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WHO Zika Virus, Microcephaly and Guillain-Barré Syndrome Situation Report, 14 July 2016

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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 13 July 2016, 65 countries and territories (Fig. 1, Table 1) have reported evidence of mosquito-borne Zika virus transmission since 2007 (62 of these countries and territories have reported evidence of mosquito-borne Zika virus transmission since 2015):

48 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 vector-borne Zika infections in 2016.

13 countries and territories have reported evidence of local vector-borne Zika infections in or before 2015, but without documentation of cases in 2016, or with outbreak terminated.

No new country or territory has reported mosquito-borne Zika virus transmission in the week to 13 July 2016.

Eleven countries have reported evidence of person-to-person transmission of Zika virus, probably via a sexual route (Table 2).

As of 13 July 2016, microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection or suggestive of congenital infection have been reported by 13 countries or territories. Three of those countries reported microcephaly cases born from mothers with a recent travel history to Zika-affected countries in the WHO Region of the Americas (Table 3).

As of 13 July 2016, the United States Centers for Disease Control and Prevention (US-CDC) reported seven live-born infants with birth defects and five pregnancy losses with birth defects with laboratory evidence of Zika virus infection.

In the context of Zika virus circulation, 15 countries and territories worldwide have reported an increased incidence of Guillain-Barré syndrome (GBS) and/or laboratory confirmation of a Zika virus infection among GBS cases. French Guiana recently confirmed four cases of GBS and one severe neurologic condition, all of which were confirmed positive for Zika virus.

Based on research to date, there is scientific consensus that Zika virus is a cause of microcephaly and GBS.

In Guadeloupe, there are four GBS cases confirmed with Zika virus infection, and 12 additional GBS cases under investigation. Five cases of other severe neurological syndrome were confirmed with Zika virus infection. Zika virus was probable or confirmed for 11 cases of unidentified neurological syndrome.

One neurologic condition laboratory confirmed for Zika virus infection was reported in Saint Martin.

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. Four additional samples were sent to IPD on 1 July for gene sequencing and 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. The WCO has availed funds to support the logistical needs of the response activities. The WHO assessment mission to Guinea-Bissau will be conducted to help identify the priority activities and to strengthen the national response capacity.

On 13 July 2016, the U.S. CDC released a risk assessment for Zika virus spread related to travel to Olympics. The assessment concluded that international spread of Zika related to the Games would not significantly alter spread, but that four countries were at special risk, because residents of those countries did not have substantial travel to Zika affected countries, outside of potential exposure at the Olympics: Eritrea, Djibouti, Chad, and Yemen.

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.