The enhanced Zika surveillance in the Philippines, November 14, 2016–February 28, 2017

Abstract

Background: After the declaration of Zika virus as a public health emergency of international concern and the increasing number of confirmed Zika cases, we enhanced Zika surveillance in the hospitals to monitor and detect early local transmission of ZVD, and characterized Zika infection in the country. Methods and materials: Sixty-one reporting sentinel hospitals nationwide were included. We used the ZVD algorithm for skin rash. A suspect Zika case was any patient admitted from the hospitals on November 14, 2016-February 2017, who had skin rashes and any of the following: fever, arthralgia, myalgia, and conjunctivitis; or any pregnant women with skin rashes at any time of pregnancy. Confirmed case was a suspect case that tested positive for Zika virus thru qRT-PCR. Paired urine and serum specimens were collected among cases. Results: A total of 515 suspect cases were identified. Two-hundred sixty-six (52%) were females. Age ranged from one month to 90 years (Median: 17 years). Sixteen (3%) were pregnant with age ranged from 19–40 years (Median: 30 years). Most common signs and symptoms were rashes (100%), fever (96%), and body weakness (45%). Of the 806 specimens collected, 437 (54%) urine and 369 (46%) serum. Specimens were collected less than one day to 36 days (Median:2 days) from rash onset. Fourteen (3%), of the 437 urine were Zika positive, 47 (11%) for Dengue, and eight (2%) for Chikungunya. Of the 369 serum, 39 (11%) were Dengue positive and 19 (5%) for Chikungunya. No serum was positive for Zika virus. No pregnant case was positive for Zika virus. Also, no case was positive for multiple viruses and had travel history outside the country. Conclusion: Our findings highlight ongoing local transmission of Zika virus in the country. Co-circulation of Zika, Dengue, and Chikungunya was also noted. An intensified community awareness campaign for the control and prevention of vector-borne diseases was then recommended.