Pathfinder
Editor, Senior Moderator
ZIKA SITUATION REPORT
ZIKA AND POTENTIAL COMPLICATIONS
12 FEBRUARY 2016
1. HIGHLIGHTS
WHO has called for a coordinated and multisectoral response through an inter-agency Strategic Response
Framework focusing on response, surveillance and research.
39 countries have reported locally acquired circulation of the virus since January 2007. Geographical
distribution of the virus has steadily expanded.
Six countries (Brazil, French Polynesia, El Salvador, Venezuela, Colombia and Suriname) have reported an
increase in the incidence of cases of microcephaly and/or Guillain-Barr? syndrome (GBS) in conjunction
with an outbreak of the Zika virus. Puerto Rico and Martinique have reported cases of GBS associated
with Zika virus infection without an increase of incidence. No scientific evidence to date confirms a link
between Zika virus and microcephaly or GBS.
Women?s reproductive health has been thrust into the limelight with the spread of the Zika virus. The
latest evidence suggests that Zika virus infection during pregnancy may be linked to microcephaly in
newborn babies.
WHO advice on travel to Zika-affected countries includes advice for pregnant women as well as women
who are trying to become pregnant and their sexual partners.
...
2. SITUATION OVERVIEW
WHO has led partners in the creation of a Strategic Response Framework (SRF) for early response
activities to the Zika virus epidemic and potential associated neurological complications to be carried out
in the next six months. It comprises activities in coordination, surveillance, community development,
vector control, child and maternal health, public health research, and epidemiological research and
development. WHO is currently finalizing an overview of urgent needs and requirements for the Zika
response.
At a Member States briefing on 10 February WHO briefed more than a hundred participants on the virus
and potential complications and on the SRF.
As global concern for the spread of the Zika virus gathers momentum, WHO is taking action to strengthen
its partnerships with respondents to the current outbreak which has affected 34 countries (Fig. 1). There
has been a simultaneous increase in the number of reported cases of microcephaly; a congenital birth
defect particularly reported in Brazil. Guillain-Barr? syndrome (GBS) is also on the rise in Brazil, Colombia,
El Salvador, Suriname and Venezuela. GBS was also observed during the 2013?2014 French Polynesia
Zika virus outbreak.
Prevention measures have become critical. There are concerns that that Zika virus may spread globally to
environments where mosquitoes can live and breed. The phenomenon has prompted a call for a global
and cross-sectoral response as various sectors may be impacted.
Last week WHO activated an Incident Management System at WHO headquarters and at the regional
level. In South America, WHO is working with the Pan-American Health Organization (PAHO) to
coordinate response activities with national governments, UN agencies, the Red Cross and Red Crescent
Movement, non-governmental organizations (NGOs) and religious groups.
The risk of babies being born with microcephaly has raised alarm among women, particularly those who
are pregnant or planning to become pregnant. There are many unknowns regarding the possible causes of
microcephaly. WHO has proposed that until more evidence comes to light, there are ways that women
can protect themselves from Zika virus infection.
3. EPIDEMIOLOGICAL UPDATE
Incidence of Zika virus
Zika viral transmission since 2007 has been documented in 46 countries and territories (Fig. 1) including
34 countries which reported autochthonous transmission, or locally acquired infection, between 2015 and
2016, six countries with indication of viral circulation, five countries where the Zika virus outbreak has
ended and one country with a locally acquired case but without vector borne transmission (Table 1).
In 2015 and 2016 the geographical range of Zika virus has steadily increased, with 26 countries and
territories in the Americas now reporting autochthonous transmission of the virus.
Brazilian national authorities estimate that up to a 1.5 million cases of Zika virus infection have occurred
since the outbreak began.
After Brazil, Colombia has been the most-affected country, with well over 25 000 suspected cases
reported and 1331 Zika virus cases confirmed since October 2015.
Cape Verde has reported more than seven thousand suspected cases of Zika virus (Fig. 1).
...
Incidence of Microcephaly
On 30 January 2016, the Ministry of Health of Brazil reported 4783 cases of microcephaly and/or central
nervous system (CNS) malformation, including 76 deaths since January 2015.
Authorities in Brazil have concluded the investigation into 1113 of the reported cases: 709 cases have
been discarded, 404 confirmed and 3670 remain under investigation.
Of the confirmed cases, 387 were compatible with a congenital infection and 17, all from the Northeast
Region, had confirmation of Zika virus infection.
Of 76 deaths due to congenital malformations, Zika virus was identified in foetal tissue in five cases, all
from the Northeast Region of Brazil. Robust investigations and research are planned to better understand
the potential link with Zika virus.
