of microcephaly
Symptoms of microcephaly, linked to mothers infected by Zika virus.[90]

On 15 January 2016, because of the "growing evidence of a link between Zika and microcephaly" the CDC issued a travel warning advising pregnant women to consider postponing travel to Brazil as well as the following countries and territories where Zika fever had been reported: Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and the Commonwealth of Puerto Rico.[98] On 20 January, the Ministry of Health of Chile published a health notice.[99] On 22 January, eight more countries and territories were added to the list of those affected: Barbados, Bolivia, Ecuador, Guadeloupe, Saint Martin, Guyana, Cape Verde, and Samoa.[100]

On 1 February, Costa Rica and Nicaragua were added to the list, bringing the number of countries and territories affected to 28.[101] The agency issued additional guidelines and suggested that women thinking about becoming pregnant consult with their physicians before traveling.[102] Canada issued a similar travel advisory.[96][103]

On 5 February 2016, after the laboratory confirmation of a Zika virus infection in the U.S. in a non-traveler, which was linked to sexual contact with an infected partner, the CDC issued interim guidelines for prevention of sexual transmission of Zika virus for the United States.[11] These guidelines recommend that men who reside in or have traveled to an area of active Zika virus transmission who have a pregnant partner should abstain from sexual activity or consistently and correctly use condoms during sex for the duration of the pregnancy.[11] The guidelines recommend that pregnant women discuss any possible Zika exposure with their male partners.[11] The guidelines recommend that non-pregnant women and their partners consider taking similar measures.[11]

On 8 February 2016, CDC elevated its response efforts to a Level 1 activation, the highest response level at the agency. On 23 February 2016, the CDC issued a statement further encouraging adherence to this guidance after 14 reports of possible sexual transmission of the virus were under investigation.[12][13]

On 11 March 2016, Paraguay reported its first case of zika in a pregnant woman.[104]

On 18 March 2016, Centers for Disease Prevention and Control (CDC) cautioned men who have been infected with Zika from attempting to conceive children due to probability of virus transfer from man to woman during sexual activity which in turn can affect the fetus, under this caution, men are advised not to try conception until six months after the infection.[105]

On 28 April 2016, the CDC authorized emergency use of a Zika Virus RNA Qualitative test to detect Zika virus in the blood of patients who have symptoms of Zika virus infection and live in or have traveled to an area with ongoing Zika virus transmission. This is the first commercial test to detect Zika virus authorized by the United States Food and Drug Administration for emergency use.[106]

On 6 May 2016, Major League Baseball announced that a series of games between the Miami Marlins and Pittsburgh Pirates scheduled to be played at the end of the month in San Juan, Puerto Rico would be relocated to Marlins Park in Miami, Florida after a number of players on each team voiced concerns regarding the threat of Zika exposure.[107]

International[edit]

Agent for endemic diseases of the city of Votuporanga, São Paulo, Brazil

Governments or health agencies such as those of the United Kingdom,[108] Ireland,[95] Japan,[109] South Korea,[110] New Zealand,[111] Malaysia,[112] Philippines[113] and the European Union[96] issued travel warnings. The warnings are predicted to have an effect on the tourism industry in affected countries.[114][115][116]

To prevent the transmission of the Zika virus, WHO recommends using insect repellent, wearing long-sleeved clothes to cover the body, and using screens and mosquito nets to exclude flying insects from dwellings or sleeping areas. It is also vital to eliminate any standing water near homes to minimize breeding areas for mosquitoes. Authorities can treat larger water containers with recommended larvicides.[87][117] Furthermore, the Centers for Disease Control and Prevention (CDC) recommends that containers holding water near homes either be sealed or scrubbed once per week, because mosquito eggs can stick to them.[88]

On 1 February 2016, WHO declared the cluster of microcephaly cases and other neurological disorders a Public Health Emergency of International Concern,[4] which may reduce the number of visitors to the Rio Olympics in 2016.[118] The designation has been applied in the past to the Ebola outbreak in 2014, the outbreak of polio in Syria in 2013, and the 2009 flu pandemic.[119] South Korea held an emergency meeting in response to the WHO declaration in 2 February 2016.[110] A second meeting of the WHO-convened emergency committee, held on 8 March 2016, reaffirmed the situation's status as a Public Health Emergency of International Concern. The committee reported that evidence was increasing for a causal relationship between Zika virus and microcephaly and other neurological conditions, and called for continued research, aggressive mosquito control, and improved surveillance and communication of risks to the public. The report stated that pregnant women should be advised not to travel to affected areas, and should use safe sex practices if their partners lived in or travelled to affected areas throughout their pregnancy.[120] On 9 March 2016, WHO announced that research should prioritise prevention and diagnosis, not treatment, and in particular non-live vaccines suitable for pregnant women and those of childbearing age, novel mosquito control measures, and diagnostic tests that can detect dengue and chikungunya as well as Zika.[121]

