WHO Zika Virus, Microcephaly and Guillain-Barr? Syndrome Situation Report, July 28, 2016

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Zika situation report

28 July 2016

Zika virus, Microcephaly and Guillain-Barr? syndrome

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Summary

• WHO and partners established a definition of what constitutes an outbreak, endemic transmission, and the interruption of mosquito-borne transmission in order to better characterize the level of transmission of Zika virus infection (Table 1, Fig. 2). This classification system was put into use as of the situation report of 7 July 2016.
• As of 27 July 2016, 67 countries and territories (Fig. 1, Table 1) have reported evidence of mosquito-borne Zika virus transmission since 2007 (64 of these countries and territories have reported evidence of mosquito-borne Zika virus transmission since 2015):
  • 50 countries and territories with a first reported outbreak from 2015 onwards (Table 1).
  • Four countries are classified as having possible endemic transmission or have reported evidence of local mosquito-borne Zika infections in 2016.
  • 13 countries and territories have reported evidence of local mosquito-borne Zika infections in or before 2015, but without documentation of cases in 2016, or with the outbreak terminated.
• One country and one territory have reported mosquito-borne Zika virus transmission for the first time in the week to 27 July 2016, Antigua and Barbuda; and Turks and Caicos (United Kingdom of Great Britain and Northern Ireland).
• Since February 2016, 11 countries have reported evidence of person-to-person transmission of Zika virus, probably via a sexual route (Table 2).
• One case of Zika virus infection, whose mode of transmission is currently being investigated, was recently reported in Utah, United States of America (USA). The case is a family contact of an individual who died in June. The blood samples of the deceased case were found to have high levels of Zika virus, more than 100 000 times higher than what has been found in samples from other infected persons. Result of the investigation on the mode of transmission is pending.
• Two non travel-related Zika infections are currently being investigated in Florida, United States of America.
• As of 27 July 2016, 14 countries or territories have reported microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection or suggestive of congenital infection. Paraguay is the latest country to report microcephaly with two cases of microcephaly associated with laboratory confirmed Zika virus infection recently documented. Three of the 14 total countries reported microcephaly cases born from mothers in countries with no endemic Zika virus transmission but who reported recent travel history to Zika-affected countries in the WHO Region of the Americas (Table 3).
• In Spain, the first baby with microcephaly linked with in-utero Zika infection was born. This microcephaly case was first reported at the end of May.
• As of 27 July 2016, the United States Centers for Disease Control and Prevention (US-CDC) reported 12 live-born infants with birth defects and six pregnancy losses with birth defects with laboratory evidence of Zika virus infection.
• As of 27 July 2016, 15 countries and territories worldwide have reported an increased incidence of Guillain-Barr? syndrome (GBS) and/or laboratory confirmation of a Zika virus infection among GBS cases (Table 4).
• Based on research to date, there is scientific consensus that Zika virus is a cause of microcephaly and GBS.
• In Guinea-Bissau, on 29 June 2016, Institute Pasteur Dakar (IPD) confirmed that three of 12 samples tested positive for Zika by PC-R. All 12 samples tested negative against IgM Zika. One additional sample from a recent case also tested positive for Zika virus infection. All four samples were sent to IPD on 1 July for gene sequencing and the results are pending. Twenty-two additional samples were collected and sent for testing; the results are still pending. The government of Guinea-Bissau with support from the WHO Country Office (WCO) is demonstrating strong leadership in response to these findings. A national Zika-inter-ministerial committee which is chaired by the Prime Minister and vice-chaired by the Minister of Health was established. The joint mission to Guinea-Bissau has arrived in the country to support the Ministry of Health?s response and to conduct an in-depth investigation of the situation. Technical material and financial support are also being provided by partners including US-CDC, Portuguese cooperation, IPD and UNICEF.
• A roster of WHO technical experts will be available to answer media queries during the Olympics.
• The global Strategic Response Framework launched by WHO in February 2016 encompasses surveillance, response activities and research. An interim report describing some of the key activities being undertaken jointly by WHO and international, regional and national partners in response to this public health emergency was published on 27 May 2016. A revised strategy for the period of July 2016 to December 2017 was published on 17 June.
• WHO has developed advice and information on diverse topics in the context of Zika virus. WHO?s latest information materials, news and resources to support corporate and programmatic risk communication and community engagement are available online.

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