{"id":38561,"date":"2019-09-17T09:21:24","date_gmt":"2019-09-17T13:21:24","guid":{"rendered":"https:\/\/www.healthynewbornnetwork.org\/?post_type=news-item&p=38561"},"modified":"2023-11-21T12:35:06","modified_gmt":"2023-11-21T17:35:06","slug":"infected-travelers-reveal-cubas-hidden-zika-outbreak","status":"publish","type":"news-item","link":"https:\/\/www.healthynewbornnetwork.org\/news-item\/infected-travelers-reveal-cubas-hidden-zika-outbreak\/","title":{"rendered":"Infected travelers reveal Cuba\u2019s \u2018hidden\u2019 Zika outbreak"},"content":{"rendered":"

This article was originally published in Science here.<\/em><\/p>\n

\n

By Jon Cohen<\/strong><\/em><\/p>\n

As Zika virus<\/a> raced through the Americas and the Caribbean in 2015 and 2016, it infected an estimated 800,000 people and left nearly 4000 newborns with serious brain damage. But by mid-2017, the virus had all but disappeared from the region\u2014or so it seemed. A new analysis of Zika-infected travelers who returned to the United States or Europe in 2017 or 2018 has found that 98% had visited Cuba, which did not report any cases to world health officials at the time the country\u2019s outbreak apparently peaked.<\/p>\n

\u201cIt was startling,\u201d says Kristian Andersen, a genomic epidemiologist at Scripps Research in San Diego, California, who led the work conducted by 38 researchers from five countries. The group estimates that Cuba had 5707 unreported Zika cases, with most occurring in 2017. Those numbers are similar to counts in other Caribbean islands with comparable populations 1 year earlier.<\/p>\n

In February 2016, the Zika outbreak was so severe in South America and the Caribbean that the World Health Organization (WHO)<\/a> took the rare step of declaring it a Public Health Emergency of International Concern. But by November 2016, cases in the region had fallen steeply and WHO lifted the emergency.<\/p>\n

To better understand the outbreaks that continued to linger, Andersen and colleagues looked at cases of Zika in travelers recorded by the Florida Department of Health and the European Centre for Disease Prevention and Control. Between June 2017 and October 2018, there were 155 cases\u2014confirmed by antibody or viral tests\u2014and all but one person had traveled to Cuba.<\/p>\n

To further probe the timing and origin of the Cuban outbreak, the researchers sequenced Zika virus from nine infected people who returned to Florida and compared their viruses to ones from other countries in the region. Because viral mutations occur at predictable rates, the group could construct a molecular clock which revealed that the virus emerged in Cuba about 1 year later than elsewhere in the Caribbean. In their study in Cell<\/cite> today, the researchers also concluded that Zika had come to Cuba several times from several different Caribbean islands.<\/p>\n

Jennifer Gardy, a genomic epidemiologist in the global health program at the Bill & Melinda Gates Foundation in Seattle, Washington, says analyzing viral sequences from travelers can help clarify the contours of epidemics that might otherwise have remained under the surveillance radar. \u201cSurveillance is one of our best defenses again infectious disease, but the systems are rarely perfect\u2014cases can be missed for many reasons,\u201d Gardy says.<\/p>\n

Andersen suggests a combination of factors likely explains why Cuba\u2019s outbreak was \u201chidden\u201d from the rest of world. Following the emergence of Zika in Brazil<\/a> in May 2015, Cuba launched an aggressive pesticide-spraying program to control the Aedes aegypti<\/em> mosquito that transmits the virus. (In lockstep with that program, cases of dengue, another disease spread by A. aegypti<\/em>, plummeted in early 2016<\/a>.) Zika cases also dropped steadily throughout Latin America and the Caribbean that year, presumably because the virus quickly infects large portions of populations, creating widespread immunity. When WHO lifted its emergency declaration, <\/em>it relaxed requirements for member countries to report Zika cases.\u00a0By the end of 2016, Cuba had confirmed only 187 cases of Zika<\/a>, and it stopped reporting numbers altogether in 2017. It reported no cases of Zika-related brain damage to babies.<\/p>\n

Contributing to the difficulty in reporting, the virus is \u201cexceptionally difficult\u201d to diagnose in infected people, Andersen notes. Antibodies to Zika and dengue viruses are similar, and tests can confuse the two. Zika-infected patients rarely have symptoms, and levels of the virus in their blood quickly drop, further complicating infection confirmation.<\/p>\n

Andersen hopes his team\u2019s approach will be applied to a wide array of diseases in returning travelers. \u201cThis [work] sets up a framework for investigating infectious diseases more closely,\u201d he says. \u201cIt\u2019s a really important new tool to monitor infectious diseases around the world.\u201d<\/p>\n

