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Establishment and cryptic transmission of Zika virus in Brazil and the Americas

2017; Nature Portfolio; Volume: 546; Issue: 7658 Linguagem: Inglês

10.1038/nature22401

1476-4687

Nuno R. Faria, Josh Quick, Ingra Morales Claro, Julien Thézé, Jhennifer Guimarães Lourenço de Jesus, Marta Giovanetti, Moritz U. G. Kraemer, Sarah C. Hill, Allison Black, Antônio Charlys da Costa, L.C. Junqueira Franco, Serena Pocas Moreno Silva, Chieh‐Hsi Wu, Jayna Raghwani, Simon Cauchemez, Louis du Plessis, Mariana Pastorello Verotti, W. K. de Oliveira, Eduardo Hage Carmo, Giovanini Evelim Coelho, A. C. F. S. Santelli, Livia Vinhal, Cláudio Maierovitch Pessanha Henriques, Jared T. Simpson, Matthew Loose, Kristian G. Andersen, Nathan D. Grubaugh, Sneha Somasekar, Charles Y. Chiu, José Esteban Muñoz‐Medina, César González-Bonilla, Carlos F. Arias, Lia Laura Lewis‐Ximenez, Sally A. Baylis, Alexandre Chieppe, Shirlei Ferreira de Aguiar, Carlos Augusto Fernandes, P. S. Lemos, Bruna Laís Sena do Nascimento, H. A. O Monteiro, Isadora Cristina de Siqueira, Maria Gabriela de Queiroz, Themis Rocha de Souza, João Felipe Bezerra, Marisa Lemos, G. F. Pereira, D. Loudal, Lúcia Cristina Corrêa Moura, Rafael Dhália, R. F. França, Tereza Magalhães, Ernesto T. A. Marques, Thomas Jaenisch, Gabriel Luz Wallau, Magliones Carneiro de Lima, Valdinete Alves do Nascimento, Erenilde Marques de Cerqueira, Maricélia Maia de Lima, D. L. Mascarenhas, José Pereira de Moura Neto, Anna S. Levin, Tânia Regina Tozetto‐Mendoza, Sílvia Nunes Szente Fonseca, Maria Cássia Mendes-Corrêa, Flavio Augusto de Pádua Milagres, Aluísio Augusto Cotrim Segurado, Edward C. Holmes, Andrew Rambaut, Trevor Bedford, Márcio Roberto Teixeira Nunes, Éster Cerdeira Sabino, Luíz Carlos Júnior Alcântara, Nicholas J. Loman, Oliver G. Pybus,

Viral Infections and Vectors

Virus genomes reveal the establishment of Zika virus in Brazil and the Americas, and provide an appropriate timeframe for baseline (pre-Zika) microcephaly in different regions. Three papers in this issue present a wealth of new Zika virus (ZIKV) genome sequences and further insights into the genetic epidemiology of ZIKV. Nathan Grubaugh et al. provide 39 new ZIKV genome sequences from infected patients and Aedes aegypti mosquitoes in Florida. Phylogenetic analysis suggests that the virus has been introduced on multiple separate occasions, probably linked to travel from the Caribbean. They find a low probability of long-term persistence of ZIKV transmission chains within Florida, suggesting that the potential for future ZIKV outbreaks there will depend on transmission dynamics in the Americas. Nuno Faria et al. and Hayden Metsky et al. reconstruct the spread of ZIKV in Brazil and the Americas. Faria et al. provide 54 new ZIKV genomes, several sequenced in real time in a mobile genomics laboratory. They trace the spatial origins and spread of ZIKV in Brazil and the Americas and date the timing of the international spread of ZIKV from Brazil. They find that northeast Brazil had a crucial role in the establishment of the epidemic and the spread of the virus within Brazil and the Americas. Metsky et al. generate 110 ZIKV genomes from clinical and mosquito samples from ten regions. They also see rapid expansion of the epidemic within Brazil and multiple introductions to other geographic areas. In agreement with Faria et al., they find that ZIKV circulated unobserved for many months before transmission was detected. Metsky et al. additionally describe ZIKV evolution and discuss how the accumulation of mutations might affect the performance of diagnostic tests in the future. Transmission of Zika virus (ZIKV) in the Americas was first confirmed in May 2015 in northeast Brazil1. Brazil has had the highest number of reported ZIKV cases worldwide (more than 200,000 by 24 December 20162) and the most cases associated with microcephaly and other birth defects (2,366 confirmed by 31 December 20162). Since the initial detection of ZIKV in Brazil, more than 45 countries in the Americas have reported local ZIKV transmission, with 24 of these reporting severe ZIKV-associated disease3. However, the origin and epidemic history of ZIKV in Brazil and the Americas remain poorly understood, despite the value of this information for interpreting observed trends in reported microcephaly. Here we address this issue by generating 54 complete or partial ZIKV genomes, mostly from Brazil, and reporting data generated by a mobile genomics laboratory that travelled across northeast Brazil in 2016. One sequence represents the earliest confirmed ZIKV infection in Brazil. Analyses of viral genomes with ecological and epidemiological data yield an estimate that ZIKV was present in northeast Brazil by February 2014 and is likely to have disseminated from there, nationally and internationally, before the first detection of ZIKV in the Americas. Estimated dates for the international spread of ZIKV from Brazil indicate the duration of pre-detection cryptic transmission in recipient regions. The role of northeast Brazil in the establishment of ZIKV in the Americas is further supported by geographic analysis of ZIKV transmission potential and by estimates of the basic reproduction number of the virus.