Rise and Fall of Zika Among Travelers
Gaelle Brun-Cottan, MD
Abstract
Introduction: International travellers contribute to the rapid spread of Zika virus (ZIKV) and its GeoSentinel sites with a focus on ZIKV acquired in the Americas and the Caribbean, describe countries of exposure and traveler characteristics, and assess ZIKV diagnostic testing by site.
Methods: Records with an international travel-related diagnosis of confirmed or probable ZIKV from January 2012 through December 2019 reported to GeoSentinel with a recorded illness onset date, were included to show reported cases over time. Records from March 2016 through December 2019 with an exposure region of the Americas or the Caribbean were included in the descriptive analysis. A survey was conducted to assess the availability, accessibility, and utilization of ZIKV diagnostic tests at GeoSentinel sites.
Results: GeoSentinel sites reported 525 ZIKV cases from 2012 through 2019. Between 2012 and 2014, 8 cases were reported; all were acquired in Asia or Oceania. After 2014, most cases were acquired in the Americas or the Caribbean; a large decline in ZIKV cases occurred in 2018–19.
Between March 2016 and December 2019, 423 patients acquired ZIKV in the Americas or the Caribbean; peak reporting to these regions occurred in 2016 (330 cases [78%]). The median age was 36 years (range: 3–92); 63% were female. The most frequent region of exposure was the Caribbean (60%). Thirteen travelers were pregnant during or after travel; one had a sexually-acquired ZIKV infection. There was one case of fetal anomaly and two travelers with Guillain-Barré syndrome. GeoSentinel sites reported various challenges to diagnose ZIKV effectively.
Conclusion: ZIKV should remain a consideration for travelers returning from areas with risk of ZIKV transmission. Travelers should discuss their travel plans with their healthcare providers to ensure ZIKV prevention measures are taken.