Responses[edit]

See also: Mosquito control
The Brazilian Army has sent more than 200,000 troops to go "house to house" in the campaign against Zika-carrying mosquitoes.
Brazilian Army soldier analyzes the water from a cistern

In January 2016, it was announced that, in response to the Zika virus outbreak, Brazil's National Biosafety Committee approved the releases of more genetically modified Aedes aegypti mosquitoes throughout their country.[122] Previously, in July 2015, Oxitec had published results of a test in the Juazeiro region of Brazil, of so-called "self-limiting" mosquitoes, to fight dengue, chikungunya, and Zika viruses. They concluded that mosquito populations were reduced by over 90% in the test region.[122][123][124] Male genetically modified mosquitoes mate with females in the wild and transmit a self-limiting gene that causes the resulting offspring to die before reaching adulthood and thus diminishes the local mosquito population.[122][124] in January 2016 the technique was being used to try to combat the Zika virus in the town of Piracicaba, São Paulo.[125]

On 1 February 2016, the WHO declared the current Zika virus outbreak an international public health emergency,[4][126] and the Brazilian President released a decree that increased local and federal pest control agents' access to private property required by mobilization actions for the prevention and elimination of Aedes mosquito outbreaks in the country.[127]

Some experts have proposed combatting the spread of the Zika virus by breeding and releasing mosquitoes that have either been genetically modified to prevent them from transmitting pathogens or that have been infected with the Wolbachia bacterium, thought to inhibit the spread of viruses.[128][129] Another proposed technique consists of using radiation to sterilize male larvae so that when they mate, they produce no progeny.[130] Male mosquitoes do not bite or spread disease.[131]

In February, the Brazilian federal government mobilized 60% of the country's Armed Forces, or about 220,000 soldiers, to warn and educate the populations of 350 municipalities on how to reduce mosquitoes breeding grounds.[132]

A joint statement on the sharing of data and results on the Zika outbreak in the Americas and future public health emergencies was issued on 10 February 2016 by a group of more than 30 global health bodies.[133] The statement reinforces a similar consensus statement issued by WHO in September 2015.[134] The statement calls for free access to all data as rapidly and widely as possible.[135]

In February 2016, Google announced that they were donating $1 million via UNICEF to fight the spread of the Zika virus and offering professional personnel to help to determine where it will hit next.[136]

Controversies[edit]

Some efforts to contain the spread of Zika virus have been controversial. Oxitec, the company behind the "self-limiting" mosquitoes, which pass on a fatal gene to their offspring, released in Brazil, has faced criticism from environmental groups, who fear that releasing a new mosquito strain into the wild will damage the ecosystem. In the short term, the concern is that a drop in the mosquito population could affect the populations of other species. Supporters claim that the environmental impact of the "self-limiting" mosquitoes will be minimal, since only one species of mosquito is being targeted and the genetically-modified mosquitoes are still safe for predators to eat. Oxitec Product Development Manager Derric Nimmo likened the process to "going in with a scalpel and taking away Aedes aegypti, leaving everything untouched."[137] Since Aedes aegypti is an imported invasive species in Brazil, some experts expect that its eradication will have little impact on the environment. However, other environmentalists emphasize that the long-term consequences of eliminating an entire species cannot be predicted.[138]

Government recommendations that women delay pregnancy have also proven to be controversial. Human and reproductive rights groups have deemed the recommendations irresponsible and difficult to follow, since women alone are tasked with avoiding pregnancy despite having little control to do so.[139] Evidence suggests that over half of the pregnancies in Latin America and the Caribbean are unplanned.[140] Access to contraceptives is limited in the predominantly Roman Catholic region,[141] and widespread sexual violence results in many women getting pregnant against their will. Anti-abortion laws in much of the region leave women with no recourse once they become pregnant. Aside from three countries where abortion is widely available (French Guiana, Guyana, and Uruguay) and three countries where abortion is allowed in cases of fetal malformation (Colombia, Mexico, and Panama), most of the region only permits abortion in the cases of rape, incest, or danger to the mother's health. In El Salvador, abortion is illegal under all circumstances.[139]