A review of birth data from the 2013 ? 2-14 Zika virus outbreak in French Polynesia indicated that the
number of congenital abnormalities of the CNS in children born between March 2014 and May 2015 was
well above average.
Zika virus infection was confirmed in a baby born with microcephaly in Hawaii1 and in the foetus of a
baby in Slovenia after pregnancy termination. No autochthonous transmission of Zika virus has been
reported in Hawaii or Slovenia.
Incidence of Guillain-Barr? syndrome (GBS)
In the context of the Zika virus outbreak, Brazil, Colombia, El Salvador, Suriname and Venezuela have
reported an increase of GBS.
In July 2015 the state of Bahia in Brazil reported 42 cases of GBS, 26 of them in patients with a history of
symptoms consistent with Zika virus infection. In November 2015 seven patients presenting GBS were
laboratory confirmed for Zika virus infection. In 2015, a 19% increase in GBS cases was reported in
comparison to the previous year.
To date, none of the reported GBS cases in Colombia have been laboratory confirmed for Zika virus
infection or other causes.
Since December 2015 El Salvador recorded 46 GBS cases, including two deaths. None of these cases have
been laboratory confirmed for Zika virus infection or other causes.
In Suriname Zika virus infection was confirmed in two of the ten GBS cases reported in 2015.
In January 2016, 252 GBS cases with a spatiotemporal association to Zika virus were reported in
Venezuela. Preliminary analysis of the 66 GBS cases in Zulia state indicates a clinical history consistent
with Zika virus infection. Zika virus infection was confirmed for three of the GBS cases, including one fatal
case.
Martinique has reported two GBS cases where Zika infection has also been confirmed; Puerto Rico has
reported one case GBS case. Neither of these occurrences constitute an increase of incidence compared
to the previous year.
In French Polynesia, all 42 GBS cases identified during the 2013 ? 2014 Zika virus outbreak tested positive
for dengue and Zika virus infection.
The cause of the increase in GBS incidence observed in Brazil, Colombia, El Salvador and Suriname
remains unknown, especially as dengue, chikungunya and Zika virus have all been circulating
simultaneously in the Americas. Investigations to determine the cause of infection are ongoing in
countries with increased incidence of GBS.
more...
http://www.who.int/emergencies/zika...who-zika-situation-report-12-02-2016.pdf?ua=1
ZIKA AND POTENTIAL COMPLICATIONS
12 FEBRUARY 2016
1. HIGHLIGHTS
WHO has called for a coordinated and multisectoral response through an inter-agency Strategic Response
Framework focusing on response, surveillance and research.
39 countries have reported locally acquired circulation of the virus since January 2007. Geographical
distribution of the virus has steadily expanded.
Six countries (Brazil, French Polynesia, El Salvador, Venezuela, Colombia and Suriname) have reported an
increase in the incidence of cases of microcephaly and/or Guillain-Barr? syndrome (GBS) in conjunction
with an outbreak of the Zika virus. Puerto Rico and Martinique have reported cases of GBS associated
with Zika virus infection without an increase of incidence. No scientific evidence to date confirms a link
between Zika virus and microcephaly or GBS.
Women?s reproductive health has been thrust into the limelight with the spread of the Zika virus. The
latest evidence suggests that Zika virus infection during pregnancy may be linked to microcephaly in
newborn babies.
WHO advice on travel to Zika-affected countries includes advice for pregnant women as well as women
who are trying to become pregnant and their sexual partners.
...
2. SITUATION OVERVIEW
WHO has led partners in the creation of a Strategic Response Framework (SRF) for early response
activities to the Zika virus epidemic and potential associated neurological complications to be carried out
in the next six months. It comprises activities in coordination, surveillance, community development,
vector control, child and maternal health, public health research, and epidemiological research and
development. WHO is currently finalizing an overview of urgent needs and requirements for the Zika
response.
At a Member States briefing on 10 February WHO briefed more than a hundred participants on the virus
and potential complications and on the SRF.
As global concern for the spread of the Zika virus gathers momentum, WHO is taking action to strengthen
its partnerships with respondents to the current outbreak which has affected 34 countries (Fig. 1). There
has been a simultaneous increase in the number of reported cases of microcephaly; a congenital birth
defect particularly reported in Brazil. Guillain-Barr? syndrome (GBS) is also on the rise in Brazil, Colombia,
El Salvador, Suriname and Venezuela. GBS was also observed during the 2013?2014 French Polynesia
Zika virus outbreak.
Prevention measures have become critical. There are concerns that that Zika virus may spread globally to
environments where mosquitoes can live and breed. The phenomenon has prompted a call for a global
and cross-sectoral response as various sectors may be impacted.
