Anticipating the international spread of Zika virus from Brazil
2016; Elsevier BV; Volume: 387; Issue: 10016 Linguagem: Inglês
10.1016/s0140-6736(16)00080-5
ISSN1474-547X
AutoresIsaac I. Bogoch, Oliver J. Brady, Moritz U. G. Kraemer, Matthew German, Marisa Creatore, Manisha A. Kulkarni, John S. Brownstein, Sumiko R. Mekaru, Simon I Hay, Emily Groot, Alexander Watts, Kamran Khan,
Tópico(s)Virology and Viral Diseases
ResumoIn May, 2015, locally acquired cases of Zika virus—an arbovirus found in Africa and Asia-Pacific and transmitted via Aedes mosquitoes—were confirmed in Brazil. The presence of Aedes mosquitoes across Latin America, coupled with suitable climatic conditions, have triggered a Zika virus epidemic in Brazil, currently estimated at 440 000–1 300 000 cases.1European Centre for Disease Prevention and ControlRapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome. 10 December 2015. ECDC, Stockholm2015Google Scholar Viraemic travellers have now introduced Zika virus into at least 13 additional countries, where susceptible Aedes mosquitoes have become infected and perpetuated local transmission cycles. In Brazil, a precipitous surge in infants born with microcephaly and the detection of Zika virus RNA in the amniotic fluid of affected newborns has been reported.1European Centre for Disease Prevention and ControlRapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome. 10 December 2015. ECDC, Stockholm2015Google Scholar We sought to identify high-risk international pathways for the dispersion of Zika virus and global geographies conducive to autochthonous transmission.We created a global Zika virus spread model by adapting a seasonal model for dengue that integrates global ecological niche data for Aedes aegypti and albopictus and worldwide temperature profiles.2Kraemer MUG Sinka ME Duda KA et al.The global distribution of the arbovirus vectors Aedes aegypti and Ae. albopictus.eLife. 2015; 4: e08347Crossref Scopus (1069) Google Scholar, 3Brady OJ Golding N Pigott DM et al.Global temperature constraints on Aedes aegypti and Ae. albopictus persistence and competence for dengue virus transmission.Parasit Vectors. 2014; 7: 338Crossref PubMed Scopus (206) Google Scholar In Brazil, we identified airports within 50 km of areas conducive to year-round Zika virus transmission. We mapped the final destinations of international travellers departing from these airports from September, 2014, to August, 2015, using worldwide flight itinerary data from the International Air Transport Association. We used LandScan, a gridded global population dataset, to estimate numbers of people living in geographies at risk for autochthonous Zika virus transmission.9·9 million travellers departed from the aforementioned Brazilian airports for international destinations, with 65% to the Americas (figure), 27% to Europe, and 5% to Asia. Traveller volumes were greatest to the USA (2 767 337), Argentina (1 314 694), Chile (614 687), Italy (419 955), Portugal (411 407), and France (404 525). China and Angola received the highest volume of travellers in Asia (84 332) and Africa (82 838), respectively. Argentina, Italy, and the USA have more than 60% of their populations residing in areas conducive to seasonal Zika virus transmission, whereas Mexico, Colombia, and the USA have an estimated 30·5, 23·2, and 22·7 million people, respectively, living in areas conducive to year-round transmission.In parallel to the recent experience with chikungunya,4Weaver SC Lecuit M Chikungunya virus and the global spread of a mosquito-borne disease.N Engl J Med. 2015; 372: 1231-1239Crossref PubMed Scopus (510) Google Scholar Zika virus has the potential to rapidly spread across Latin America and the Caribbean. With no vaccine or antiviral therapy available, possible interventions include: personal protection (ie, repellent use) and daytime avoidance of mosquito bites (especially pregnant women until more is known about the association between Zika virus infection and microcephaly); daytime avoidance of mosquito bites among Zika virus-infected individuals to disrupt human to mosquito to human transmission cycles (80% of infected individuals are asymptomatic and the remainder have clinical syndromes overlapping with dengue and chikungunya);5Duffy MR Chen T-H Hancock WT et al.Zika virus outbreak on Yap Island, Federated States of Micronesia.N Engl J Med. 2009; 360: 2536-2543Crossref PubMed Scopus (2123) Google Scholar and community-level mosquito surveillance and control measures. The summer Olympic Games in Brazil in August, 2016, heighten the need for awareness of this emerging virus.KK is the founder of BlueDot, a social benefit corporation that models global infectious disease threats. MIC, MG, and AW have received employment income from BlueDot. IIB has consulted to BlueDot. We acknowledge support from the Canadian Institutes of Health Research , National Institute of Health , R01 LM010812 , the Wellcome Trust (# 095066 ), the Bill & Melinda Gates Foundation ( OPP1119467 , OPP1106023 , and OPP1093011 ), and the RAPIDD program of the Science & Technology Directorate , Department of Homeland Security , and the Fogarty International Center , National Institutes of Health . In May, 2015, locally acquired cases of Zika virus—an arbovirus found in Africa and Asia-Pacific and transmitted via Aedes mosquitoes—were confirmed in Brazil. The presence of Aedes mosquitoes