On 5 February 2016, the UN High Commissioner for Human Rights urged Latin American governments to consider repealing their policies regarding contraception and abortion, emphasizing that "upholding human rights is essential to an effective public health response."[142] On 16 February 2016, the Vatican condemned the UN for its call to action, deeming it "an illegitimate response" to the Zika crisis and emphasizing that "a diagnosis of microcephaly in a child should not warrant a death sentence."[143]

On 18 February 2016, after a trip to Latin America, Pope Francis stated that "avoiding pregnancy is not an absolute evil" in cases such as the Zika virus outbreak. His comments sparked speculation that the use of contraception may be morally permissible in the fight against the Zika virus.[144]

See also[edit]

Portal icon Viruses portal

References[edit]

  1. ^ "All Countries and Territories with Active Zika Virus Transmission". Centers for Disease Control and Prevention. 19 May 2016. 
  2. ^ "Zika outbreak in the Americas and the Pacific". Zika virus infection. European Centre for Disease Control and Prevention. Retrieved 9 April 2016. 
  3. ^ "WHO sees Zika outbreak spreading through the Americas". Reuters. 25 January 2016. 
  4. ^ a b c "WHO Director-General summarizes the outcome of the Emergency Committee regarding clusters of microcephaly and Guillain–Barré syndrome". World Health Organization. 1 February 2016. Retrieved 2 February 2016. 
  5. ^ a b c d e Sikka, Veronica; Chattu, Vijay Kumar; Popli, Raaj K.; et al. (11 February 2016). "The emergence of zika virus as a global health security threat: A review and a consensus statement of the INDUSEM Joint working Group (JWG)". Journal of Global Infectious Diseases 8 (1): 3–15. doi:10.4103/0974-777X.176140 (inactive 2016-05-28). ISSN 0974-8245. 
  6. ^ a b Rasmussen, Sonja A.; Jamieson, Denise J.; Honein, Margaret A.; Petersen, Lyle R. (13 April 2016). "Zika Virus and Birth Defects — Reviewing the Evidence for Causality". New England Journal of Medicine 374 (20): 1981. doi:10.1056/NEJMsr1604338. ISSN 0028-4793. PMID 27074377. 
  7. ^ "CDC Concludes Zika Causes Microcephaly and Other Birth Defects". CDC. 13 April 2016. Retrieved 14 April 2016. 
  8. ^ a b c d "Zika Virus Microcephaly And Guillain–Barré Syndrome Situation Report" (PDF). World Health Organization. 7 April 2016. Retrieved 8 April 2016. 
  9. ^ "Brazil Health Minister: Zika epidemic worse than thought". ITV News. 28 January 2016. Retrieved 1 February 2016. 
  10. ^ a b Kraemer, Moritz U.G.; Sinka, Marianne E.; Duda, Kirsten A.; et al. (7 July 2015). "The global distribution of the arbovirus vectors Aedes aegypti and Ae. albopictus". ELife 4: e08347. doi:10.7554/eLife.08347. ISSN 2050-084X. PMC 4493616. PMID 26126267. 
  11. ^ a b c d e f Oster, Alexandra M.; Brooks, John T.; Stryker, Jo Ellen; et al. (2016). "Interim Guidelines for Prevention of Sexual Transmission of Zika Virus – United States, 2016". Morbidity and Mortality Weekly Report 65 (5): 120–121. doi:10.15585/mmwr.mm6505e1. ISSN 0149-2195. PMID 26866485. 
  12. ^ a b "CDC encourages following guidance to prevent sexual transmission of Zika virus". CDC Newsroom. Centers for Disease Control and Prevention. 23 February 2016. 
  13. ^ a b Tavernise, Sabrina (23 February 2016). "C.D.C. Investigating 14 New Reports of Zika Transmission Through Sex". The New York Times. Retrieved 24 February 2016. 
  14. ^ Kiernan, Paul; Jelmayer, Rogerio (3 February 2016). "Zika Fears Imperil Brazil's Tourism Push". The Wall Street Journal (Dow Jones & Company). Retrieved 27 February 2016. 
  15. ^ a b "Zika virus triggers pregnancy delay calls". BBC News Online. 23 January 2016. 
  16. ^ Rogers, Martin (25 February 2016). "World Health Organization: Athletes should not fear Zika virus at Rio Olympics". USA Today. 