Michael Worobey, an evolutionary biologist who has analyzed viral histories in his lab at the University of Arizona in Tucson, says the new study reminds him of when he worked as a forest fighter. People posted on towers throughout the forest tracked lightning strikes. The next day, they would fly over the spots in the forest where lightning had hit. \u201cIf you saw smoke, you\u2019d send crews out there before there was a conflagration,\u201d Worobey says. \u201cThis new work is a demonstration of something we missed. If we improve our surveillance next time, we\u2019ll catch it earlier, and certainly knowing there\u2019s an outbreak of something like Zika spreading around could impact controlling it.\u201d<\/p>\n","protected":false},"author":7211,"featured_media":38563,"template":"","acf":[],"yoast_head":"\nHealthy Newborn Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.healthynewbornnetwork.org\/news-item\/infected-travelers-reveal-cubas-hidden-zika-outbreak\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Infected travelers reveal Cuba\u2019s \u2018hidden\u2019 Zika outbreak - Healthy Newborn Network\" \/>\n<meta property=\"og:description\" content=\"This article was originally published in Science here. By Jon Cohen As Zika virus raced through the Americas and the Caribbean in 2015 and 2016, it infected an estimated 800,000 people and left nearly 4000 newborns with serious brain damage. 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To date we have reached 200,363 people, including 126,291 children in El Salvador. 88 anti-vector community campaigns (house by house) along with local authorities in 85 communities of intervention, using our radio spots. 115 tool kits for eliminating mosquitoes (cleaning activities) have been distributed to 115 civil protection committees.\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/news-item\/infected-travelers-reveal-cubas-hidden-zika-outbreak\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.healthynewbornnetwork.org\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Infected travelers reveal Cuba\u2019s \u2018hidden\u2019 Zika outbreak\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/#website\",\"url\":\"https:\/\/www.healthynewbornnetwork.org\/\",\"name\":\"Healthy Newborn Network\",\"description\":\"Addressing critical knowledge gaps in newborn health.\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.healthynewbornnetwork.org\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Healthy Newborn Network","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.healthynewbornnetwork.org\/news-item\/infected-travelers-reveal-cubas-hidden-zika-outbreak\/","og_locale":"en_US","og_type":"article","og_title":"Infected travelers reveal Cuba\u2019s \u2018hidden\u2019 Zika outbreak - Healthy Newborn Network","og_description":"This article was originally published in Science here. 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In El Salvador, the Ministry of Health has documented 20,348 suspected cases of Zika from December 2015 (1,706 more cases since the last SitRep), among these cases 270 suspected cases of Zika have been reported in pregnant women (32 more cases). To date we have reached 200,363 people, including 126,291 children in El Salvador. 88 anti-vector community campaigns (house by house) along with local authorities in 85 communities of intervention, using our radio spots. 115 tool kits for eliminating mosquitoes (cleaning activities) have been distributed to 115 civil protection committees."},{"@type":"BreadcrumbList","@id":"https:\/\/www.healthynewbornnetwork.org\/news-item\/infected-travelers-reveal-cubas-hidden-zika-outbreak\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.healthynewbornnetwork.org\/"},{"@type":"ListItem","position":2,"name":"Infected travelers reveal Cuba\u2019s \u2018hidden\u2019 Zika outbreak"}]},{"@type":"WebSite","@id":"https:\/\/www.healthynewbornnetwork.org\/#website","url":"https:\/\/www.healthynewbornnetwork.org\/","name":"Healthy Newborn Network","description":"Addressing critical knowledge gaps in newborn health.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.healthynewbornnetwork.org\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"}]}},"featured_image":"<img width=\"768\" height=\"512\" src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/zika-1-768x512.jpg\" class=\"attachment-medium_large size-medium_large\" alt=\"\" decoding=\"async\" srcset=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/zika-1-768x512.jpg 768w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/zika-1-300x200.jpg 300w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/zika-1-1024x683.jpg 1024w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/zika-1.jpg 1200w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/>","author_name":"HNN Team","author_image":"<img src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/themes\/hnn\/dist\/images\/member-default.jpg\" alt=\"\" class=\"avatar avatar-32 photo\" height=\"32\" width=\"32\"\/>","acf_custom_fields":{"external_link":"https:\/\/www.sciencemag.org\/news\/2019\/08\/infected-travelers-reveal-cuba-s-hidden-zika-outbreak?utm_source=Global+Health+NOW+Main+List&utm_campaign=a444cc3210-EMAIL_CAMPAIGN_2019_08_22_07_06&utm_medium=email&utm_term=0_8d0d062dbd-a444cc3210-2989537","publication_date":"20190822","publication":"Science","partners":[],"issues":[{"ID":19165,"post_author":"7211","post_date":"2016-08-26 