Abstract

Zika virus (ZIKV) is a mosquito-borne pathogen that recently caused a major epidemic in the Americas. Although the majority of ZIKV infections are asymptomatic, the virus has been associated with birth defects in fetuses and newborns of infected mothers as well as neurological complications in adults. We performed a descriptive analysis on approximately 106,000 suspected and laboratory-confirmed cases of Zika virus disease (ZVD) that were reported during the 2015-2017 epidemic in Colombia. We also analyzed a dataset containing patients with neurological complications and recent febrile illness compatible with ZVD. Females had higher cumulative incidence of ZVD than males. Compared to the general population, cases were more likely to be reported in young adults (20 to 39 years of age). We estimated the cumulative incidence of ZVD in pregnant females at 3,120 reported cases per 100,000 population (95% CI: 3,077-3,164), which was considerably higher than the incidence in both males and non-pregnant females. ZVD cases were reported in all 32 departments. Four-hundred and eighteen patients suffered from ZIKV-associated neurological complications, of which 85% were diagnosed with Guillain-Barré syndrome. The median age of ZIKV cases with neurological complications was 12 years older than that of ZVD cases. ZIKV-associated neurological complications increased with age, and the highest incidence was reported among individuals aged 75 and older. Even though neurological complications and deaths due to ZIKV were rare in this epidemic, better risk communication is needed for people living in or traveling to ZIKV-affected areas.

Highlights

  • Zika virus disease (ZVD) is an emerging infectious disease caused by Zika virus (ZIKV), a single-stranded RNA virus that belongs to the genus Flavivirus [1]

  • More ZVD cases were reported in females than males each year from 2015–2017 (Table 1)

  • The Risk ratios (RR) of ZVD in females was nearly two times higher than in males (1.91, 95% CI: 1.88–1.93)

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Summary

Methods

Ethics statementThe technical and ethical endorsement of this study was provided by the Comitede Etica y de Metodologıas de Investigacion (CEMIN) of the Instituto Nacional de Salud (INS) of Colombia (project number 35–2017). We analyzed two anonymized line lists on ZVD cases and ZIKV-associated neurological complications. The ZIKV dataset consists of 106,033 suspected and laboratory-confirmed cases of ZVD reported to Sivigila, Colombia’s national public health surveillance system, between 2015 and 2017. We included cases with missing information on municipality (administrative level 2) location. Information related to public health events in the national territory is generated from the local levels by local health service providers. There are roughly 14,000 institutional, municipal, departmental, or national reporting bodies in Colombia. ZVD was added to the list of notifiable conditions in 2015. Each week these data are aggregated and published [26]

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