  17. ^ Vox, Ford (12 February 2016). "What real threat does Zika pose to the Rio Olympics? History has an answer". CNN. 
  18. ^ "USA cyclist Tejay van Garderen withdraws from Olympics over Zika virus". www.theguardian.com. The Guardian. 2 June 2016. 
  19. ^ "Cumulative Zika suspected and confirmed cases reported by countries and territories in the Americas, 2015–2016". Pan American Health Organization. 24 June 2016. 
  20. ^ Pantaleón, Doris (19 May 2016). "Se registran seis muertes a causa de Guillain Barré" [Six deaths are recorded caused by Guillain–Barré Syndrome]. Listin Diario (in Spanish) (Santo Domingo). 
  21. ^ "Premier décès lié au virus Zika en France, avec un mort en Martinique (ARS)" [First death linked to the Zika virus in France, with a death in Martinique (ARS)]. i24news (in French) (Tel Aviv). 20 May 2016. 
  22. ^ "Cumulative Locally Acquired Zika Cases by Country in the Americas, 2015-2016" (PDF). ReliefWeb Updates. Pacific Disaster Center. 3 June 2016. 
  23. ^ a b c "Zika virus disease in the United States, 2015–2016". Zika virus. Centers for Disease Control and Prevention. 22 June 2016. 
  24. ^ Kindhauser, Mary Kay; Allen, Tomas; Frank, Veronika; et al. (9 February 2016). "Zika: the origin and spread of a mosquito-borne virus" (PDF). Bulletin of the World Health Organization. doi:10.2471/BLT.16.171082. ISSN 0042-9686. 
  25. ^ Costa, Denise (11 March 2016). "Zika em Cabo Verde levanta suspeitas de "estirpe africana" do vírus" [Zika in Cape Verde is suspected to be "African strain" of the virus]. United Nations Radio (in Portuguese) (United Nations). 
  26. ^ "Zika: Local transmission reported in Laos". Outbreak News Today. 5 March 2016. 
  27. ^ "Zika virus infection – Maldives". Disease Outbreak News. World Health Organization. 8 February 2016. Retrieved 11 February 2016. 
  28. ^ Valente, Catherine S. (7 March 2016). "Palace: No Zika outbreak". The Manila Times. 
  29. ^ "Countries with local Zika transmission". European Centre for Disease Prevention and Control (Stockholm). 5 February 2016. Retrieved 8 February 2016. 
  30. ^ Lefevre, Amy Sawitta; Birsel, Robert (2 February 2016). "Thai health ministry says don't panic over Zika virus". Reuters. Retrieved 12 February 2016. 
  31. ^ "Zika confirmed in Vietnam: Female patients from Khanh Hoa province and Ho Chi Minh city". Outbreak News Today. 5 April 2016. 
  32. ^ "400 suspected Zika cases in American Samoa". Marianas Variety. 29 March 2016. 
  33. ^ Dipitika, Sharon (18 May 2016). "332 dengue fever cases recorded from January this year". Fijivillage. 
  34. ^ "Situation Report #4: Zika in Kosrae, Federated States of Micronesia, 2016" (PDF). ReliefWeb Updates. Government of the Federated States of Micronesia. 7 May 2016. 
  35. ^ "Zika in Republic of the Marshall Islands, 2015-2016" (PDF). ReliefWeb Updates. Government of the Marshall Islands. 20 April 2016. 
  36. ^ "Nauru latest Pacific country to discover zika". Radio New Zealand News. 28 April 2016. 
  37. ^ a b c "Zika virus infection outbreak, Brazil and the Pacific region" (PDF). Stockholm: European Centre for Disease Prevention and Control. 25 May 2015. p. 4. Retrieved 12 February 2016. 
  38. ^ "Zika virus infection – Papua New Guinea". Disease Outbreak News. World Health Organization. 22 April 2016. 
  39. ^ "Samoa records 10 Zika cases". Xinhua. 21 March 2016. 
  40. ^ "Tonga says Zika clean-up working". Radio New Zealand. 5 March 2016. 
  41. ^ Herriman, Robert (28 April 2015). "Zika virus reported on Vanuatu for the first time". Outbreak News Today. 
  42. ^ "Épidémie – Madagascar vulnérable au virus Zika" [Epidemic — Madagascar vulnerable to Zika]. L'Express de Madagascar (in French). 12 March 2016. 
