Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul 14;27(4):taaa061.
doi: 10.1093/jtm/taaa061.

Zika among international travellers presenting to GeoSentinel sites, 2012-2019: implications for clinical practice

Kristina M Angelo  1 , Rhett J Stoney  1 , Gaelle Brun-Cottan  2 , Karin Leder  3 , Martin P Grobusch  4 , Natasha Hochberg  5 , Susan Kuhn  6 , Emmanuel Bottieau  7 , Patricia Schlagenhauf  8 , Lin Chen  9 , Noreen A Hynes  10 , Cecilia Perret Perez  11 , Frank P Mockenhaupt  12 , Israel Molina  13 , Clara Crespillo-Andújar  14 , Denis Malvy  15 , Eric Caumes  16 , Pierre Plourde  17 , Marc Shaw  18   19 , Anne E McCarthy  20 , Nancy Piper-Jenks  21 , Bradley A Connor  22 , Davidson H Hamer  23   24 , Annelies Wilder-Smith  25   26
Affiliations

Zika among international travellers presenting to GeoSentinel sites, 2012-2019: implications for clinical practice

Kristina M Angelo et al. J Travel Med. .

Abstract

Introduction: International travellers contribute to the rapid spread of Zika virus (ZIKV) and its sentinel identification globally. We describe ZIKV infections among international travellers seen at GeoSentinel sites with a focus on ZIKV acquired in the Americas and the Caribbean, describe countries of exposure and traveller characteristics, and assess ZIKV diagnostic testing by site.

Methods: Records with an international travel-related diagnosis of confirmed or probable ZIKV from January 2012 through December 2019 reported to GeoSentinel with a recorded illness onset date were included to show reported cases over time. Records from March 2016 through December 2019 with an exposure region of the Americas or the Caribbean were included in the descriptive analysis. A survey was conducted to assess the availability, accessibility and utilization of ZIKV diagnostic tests at GeoSentinel sites.

Results: GeoSentinel sites reported 525 ZIKV cases from 2012 through 2019. Between 2012 and 2014, eight cases were reported, and all were acquired in Asia or Oceania. After 2014, most cases were acquired in the Americas or the Caribbean, a large decline in ZIKV cases occurred in 2018-19.Between March 2016 and December 2019, 423 patients acquired ZIKV in the Americas or the Caribbean, peak reporting to these regions occurred in 2016 [330 cases (78%)]. The median age was 36 years (range: 3-92); 63% were female. The most frequent region of exposure was the Caribbean (60%). Thirteen travellers were pregnant during or after travel; one had a sexually acquired ZIKV infection. There was one case of fetal anomaly and two travellers with Guillain-Barré syndrome. GeoSentinel sites reported various challenges to diagnose ZIKV effectively.

Conclusion: ZIKV should remain a consideration for travellers returning from areas with risk of ZIKV transmission. Travellers should discuss their travel plans with their healthcare providers to ensure ZIKV prevention measures are taken.

Keywords: Guillain-Barre syndrome; Survey; Zika diagnostics; declining epidemic; sentinel surveillance.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest

None declared.

Figures

Figure 1.
Figure 1.
Confirmed cases of ZIKV infection among international travellers with known illness onset date seen at a GeoSentinel clinic, by year and region, 2012–2019 (n=421).
Figure 2.
Figure 2.
Percent of GeoSentinel sites above to test for ZIKV by specimen site, 2018 (n=103). CSF, cerebrospinal fluid; other: respondents noted that their site could run female and male genital tract swabs, urine and serum, or had no local capacity because all Zika testing was performed as send outs to commercial or public reference labs.
See this image and copyright information in PMC

References

    1. Heymann DL, Hodgson A, Sall AA et al. Zika virus and microcephaly: why is this situation a PHEIC? The Lancet 2016; 387:719–21. - PMC - PubMed
    1. Musso D, Gubler DJ. Zika virus. Clin Microbiol Rev 2016; 29:487–524. - PMC - PubMed
    1. Duffy MR, Chen TH, Hancock WT et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med 2009; 360:2536–43. - PubMed
    1. Faria NR, Quick J, Claro IM et al. Establishment and cryptic transmission of Zika virus in Brazil and the Americas. Nature 2017; 546:406–10. - PMC - PubMed
    1. Le Hingrat Q, Perrier M, Charpentier C et al. Was Zika introduced to Brazil by participants at the 2013 Beach Soccer World Cup held in Tahiti: a phylogeographical analysis. Travel Med Infect Dis 2019; 32:101512. - PubMed