10:55:19","post_date_gmt":"2016-08-26 14:55:19","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<p style=\"margin: 0in; margin-bottom: .0001pt; line-height: 20.25pt;\"><span style=\"font-family: 'Arial',sans-serif; color: #333333;\">According to the World Health Organization, Zika virus disease is transmitted primarily by Aedes mosquitoes. It may also be transmitted sexually, and other modes of transmission (such as through blood transfusions) are under study. While the disease commonly has only mild effects in adults, there is scientific consensus that the virus can cause microcephaly in newborns, which can\u00a0result in serious, long-term impairments. The mechanism of how Zika infection during pregnancy causes disruptions in brain growth and development as well as links to other neurological complications are also being investigated.<\/span><\/p>\r\n[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/4\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><b><span class=\"ticker\">86<\/span><\/b><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"3\/4\"][vc_column_text css=\".vc_custom_1652127217210{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number to date of total countries and territories <a href=\"https:\/\/www.who.int\/health-topics\/zika-virus-disease?msclkid=3912fb49cfd411ec8a8a8d3c00ddb2ca#tab=tab_1\" target=\"_blank\" rel=\"noopener\">that have reported<\/a> evidence of mosquito-transmitted Zika infection.\u00a0<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]\r\n<h6 style=\"text-align: center;\"><span style=\"font-style: italic;\">All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<\/span><a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\"><span style=\"font-style: italic;\">Newborn Numbers<\/span><\/a><span style=\"font-style: italic;\">\u00a0page and download the Excel spreadsheet to explore the data further.<\/span><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_text_separator title=\"Key Resources\"][vc_row_inner equal_height=\"yes\"][vc_column_inner][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"http:\/\/www.cdc.gov\/zika\/index.html\" target=\"_blank\" rel=\"noopener\">Centers for Disease Control and Prevention Zika resources<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/health-topics\/zika-virus-disease?msclkid=3912fb49cfd411ec8a8a8d3c00ddb2ca#tab=tab_1\" target=\"_blank\" rel=\"noopener\">WHO Zika facts and resources\u00a0<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.cidrap.umn.edu\/\" target=\"_blank\" rel=\"noopener\">Center for Infectious Disease Research and Policy, University of Minnesota<\/a><\/li>\r\n \t<li><a href=\"http:\/\/ecdc.europa.eu\/en\/Pages\/home.aspx\" target=\"_blank\" rel=\"noopener\">European Center for Disease Control<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_text_separator title=\"Other Resources\"][\/vc_column][\/vc_row][vc_row][vc_column width=\"1\/2\"][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"http:\/\/pubs.rsna.org\/doi\/full\/10.1148\/radiol.2016161584\" target=\"_blank\" rel=\"noopener\">Congenital Brain Abnormalities and Zika Virus: What the Radiologist Can Expect to See Prenatally and Postnatally <\/a>(2016)<\/li>\r\n \t<li><a href=\"https:\/\/www.marchofdimes.org\/find-support\/topics\/planning-baby\/zika-virus-and-pregnancy-infographic\">March of Dimes Zika virus and pregnancy infographic<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.paho.org\/hq\/index.php?option=com_content&view=article&id=11585&Itemid=41688&lang=en\">PAHO Zika page<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.gov.uk\/government\/collections\/zika-virus-zikv-clinical-and-travel-guidance\">Public Health England<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.statnews.com\/series\/zika-update\/\">STAT: Zika in 30 seconds: What you need to know today<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.theguardian.com\/world\/zika-virus\">The Guardian<\/a><\/li>\r\n \t<li><a href=\"http:\/\/afludiary.blogspot.com\/\">Avian Flu Diary (Florida-based blog)<\/a><\/li>\r\n \t<li><a href=\"http:\/\/crofsblogs.typepad.com\/h5n1\/\">H5N1 blog (Vancouver-based)<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Zika virus disease","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"zika","to_ping":"","pinged":"","post_modified":"2022-11-02 17:41:49","post_modified_gmt":"2022-11-02 21:41:49","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=19165","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[{"ID":250,"post_author":"7211","post_date":"2015-10-21 22:10:30","post_date_gmt":"2015-10-21 22:10:30","post_content":"","post_title":"Latin America and Caribbean","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"latin-america-and-caribbean","to_ping":"","pinged":"","post_modified":"2016-02-11 21:52:01","post_modified_gmt":"2016-02-11 21:52:01","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=region&p=250","menu_order":0,"post_type":"region","post_mime_type":"","comment_count":"0","filter":"raw"}],"countries":[]},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item\/38561"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/news-item"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/7211"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item\/38561\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/38563"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=38561"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}