across Latin America, coupled with suitable climatic conditions, have triggered a Zika virus epidemic in Brazil, currently estimated at 440 000–1 300 000 cases.1European Centre for Disease Prevention and ControlRapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome. 10 December 2015. ECDC, Stockholm2015Google Scholar Viraemic travellers have now introduced Zika virus into at least 13 additional countries, where susceptible Aedes mosquitoes have become infected and perpetuated local transmission cycles. In Brazil, a precipitous surge in infants born with microcephaly and the detection of Zika virus RNA in the amniotic fluid of affected newborns has been reported.1European Centre for Disease Prevention and ControlRapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome. 10 December 2015. ECDC, Stockholm2015Google Scholar We sought to identify high-risk international pathways for the dispersion of Zika virus and global geographies conducive to autochthonous transmission. We created a global Zika virus spread model by adapting a seasonal model for dengue that integrates global ecological niche data for Aedes aegypti and albopictus and worldwide temperature profiles.2Kraemer MUG Sinka ME Duda KA et al.The global distribution of the arbovirus vectors Aedes aegypti and Ae. albopictus.eLife. 2015; 4: e08347Crossref Scopus (1069) Google Scholar, 3Brady OJ Golding N Pigott DM et al.Global temperature constraints on Aedes aegypti and Ae. albopictus persistence and competence for dengue virus transmission.Parasit Vectors. 2014; 7: 338Crossref PubMed Scopus (206) Google Scholar In Brazil, we identified airports within 50 km of areas conducive to year-round Zika virus transmission. We mapped the final destinations of international travellers departing from these airports from September, 2014, to August, 2015, using worldwide flight itinerary data from the International Air Transport Association. We used LandScan, a gridded global population dataset, to estimate numbers of people living in geographies at risk for autochthonous Zika virus transmission. 9·9 million travellers departed from the aforementioned Brazilian airports for international destinations, with 65% to the Americas (figure), 27% to Europe, and 5% to Asia. Traveller volumes were greatest to the USA (2 767 337), Argentina (1 314 694), Chile (614 687), Italy (419 955), Portugal (411 407), and France (404 525). China and Angola received the highest volume of travellers in Asia (84 332) and Africa (82 838), respectively. Argentina, Italy, and the USA have more than 60% of their populations residing in areas conducive to seasonal Zika virus transmission, whereas Mexico, Colombia, and the USA have an estimated 30·5, 23·2, and 22·7 million people, respectively, living in areas conducive to year-round transmission. In parallel to the recent experience with chikungunya,4Weaver SC Lecuit M Chikungunya virus and the global spread of a mosquito-borne disease.N Engl J Med. 2015; 372: 1231-1239Crossref PubMed Scopus (510) Google Scholar Zika virus has the potential to rapidly spread across Latin America and the Caribbean. With no vaccine or antiviral therapy available, possible interventions include: personal protection (ie, repellent use) and daytime avoidance of mosquito bites (especially pregnant women until more is known about the association between Zika virus infection and microcephaly); daytime avoidance of mosquito bites among Zika virus-infected individuals to disrupt human to mosquito to human transmission cycles (80% of infected individuals are asymptomatic and the remainder have clinical syndromes overlapping with dengue and chikungunya);5Duffy MR Chen T-H Hancock WT et al.Zika virus outbreak on Yap Island, Federated States of Micronesia.N Engl J Med. 2009; 360: 2536-2543Crossref PubMed Scopus (2123) Google Scholar and community-level mosquito surveillance and control measures. The summer Olympic Games in Brazil in August, 2016, heighten the need for awareness of this emerging virus. KK is the founder of BlueDot, a social benefit corporation that models global infectious disease threats. MIC, MG, and AW have received employment income from BlueDot. IIB has consulted to BlueDot. We acknowledge support from the Canadian Institutes of Health Research , National Institute of Health , R01 LM010812 , the Wellcome Trust (# 095066 ), the Bill & Melinda Gates Foundation ( OPP1119467 , OPP1106023 , and OPP1093011 ), and the RAPIDD program of the Science & Technology Directorate , Department of Homeland Security , and the Fogarty International Center , National Institutes of Health . El Niño and climate change—contributing factors in the dispersal of Zika virus in the Americas?In their letter, Isaac I Bogoch and colleagues (Jan 23, p 335)1 anticipated the international spread of Zika virus from Brazil through air traffic. Permissive climatic conditions for Aedes mosquitoes might have contributed to the explosive spread of Zika virus in Brazil. In fact, the 2015 El Niño caused exceptional climatic conditions in northeastern South America during winter and spring in the southern hemisphere. According to the US National Oceanic and Atmospheric Administration,2 the temperatures over north and eastern South America were “record warmest”, accompanied by a severe drought, throughout the second half of 2015. Full-Text PDF
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