Last week WHO activated an Incident Management System at WHO headquarters and at the regional
level. In South America, WHO is working with the Pan-American Health Organization (PAHO) to
coordinate response activities with national governments, UN agencies, the Red Cross and Red Crescent
Movement, non-governmental organizations (NGOs) and religious groups.
The risk of babies being born with microcephaly has raised alarm among women, particularly those who
are pregnant or planning to become pregnant. There are many unknowns regarding the possible causes of
microcephaly. WHO has proposed that until more evidence comes to light, there are ways that women
can protect themselves from Zika virus infection.
3. EPIDEMIOLOGICAL UPDATE
Incidence of Zika virus
Zika viral transmission since 2007 has been documented in 46 countries and territories (Fig. 1) including
34 countries which reported autochthonous transmission, or locally acquired infection, between 2015 and
2016, six countries with indication of viral circulation, five countries where the Zika virus outbreak has
ended and one country with a locally acquired case but without vector borne transmission (Table 1).
In 2015 and 2016 the geographical range of Zika virus has steadily increased, with 26 countries and
territories in the Americas now reporting autochthonous transmission of the virus.
Brazilian national authorities estimate that up to a 1.5 million cases of Zika virus infection have occurred
since the outbreak began.
After Brazil, Colombia has been the most-affected country, with well over 25 000 suspected cases
reported and 1331 Zika virus cases confirmed since October 2015.
Cape Verde has reported more than seven thousand suspected cases of Zika virus (Fig. 1).
...
Incidence of Microcephaly
On 30 January 2016, the Ministry of Health of Brazil reported 4783 cases of microcephaly and/or central
nervous system (CNS) malformation, including 76 deaths since January 2015.
Authorities in Brazil have concluded the investigation into 1113 of the reported cases: 709 cases have
been discarded, 404 confirmed and 3670 remain under investigation.
Of the confirmed cases, 387 were compatible with a congenital infection and 17, all from the Northeast
Region, had confirmation of Zika virus infection.
Of 76 deaths due to congenital malformations, Zika virus was identified in foetal tissue in five cases, all
from the Northeast Region of Brazil. Robust investigations and research are planned to better understand
the potential link with Zika virus.
A review of birth data from the 2013 ? 2-14 Zika virus outbreak in French Polynesia indicated that the
number of congenital abnormalities of the CNS in children born between March 2014 and May 2015 was
well above average.
Zika virus infection was confirmed in a baby born with microcephaly in Hawaii1 and in the foetus of a
baby in Slovenia after pregnancy termination. No autochthonous transmission of Zika virus has been
reported in Hawaii or Slovenia.
Incidence of Guillain-Barr? syndrome (GBS)
In the context of the Zika virus outbreak, Brazil, Colombia, El Salvador, Suriname and Venezuela have
reported an increase of GBS.
In July 2015 the state of Bahia in Brazil reported 42 cases of GBS, 26 of them in patients with a history of
symptoms consistent with Zika virus infection. In November 2015 seven patients presenting GBS were
laboratory confirmed for Zika virus infection. In 2015, a 19% increase in GBS cases was reported in
comparison to the previous year.
To date, none of the reported GBS cases in Colombia have been laboratory confirmed for Zika virus
infection or other causes.
Since December 2015 El Salvador recorded 46 GBS cases, including two deaths. None of these cases have
been laboratory confirmed for Zika virus infection or other causes.
In Suriname Zika virus infection was confirmed in two of the ten GBS cases reported in 2015.
In January 2016, 252 GBS cases with a spatiotemporal association to Zika virus were reported in
Venezuela. Preliminary analysis of the 66 GBS cases in Zulia state indicates a clinical history consistent
with Zika virus infection. Zika virus infection was confirmed for three of the GBS cases, including one fatal
case.
Martinique has reported two GBS cases where Zika infection has also been confirmed; Puerto Rico has
reported one case GBS case. Neither of these occurrences constitute an increase of incidence compared
to the previous year.
In French Polynesia, all 42 GBS cases identified during the 2013 ? 2014 Zika virus outbreak tested positive
for dengue and Zika virus infection.
The cause of the increase in GBS incidence observed in Brazil, Colombia, El Salvador and Suriname
remains unknown, especially as dengue, chikungunya and Zika virus have all been circulating
simultaneously in the Americas. Investigations to determine the cause of infection are ongoing in
countries with increased incidence of GBS.
more...
http://www.who.int/emergencies/zika...who-zika-situation-report-12-02-2016.pdf?ua=1