  43. ^ "Un nouveau cas de Zika importé à La Réunion" [A new case of Zika imported into Réunion]. Réunion 1re (in French) (Saint-Denis: France Télévisions). 27 April 2016. 
  44. ^ Chastain, Mary (23 February 2016). "Colombian Becomes South Africa's First Zika Case". Breitbart News Network. Retrieved 26 February 2016. 
  45. ^ "The first case of Zika recorded in Antigua". The Antigua Observer. 3 May 2016. 
  46. ^ "Surveillance of Zika virus". Healthy Canadians. Government of Canada. 23 June 2016. 
  47. ^ Bronstein, Hugh (27 March 2016). "Chile Reports Its First Sexually Transmitted Zika Case". Medical Daily. 
  48. ^ "Uruguay confirma primer caso de zika importado" [Uruguay confirms the first imported case of Zika]. Prensa Latina (in Spanish) (Havana). 6 April 2016. 
  49. ^ "Zika: Beijing sees 2nd imported case". Outbreak News Today. 24 May 2016. 
  50. ^ Schuster, Ruth (31 May 2016). "Number of Known Zika Cases in Israel Climbs to 9". Haaretz. 
  51. ^ "Zika case No. 7 confirmed in Japanese returnee from Latin America". The Japan Times. 10 June 2016. 
  52. ^ "Russia Reports Fourth Zika Case". Radio Free Europe/Radio Liberty. 25 May 2016. 
  53. ^ "Singapore reports first imported Zika case". Channel NewsAsia. 13 May 2016. Retrieved 14 May 2016. 
  54. ^ "South Korea: Business traveler to Batangas, Philippines contracts Zika; 5th case to date". Outbreak News Today. 11 May 2016. 
  55. ^ "Taiwan reports 2nd imported Zika case". Outbreak News Today. 22 May 2016. 
  56. ^ a b c d e f g h "Zika virus disease epidemic: potential association with microcephaly and Guillain–Barré syndrome" (PDF). Rapid Risk Assessments. Stockholm: European Centre for Disease Prevention and Control. 9 March 2016. 
  57. ^ "Canary Islands report 3rd imported Zika case". Outbreak News Today. 16 April 2016. 
  58. ^ "Fourth case of Zika reported in Czech Republic". Prague Daily Monitor. 24 March 2016. 
  59. ^ "Données épidémiologiques" [Epidemiological data]. Zika (in French). Institut de Veille Sanitaire. 23 June 2016. 
  60. ^ "12 Zika cases registered in Germany in May". New China. 1 June 2016. 
  61. ^ "Zika cases reported in Ireland". Health Protection Surveillance Center. 23 May 2016. 
  62. ^ "Madeira reports two imported Zika cases". Outbreak News Today. 27 March 2016. 
  63. ^ "Zikavirus" [Zikavirus]. Public Health (in Dutch). Rijksinstituut voor Volksgezondheid en Milieu. 24 May 2016. 
  64. ^ Kagge, Gunnar; Slettholm, Andreas (13 April 2016). "Tolv personer i Norge har fått zikavirus" [Twelve people in Norway have contracted Zika virus]. Aftenposten (in Norwegian). Retrieved 13 April 2016. 
  65. ^ "Doença por vírus Zika" [Zika virus disease] (in Portuguese). Serviço Nacional de Saúde. 19 May 2016. 
  66. ^ "Casos diagnosticados" [Diagnosed cases]. Public Health (in Spanish). Ministerio de Sanidad, Servicios Sociales e Igualdad. 20 June 2016. 
  67. ^ "Zika: Switzerland case count now 16, South Korea reports 4th imported case". Outbreak News Today. 9 May 2016. 
  68. ^ "Zika virus – Detailed guidance". Health protection – guidance. Public Health England. 22 June 2016. 
  69. ^ Branco, Jorge (20 March 2016). "Queensland Zika virus cases: Bowen residents urged to spray for pests". Brisbane Times. 
  70. ^ "Zika virus infection weekly report" (PDF). Public Health Surveillance. Institute of Environmental Science and Research. 22 June 2016. 
  71. ^ "CDTR Week 25, 19–25 June 2016" (PDF). Communicable Disease Threats Reports. European Centre for Disease Prevention and Control. 24 June 2016. 
  72. ^ a b McNeil, Jr., Donald G.; Romero, Simon; Tavernise, Sabrina (6 February 2016). "How a Medical Mystery in Brazil Led Doctors to Zika". The New York Times. Retrieved 6 March 2016. 
