Zika Virus Transmission - Region of the Americas, May 15, 2015-December 15, 2016

Abstract

Zika virus, a mosquito-borne flavivirus that can cause rash with fever, emerged in the Region of the Americas on Easter Island, Chile, in 2014 and in northeast Brazil in 2015 (1). In response, in May 2015, the Pan American Health Organization (PAHO), which serves as the Regional Office of the Americas for the World Health Organization (WHO), issued recommendations to enhance surveillance for Zika virus. Subsequently, Brazilian investigators reported Guillain-Barré syndrome (GBS), which had been previously recognized among some patients with Zika virus disease, and identified an association between Zika virus infection during pregnancy and congenital microcephaly (2). On February 1, 2016, WHO declared Zika virus-related microcephaly clusters and other neurologic disorders a Public Health Emergency of International Concern.* In March 2016, PAHO developed case definitions and surveillance guidance for Zika virus disease and associated complications (3). Analysis of reports submitted to PAHO by countries in the region or published in national epidemiologic bulletins revealed that Zika virus transmission had extended to 48 countries and territories in the Region of the Americas by late 2016. Reported Zika virus disease cases peaked at different times in different areas during 2016. Because of ongoing transmission and the risk for recurrence of large outbreaks, response efforts, including surveillance for Zika virus disease and its complications, and vector control and other prevention activities, need to be maintained.

FIGURE 1

Cumulative suspected and confirmed cases of Zika virus disease per 100,000 population — Region of the Americas, October 2015, January 2016, and December 2016 * Maps show first-level administrative divisions (states, departments, and provinces) with circulation of Zika virus, as officially reported by national health authorities. Where data on the incidence of Zika virus disease at the subnational level were not available, the national incidence rate was used for the entire country/territory; Zika virus was not necessarily present throughout the entire shaded area.

FIGURE 3

Suspected and confirmed cases of Zika virus* and Guillain-Barré syndrome,^† by epidemiologic week — Region of the Americas, May 2015–December 2016 * The following countries and territories reporting Zika virus disease cases by epidemiologic week were included in this figure: Anguilla, Antigua and Barbuda, Aruba, Barbados, Belize, Bolivia, Bonaire, St Eustatius, and Saba, Brazil, Cayman Islands, Colombia, Costa Rica, Dominica, Dominican Republic, Ecuador, El Salvador, French Guiana, Grenada, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, Mexico, Montserrat, Panama, Paraguay, Peru, Saint Barthelemy, Saint Kitts and Nevis, Saint Vincent and the Grenadines, Sint Maarten, St. Martin, Suriname, Trinidad and Tobago, Turks and Caicos Islands, Venezuela, British Virgin Islands ^† The following countries and territories reporting Guillain-Barré syndrome cases by epidemiologic week were included in this figure: Barbados, Belize, Bolivia, Colombia, Costa Rica, Dominica, Dominican Republic, Ecuador, El Salvador, Grenada, Guadeloupe, Guatemala, Haiti, Honduras, Jamaica, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Vincent and the Grenadines, Suriname, Venezuela.

FIGURE 2

Suspected and confirmed cases of Zika virus disease per 100,000 population, by subregion* and epidemiologic week — Region of the Americas, May 2015–December 2016 * The following countries and territories reporting Zika virus disease cases by epidemiologic week were included in this figure. Southern Cone: Brazil; Paraguay. Andean: Bolivia; Colombia; Ecuador; Peru; Venezuela. Central America: Belize; Costa Rica; El Salvador; Guatemala; Honduras; Panama. Non-Latin Caribbean: Anguilla; Antigua and Barbuda; Aruba; Barbados; Bonaire, Sint Eustatius, and Saba; British Virgin Islands; Cayman Islands; Dominica; Grenada; Guyana; Jamaica; Montserrat; Saint Kitts and Nevis; Saint Vincent and the Grenadines; Sint Maarten; Suriname; Trinidad and Tobago; Turks and Caicos. Latin Caribbean: Dominican Republic; French Guiana; Guadeloupe; Haiti; Martinique; Saint Barthélemy; Saint Martin. North America: Mexico.