Potential for Zika Entry into Africa and the Asia-Pacific Region

Summary and Comment |
September 8, 2016

Potential for Zika Entry into Africa and the Asia-Pacific Region

  1. Mary E. Wilson, MD

A model identifies countries and times of year vulnerable to the introduction and transmission of Zika virus infections.

  1. Mary E. Wilson, MD

To develop monthly risk maps for mosquito-transmitted Zika virus in Africa and the Asia-Pacific region, investigators combined population density analysis, modeling of mosquito distribution and vector competence, data from the International Air Transport Association, and climate condition data. They looked at flows of airline passengers to Africa and the Asia-Pacific region from areas in the Americas that are suitable for year-round transmission of Zika virus.

The authors found that an estimated 2.6 billion people in Africa and the Asia-Pacific region live in areas with conditions suitable for local vector-borne transmission. Countries that have competent mosquito vectors and climatic conditions that would support local transmission, coupled with large populations and large volumes of travelers arriving from Zika-transmission areas in the Americas, include India, China, Indonesia, the Philippines, and Thailand.

When the investigators also considered per-capita health expenditure as a proxy of a country's capacity to find and respond to Zika importations, they identified India, the Philippines, Indonesia, Nigeria, Vietnam, Pakistan, and Bangladesh as countries with high risk and high population consequences.

Comment

Editorialists caution, and the study authors acknowledge, that this analysis did not taken into account background immunity to Zika that may be present in parts of Africa and the Asia-Pacific region. Hence the entire populations may not be susceptible. Surveys are needed to assess vulnerabilities of these populations. This analysis looks only at the potential for vector-borne transmission and does not account for human-to-human sexual transmission, an alternate route for spread. Although the current Zika outbreak in Singapore may not have originated from Brazil, it shows the potential for rapid spread in Asia and may be a harbinger of future outbreaks in Asia and Africa.

Editor Disclosures at Time of Publication

  • Disclosures for Mary E. Wilson, MD at time of publication Consultant / Advisory board FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health (Advisory Committee) Editorial boards UpToDate; Clinical Infectious Diseases; International Health; Infectious Diseases in Clinical Practice; Travel Medicine and Infectious Diseases

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