Zika beyond the Americas: Travelers as sentinels of Zika virus transmission. A GeoSentinel analysis, 2012 to 2016.

Leder, Karin; Grobusch, Martin P.; Gautret, Philippe; Chen, Lin H.; Kuhn, Susan; Lim, Poh Lian; Yates, Johnnie; McCarthy, Anne; Rothe, Camilla; Kato, Yasuyuki; Bottieau, Emmanuel; Huber, Kristina L.; Schwartz, Eli; Stauffer, William M.; Malvy, Denis; Shaw, Marc; Rapp, C.; Blumberg, Lucille; Jensenius, Mogens; Genderen, Perry J.J. van; Hamer, Davidson H.

doi:10.1371/journal.pone.0185689

Cited by 39 publications

(26 citation statements)

References 35 publications

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“…These travelers essentially act as sentinels of emerging epidemics when a source country does not have the capacity to detect these infections in a timely manner. Such networks have detected a sarcocystis outbreak in Malaysia [100], dengue virus outbreaks in Angola [101], and tracked the spread of Zika virus globally [102]. With improved surveillance and early warning systems, and by harnessing travelers as sentinels, it is possible to piece together a global picture of emerging and re-emerging infectious diseases.…”

Section: Public Health Implications Of Infections Transmitted Via Airmentioning

confidence: 99%

Human Mobility and the Global Spread of Infectious Diseases: A Focus on Air Travel

Findlater

Bogoch

2018

Trends in Parasitology

238

168

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Greater human mobility, largely driven by air travel, is leading to an increase in the frequency and reach of infectious disease epidemics. Air travel can rapidly connect any two points on the planet, and this has the potential to cause swift and broad dissemination of emerging and re-emerging infectious diseases that may pose a threat to global health security. Investments to strengthen surveillance, build robust early-warning systems, improve predictive models, and coordinate public health responses may help to prevent, detect, and respond to new infectious disease epidemics.

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Section: Public Health Implications Of Infections Transmitted Via Airmentioning

confidence: 99%

Human Mobility and the Global Spread of Infectious Diseases: A Focus on Air Travel

Findlater

Bogoch

2018

Trends in Parasitology

238

168

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“…The detection of ZIKV-RNA on BFP collected by a symptomatic traveller to Haiti in EW 39 ( Figure 1E), confirmed ongoing transmission of ZIKV beyond EW 33, when Haiti sent its last update to PAHO (Pan American Health Organization, 2017;Journel et al, 2017). This finding highlights the role of travellers as sentinels for ZIKV circulation (Leder et al, 2017). It also illustrates the utility of BFP, which allowed us to obtain a molecular diagnosis of ZIKV in three cases.…”

Section: Discussionmentioning

confidence: 54%

Incidence of Zika virus infection in a prospective cohort of Belgian travellers to the Americas in 2016

Huits

Bossche

Eggermont

et al. 2019

International Journal of Infectious Diseases

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were recruited prospectively to study the incidence and characteristics of ZIKV. Demographic data and sera were collected at baseline. Participants were trained to collect capillary blood on filter paper (BFP). When ill during travel, the participants completed a questionnaire and they sampled BFP for post-hoc analysis. All symptomatic participants were screened for ZIKV using ZIKV-specific RT-PCR on serum or urine, or BFP, and antibody detection assays (ELISA). Follow-up sera of asymptomatic travellers, obtained at least 20 days post travel, were tested by ZIKV ELISA only. All positive ELISA results were subject to confirmation by virus neutralization testing (VNT). Results: Forty-nine participants completed follow-up: 38 women and 11 men, with a median age of 32 years (range 19-64 years). Travel destinations were countries in South America (n = 20), Central America (n = 24), and the Caribbean (n = 5). The total travel duration was 67.8 person-months. Illness was reported by 24 participants (49.0%). ZIKV infection was confirmed in nine cases, by RT-PCR (n = 5) and by VNT (n = 4). Only one of nine ZIKV cases (11.1%) was asymptomatic. The ZIKV incidence rate was 17.0% (95% confidence interval 7.8-32.2%) per month of travel. Conclusions: The ZIKV incidence rate in adult travellers from non-endemic countries to the epidemic territories during the 2016 outbreak was high. Asymptomatic ZIKV infection was rare in this population.

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“…1B). To further confirm the timing of a Zika outbreak in Cuba, we obtained travel-related infection data from the GeoSentinel Surveillance Network (Hamer et al, 2017;Leder et al, 2017) and found that 76% of the Zika cases associated with travel from Cuba were diagnosed in 2017 (22 of 29; Fig. 1C).…”

Section: Uncovering An Unreported Zika Outbreak In Cubamentioning

confidence: 99%

“…Infectious disease surveillance of international travelers has long been an effective method to detect pathogens circulating in resource-limited areas (Hamer et al, 2017;Harvey et al, 2013;Leder et al, 2013Leder et al, , 2017Wilder-Smith et al, 2012). We hypothesized that similar frameworks could be leveraged to improve Zika virus surveillance, as many regions in the Americas affected by the epidemic attract large volumes of international visitors from countries with stronger healthcare and surveillance systems (Wilder-Smith et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

International travelers and genomics uncover a ‘hidden’ Zika outbreak

Saraf²,

Gangavarapu³

et al. 2018

Preprint

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The ongoing Zika epidemic in the Americas has challenged public health surveillance, response, and control systems. Even as the epidemic appears to be near its end in the Americas, it is unclear whether substantial Zika virus transmission may still be ongoing. This issue is exacerbated by large discrepancies in local case reporting and significant delays in detecting outbreaks due to surveillance gaps. To uncover locations with lingering outbreaks in the Americas, we investigated travel-associated Zika cases diagnosed in the United States and Europe to identify signatures of transmission dynamics that were not captured by local reporting. We found that a large and unreported Zika outbreak occurred in Cuba during 2017, a year after peak transmission in neighboring countries, with cases still appearing in 2018. By sequencing Zika virus from infected travelers, we show that the 2017 outbreak in Cuba was sparked by longlived lineages of Zika virus introduced from multiple places in the Americas a year prior. Our data suggest that while aggressive mosquito control in Cuba may initially have been effective at mitigating Zika virus transmission, in the absence of vaccines, herd immunity, or strong international coordination, such control measures may need to be maintained to be effective. Our study highlights how Zika virus may still be 'silently' spreading in the Americas and provides a framework for more accurately understanding outbreak dynamics.

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Zika beyond the Americas: Travelers as sentinels of Zika virus transmission. A GeoSentinel analysis, 2012 to 2016.

Cited by 39 publications

References 35 publications

Human Mobility and the Global Spread of Infectious Diseases: A Focus on Air Travel

Human Mobility and the Global Spread of Infectious Diseases: A Focus on Air Travel

Incidence of Zika virus infection in a prospective cohort of Belgian travellers to the Americas in 2016

International travelers and genomics uncover a ‘hidden’ Zika outbreak

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