  73. ^ "Identificado vírus causador de doença misteriosa em Salvador e RMS – notícias em Bahia". GloboNews (in Portuguese) (São Paulo). 29 April 2015. 
  74. ^ "Zika virus – Brazil: confirmed". ProMED-mail. International Society for Infectious Diseases. 19 May 2015. 
  75. ^ a b Duffy, Mark R.; Chen, Tai-Ho; Hancock, W. Thane (11 June 2009). "Zika virus outbreak on Yap Islands, Federated States of Micronesia". The New England Journal of Medicine 360 (24): 2536–2543. doi:10.1056/NEJMoa0805715. PMID 19516034. 
  76. ^ Hayes, Edward B. (September 2009). "Zika virus outside Africa". Emerging Infectious Diseases (Centers for Disease Control and Prevention) 15 (9): 1347–1350. doi:10.3201/eid1509.090442. ISSN 1080-6059. PMC 2819875. PMID 19788800. 
  77. ^ a b Romero, Simon (29 January 2016). "Tears and Bewilderment in Brazilian City Facing Zika Crisis". The New York Times. Retrieved 1 February 2016. 
  78. ^ a b c Musso, Didier (October 2015). "Zika Virus Transmission from French Polynesia to Brazil". Emerging Infectious Diseases (Centers for Disease Control and Prevention) 21 (10): 1887. doi:10.3201/eid2110.151125. Retrieved 8 March 2016. 
  79. ^ a b Murthy, Bhavini (28 January 2016). "Origin of Zika Virus Outbreak in Brazil May Be Linked to Major Sporting Events". ABC News. Retrieved 6 March 2016. 
  80. ^ Musso, D; Cao-Lormeau, VM; Gubler, DJ (18 July 2015). "Zika virus: following the path of dengue and chikungunya?". The Lancet 386 (9990): 243–4. doi:10.1016/S0140-6736(15)61273-9. PMID 26194519. 
  81. ^ a b McNeil, Donald G., Jr. (24 March 2016). "One Traveler May Have Brought Zika to the Americas in 2013". The New York Times. Retrieved 24 March 2016. 
  82. ^ Faria, N. R.; Azevedo, R. d. S. d. S.; Kraemer, M. U. G.; et al. (24 March 2016). "Zika virus in the Americas: Early epidemiological and genetic findings". Science 352 (6283): 345. doi:10.1126/science.aaf5036. ISSN 0036-8075. PMID 27013429. 
  83. ^ Ai, Jing-Wen; Zhang, Ying; Zhang, Wenhong (23 February 2016). "Zika virus outbreak: ‘a perfect storm’". Emerging Microbes and Infections (Shanghai Shangyixun Cultural Communication) 5 (3): e21. doi:10.1038/emi.2016.42. ISSN 2222-1751. 
  84. ^ "Geographic distribution of confirmed autochthonous cases of Zika virus (vector-borne transmission) in countries and territories of the Americas, 2015-2016". Epidemic Diseases–Zika in the Americas. Pan American Health Organization. 26 May 2016. Retrieved 30 May 2016. 
  85. ^ Oster, Alexandra M.; Russell, Kate; Stryker, Jo Ellen; et al. (1 April 2016). "Update: Interim Guidance for Prevention of Sexual Transmission of Zika Virus — United States, 2016". MMWR. Morbidity and Mortality Weekly Report 65 (12): 323–325. doi:10.15585/mmwr.mm6512e3. PMID 27032078. 
  86. ^ "Aedes aegypti". European Centre for Disease Prevention and Control. 
  87. ^ a b "Zika virus fact sheet". World Health Organization. February 2016. Retrieved 15 February 2016. 
  88. ^ a b "Help Control Mosquitoes that Spread Dengue, Chikungunya, and Zika Viruses" (PDF). Fact Sheets. Centers for Disease Control. August 2015. 
  89. ^ "Canada reports 1st sexually transmitted Zika case, 9th country to report person-to-person transmission". Outbreak News Today. 26 April 2016. 
  90. ^ a b "Understanding Zika". Retrieved 8 February 2016. 
  91. ^ a b Musso, D.; Nilles, E.J.; Cao-Lormeau, V.-M. (2014). "Rapid spread of emerging Zika virus in the Pacific area". Clinical Microbiology and Infection 20 (10): O595–6. doi:10.1111/1469-0691.12707. PMID 24909208. 
  92. ^ Fauci, Anthony S.; Morens, David M. (18 February 2016). "Zika Virus in the Americas – Yet Another Arbovirus Threat". New England Journal of Medicine 374 (7): 601–604. doi:10.1056/NEJMp1600297. PMID 26761185. 
