Abstract
Background: Zika virus (ZIKV) emerged in May 2015 in Brazil, from which it spread to many other countries in Latin America. Cases of ZIKV infection were eventually also reported in Curaçao (January 2016) and Bonaire (February 2016).Methods: In the period of 16 December 2015 until 26 April 2017, serum, EDTA-plasma or urine samples were taken at Medical Laboratory Services (MLS) from patients on Curaçao and tested in qRT-PCR at the Erasmus Medical Centre (EMC) in the Netherlands. Between 17 October 2016 until 26 April 2017 all samples of suspected ZIKV-patients collected on Curaçao, as well as on Bonaire, were tested at MLS. Paired urine and/or serum samples from patients were analyzed for ZIKV shedding kinetics, and compared in terms of sensitivity for ZIKV RNA detection. Furthermore, the age and gender of patients were used to determine ZIKV incidence rates, and their geozone location to determine the spatial distribution of ZIKV cases.Results: In total, 781 patients of 2820 tested individuals were found qRT-PCR-positive for ZIKV on Curaçao. The first two ZIKV cases were diagnosed in December 2015. A total of 112 patients of 382 individuals tested qRT-PCR-positive for ZIKV on Bonaire. For both islands, the peak number of absolute cases occurred in November 2016, with 247 qRT-PCR confirmed cases on Curaçao and 66 qRT-PCR-positive cases on Bonaire. Overall, a higher proportion of women than men was diagnosed with ZIKV on both islands, as well as mostly individuals in the age category of 25–54 years old. Furthermore, ZIKV cases were mostly clustered in the east of the island, in Willemstad.Conclusions: ZIKV cases confirmed by qRT-PCR indicate that the virus was circulating on Curaçao between at least December 2015 and March 2017, and on Bonaire between at least October 2016 and February 2017, with peak cases occurring in November 2016. The lack of preparedness of Curaçao for the ZIKV outbreak was compensated by shipping all samples to the EMC for diagnostic testing; however, both islands will need to put the right infrastructure in place to enable a rapid response to an outbreak of any new emergent virus in the future.
Highlights
Zika virus (ZIKV) is an arbovirus that belongs to the Flaviviridae family, genus Flavivirus, and is transmitted through the bite of infected Aedes aegypti mosquitoes, via sexual contact [1,2,3], or from mother to fetus [4]
In the period of 16 December 2015 until 26 April 2017, serum, ethylenediaminetetraacetic acid (EDTA)-plasma or urine samples were taken at Medical Laboratory Services (MLS) from patients on Curaçao presenting with symptoms resembling ZIKV infection, such as fever, rash, headache or conjunctivitis
As neither an ELISApositive immunoglobulin M (IgM) or immunoglobulin G (IgG) result for ZIKV in a dengue virus (DENV)-endemic area can be considered reliable due to the cross-reactivity known to exist between DENV and ZIKV antibodies [36, 37], we only considered positive results obtained in the quantitative realtime PCR (qRT-PCR) for the analyses
Summary
Zika virus (ZIKV) is an arbovirus that belongs to the Flaviviridae family, genus Flavivirus, and is transmitted through the bite of infected Aedes aegypti mosquitoes, via sexual contact [1,2,3], or from mother to fetus [4]. ZIKV spread rapidly across the Pacific Ocean, causing outbreaks in French Polynesia [20], Cook Islands [20], Easter Island [21], New Caledonia [22], until eventually emerging in the Americas [23] It was first reported in Brazil in continental South America in May 2015, after which the virus spread to other Latin American countries, such as Colombia (October 2015), Surinam, El Salvador, Mexico, Guatemala, Paraguay, Venezuela (November 2015), Panama, Honduras, French Guiana, Martinique, Puerto Rico (December 2015), Maldives, Guyana, Ecuador, Barbados, Bolivia, Haiti, Saint Martin, Dominican Republic, Nicaragua, Jamaica, Curaçao, Costa Rica (January 2016), Bonaire and Aruba (February 2016) [24, 25]. Cases of ZIKV infection were eventually reported in Curaçao (January 2016) and Bonaire (February 2016)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
