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The Zika Virus Epidemic in Brazil: From Discovery to Future Implications.

Abstract

The first confirmed case of Zika virus infection in the Americas was reported in Northeast Brazil in May 2015, although phylogenetic studies indicate virus introduction as early as 2013. Zika rapidly spread across Brazil and to more than 50 other countries and territories on the American continent. The Aedesaegypti mosquito is thought to be the principal vector responsible for the widespread transmission of the virus. However, sexual transmission has also been reported. The explosively emerging epidemic has had diverse impacts on population health, coinciding with cases of Guillain-Barré Syndrome and an unexpected epidemic of newborns with microcephaly and other neurological impairments. This led to Brazil declaring a national public health emergency in November 2015, followed by a similar decision by the World Health Organization three months later. While dengue virus serotypes took several decades to spread across Brazil, the Zika virus epidemic diffused within months, extending beyond the area of permanent dengue transmission, which is bound by a climatic barrier in the south and low population density areas in the north. This rapid spread was probably due to a combination of factors, including a massive susceptible population, climatic conditions conducive for the mosquito vector, alternative non-vector transmission, and a highly mobile population. The epidemic has since subsided, but many unanswered questions remain. In this article, we provide an overview of the discovery of Zika virus in Brazil, including its emergence and spread, epidemiological surveillance, vector and non-vector transmission routes, clinical complications, and socio-economic impacts. We discuss gaps in the knowledge and the challenges ahead to anticipate, prevent, and control emerging and re-emerging epidemics of arboviruses in Brazil and worldwide.

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  • Authors+Show Affiliations

    ,

    Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK. rachel.lowe@lshtm.ac.uk. Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK. rachel.lowe@lshtm.ac.uk. Barcelona Institute for Global Health (ISGLOBAL), Doctor Aiguader, 88, 08003 Barcelona, Spain. rachel.lowe@lshtm.ac.uk.

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    Institute of Health Communication and Information, Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Rio de Janeiro 21045-900, Brazil. xris@fiocruz.br.

    ,

    Instituto Nacional de Infectologia Evandro Chagas, Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Rio de Janeiro 21045-900, Brazil. patricia.brasil@ini.fiocruz.br.

    ,

    Scientific Computation Program, Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Rio de Janeiro 21045-900, Brazil. oswaldo.cruz@fiocruz.br.

    ,

    Laboratório de Mosquitos Transmissores de Hematozoários, Instituto Oswaldo Cruz (Fiocruz), Avenida Brasil 4365, Rio de Janeiro 21045-900, Brazil. honorio@ioc.fiocruz.br. Núcleo Operacional Sentinela de Mosquitos Vetores-Nosmove/Fiocruz, Avenida Brasil 4365, Rio de Janeiro 21045-900, Brazil. honorio@ioc.fiocruz.br.

    ,

    International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK. hannah.kuper@lshtm.ac.uk.

    Scientific Computation Program, Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Rio de Janeiro 21045-900, Brazil. marilia.carvalho@fiocruz.br.

    Source

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    29315224