  93. ^ "Revised diagnostic testing for Zika, chikungunya, and dengue viruses in US Public Health Laboratories" (PDF). Division of Vector-Borne Diseases. Centers for Disease Control and Prevention. 7 February 2016. 
  94. ^ Karwowski, Mateusz P.; Nelson, Jennifer M.; Staples, J. Erin; Fischer, Marc; Fleming-Dutra, Katherine E.; Villanueva, Julie; Powers, Ann M.; Mead, Paul; Honein,, Margaret A.; Moore, Cynthia A.; Rasmussen, Sonja A. (May 2016). "Zika Virus Disease: A CDC Update for Pediatric Health Care Providers". Pediatrics 137 (5): e20160621. doi:10.1542/peds.2016-0621. Retrieved 27 May 2016. 
  95. ^ a b "Pregnant Irish women warned over Zika virus in central and South America". RTÉ News. 22 January 2016. 
  96. ^ a b c "Zika: Olympics plans announced by Rio authorities". BBC News. 24 January 2016. 
  97. ^ Post, Colin (25 January 2016). "Northern Peru braces for mosquito-borne Zika virus". Peru Reports. 
  98. ^ Lowes, Robert (15 January 2016). "CDC Issues Zika Travel Alert". Medscape Medical News. 
  99. ^ "Recomendaciones por Dengue Zika Chikungunya" (in Spanish). Chile Ministry of Health. 20 January 2016. 
  100. ^ Branswell, Helen (22 January 2016). "CDC expands Zika travel advisory to include more countries". Stat News. 
  101. ^ Mohney, Gillian (2 February 2016). "Latest on Zika Virus: WHO's Recommendations, CDC Advisory Expanded to 28 Countries". ABC News. Retrieved 28 February 2016. 
  102. ^ Petersen, Emily E.; Staples, J. Erin; et al. (22 January 2016). "Interim Guidelines for Pregnant Women During a Zika Virus Outbreak – United States, 2016". Morbidity and Mortality Weekly Report 65 (2): 30–33. doi:10.15585/mmwr.mm6502e1. PMID 26796813. 
  103. ^ "Zika virus infection in the Americas". Government of Canada. 3 February 2016. 
  104. ^ http://www.abc.com.py/nacionales/primer-caso-de-zika-en-embarazada-1460904.html Paraguay: primer caso de zika en embarazada
  105. ^ Branswell, Helen (25 March 2016). "Couples exposed to Zika virus are urged to delay pregnancy". Stat News. 
  106. ^ "Zika Virus Response Updates from FDA". Retrieved 29 April 2016. 
  107. ^ Almasy, Steve (6 May 2016). "MLB moves games from Puerto Rico due to Zika concerns". CNN. Retrieved 1 June 2016. 
  108. ^ "Zika virus: Advice for those planning to travel to outbreak areas". ITV News. 22 January 2016. 
  109. ^ "Japan to step up screening for Zika virus". The Japan Times. Kyodo, Associated Press. 2 February 2016. 
  110. ^ a b "S. Korea holds emergency meeting on Zika virus threat". Yonhap News Agency. 2 February 2016. 
  111. ^ Burton, Nina (24 January 2016). "Zika virus prompts travel warning for Kiwis". 3News. New Zealand. 
  112. ^ Anis, Mazwin Nik (3 February 2016). "Zika virus: Health Ministry issues travel advisory". The Star (Malaysia). 
  113. ^ "DOH cautions public on Zika virus". Sun Star (Manila). 31 January 2016. 
  114. ^ "Tourist industry on edge as Zika virus spreads". BBC News. 3 February 2016. 
  115. ^ Harpaz, Beth J. (3 February 2016). "Zika affects plans for destination weddings, babymoons". Associated Press (Associated Press). 
  116. ^ Dastin, Jeffrey (8 February 2016). "Zika virus discourages many Americans from Latin America travel". Reuters. 
  117. ^ "WHO Declares Public Health Emergency of International Concern". Pro-MED-mail. International Society for Infectious Diseases. 1 February 2016. 
  118. ^ Calamur, Krishnadev (1 February 2016). "An Emergency Meeting on the Zika Virus". The Atlantic. 
  119. ^ "WHO statement on the 2nd meeting of IHR Emergency Committee on Zika virus and observed increase in neurological disorders and neonatal malformations". WHO. 8 March 2016. Retrieved 8 March 2016. 
  120. ^ "WHO and experts prioritize vaccines, diagnostics and innovative vector control tools for Zika R&D". WHO. 9 March 2016. Retrieved 13 March 2016. 
  121. ^ a b c Kim, Meeri (29 January 2016). "How mosquitoes with 'self-destruct' genes could save us from Zika virus". The Washington Post. 
  122. ^ "Oxitec mosquito works to control Aedes aegypti in dengue hotspot". Press release. Oxitec. 2 July 2015. 
  123. ^ a b Olson, Ken E.; Carvalho, Danilo O.; McKemey, Andrew R.; et al. (2015). "Suppression of a Field Population of Aedes aegypti in Brazil by Sustained Release of Transgenic Male Mosquitoes" (PDF). PLOS Neglected Tropical Diseases 9 (7): e0003864. doi:10.1371/journal.pntd.0003864. ISSN 1935-2735. PMID 26135160. 
  124. ^ Pollack, Andrew (30 January 2016). "New Weapon to Fight Zika: The Mosquito". New York Times. Retrieved 16 March 2016. 
  125. ^ Tavernise, Sabrina; McNeil, Jr., Donald G. (1 February 2016). "W.H.O. Declares Zika Virus an International Health Emergency". The New York Times. 
  126. ^ "Decreto Nº 8.662" [Decree No. 8662] (in Portuguese). Palácio do Planalto, Presidência da República. 1 February 2016. Retrieved 4 February 2016. 
  127. ^ Kelland, Kate (18 March 2016). "WHO backs trials of genetically modified mosquitoes to fight Zika". The Globe and Mail. Retrieved 19 March 2016. 
  128. ^ Jason Gale (4 February 2016). "The Best Weapon for Fighting Zika? More Mosquitoes". Bloomberg News. 
  129. ^ Tirone, Jonathan (12 February 2016). "UN Readies Nuclear Solution to Destroy the Zika Virus". Bloomberg Business. 
  130. ^ "Mosquito Biology". Michigan Mosquito Control Association. Retrieved 23 February 2016. 
  131. ^ Martín, María (13 February 2016). "Brasil destina 60% das suas Forças Armadas na luta contra um mosquito" [Brazil deploys 60% of its armed forces in the fight against mosquitoes]. El Pais (in Portuguese) (Río de Janeiro). 
  132. ^ "Data sharing in public health emergencies". Wellcome Trust Blog. 10 February 2016. Retrieved 21 February 2016. 
  133. ^ "Developing global norms for sharing data and results during public health emergencies". World Health Organization. September 2015. Retrieved 21 February 2016. 
  134. ^ "Sharing data during Zika and other global health emergencies". Wellcome Trust Blog. 10 February 2016. Retrieved 21 February 2016. 
  135. ^ "Google donates $1M to help fight Zika virus spread". The Baltimore Sun. 3 March 2016. 
  136. ^ Kim, Meeri (29 January 2016). "How mosquitoes with 'self-destruct' genes could save us from Zika virus". The Washington Post. ISSN 0190-8286. Retrieved 20 March 2016. 
  137. ^ "Support grows for genetically modified mosquitoes in Zika fight". CBS News. 16 February 2016. Retrieved 20 March 2016. 
  138. ^ a b Alter, Charlotte (29 January 2016). "Governments: Avoid Pregnancy Because of Zika. But How?". Time. Retrieved 20 March 2016. 
  139. ^ Brodzinsky, Sibylla (27 January 2016). "Rights groups denounce Zika advice to avoid pregnancy in Latin America". The Guardian. ISSN 0261-3077. Retrieved 20 March 2016. 
  140. ^ Partlow, Joshua (22 January 2016). "As Zika virus spreads, El Salvador asks women not to get pregnant until 2018". The Washington Post. ISSN 0190-8286. Retrieved 20 March 2016. 
  141. ^ "Upholding women's human rights essential to Zika response — Zeid". News and Events (United Nations). 5 February 2016. Retrieved 20 March 2016. 
  142. ^ "Holy See on Zika Virus: International Community Should Exercise Due Diligence, But Not Panic". Zenit. 17 February 2016. Retrieved 20 March 2016. 
  143. ^ Bailey, Sarah Pulliam; Boorstein, Michelle (17 February 2016). "Pope Francis suggests contraception could be permissible in Zika fight". The Washington Post. ISSN 0190-8286. Retrieved 20 March 2016. 

External links[edit]

Wikimedia Commons has media related to Zika virus outbreak in the Americas (2015-2016).
Retrieved from "https://en.wikipedia.org/w/index.php?title=2015–16_Zika_virus_epidemic&oldid=727287545"