The third meeting of the Emergency Committee (EC) convened by the Director-General under the International Health Regulations (2005) regarding microcephaly, other neurological disorders and Zika virus was held by teleconference on 14 June 20161. The committee concurred with the international scientific consensus that Zika virus is a cause of microcephaly and GBS, and, consequently, that Zika virus infection and its associated congenital and other neurological disorders is a Public Health Emergency of International Concern (PHEIC). Based on the existing evidence from the current Zika virus outbreak, it is known that this virus can spread internationally and establish new transmission chains in areas where the vector is present. Focusing on the potential risks associated with the Olympic and Paralympic Games, the Committee reviewed information provided by Brazil and Advisors specializing in arboviruses, the international spread of infectious diseases, travel medicine, mass gatherings and bioethics. The Committee concluded that there is a very low risk of further international spread of Zika virus as a result of the Olympic and Paralympic Games as Brazil will be hosting the Games during the Brazilian winter when the intensity of autochthonous transmission of arboviruses, such dengue and Zika viruses, will be minimal and is intensifying vector-control measures in and around the venues for the Games which should further reduce the risk of transmission.
As of 15 June 2016, 60 countries and territories report continuing mosquito-borne transmission (Fig. 1) of which:
46 countries are experiencing a first outbreak of Zika virus since 2015, with no previous evidence of circulation, and with ongoing transmission by mosquitos (Table 1).
14 countries reported evidence of Zika virus transmission between 2007 and 2014, with ongoing transmission.
In addition, four countries or territories have reported evidence of Zika virus transmission between 2007 and 2014, without ongoing transmission: Cook Islands, French Polynesia,
ISLA DE PASCUA – Chile and YAP (Federated States of Micronesia).
Ten countries have reported evidence of person-to-person transmission of Zika virus, probably via a sexual route (Table 2).
In the week to 15 June 2016, no new country reported mosquito-borne or person-toperson Zika virus transmission.
As of 15 June 2016, microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection or suggestive of congenital infection have been reported by twelve countries or territories. Three of those reported microcephaly cases borne from mothers with a recent travel history to Brazil (Slovenia, United States of America), the Bolivarian Republic of Venezuela and Colombia (Spain), for one additional case the precise country of infection is not determined (as the case travelled to 3 known affected countries in Latin America) (Table 3).
A first case of microcephaly associated with Zika infection was confirmed in El Salvador.
A case of microcephaly and other neurological abnormalities, from a mother with recent travel to Honduras, is currently under verification for Zika virus in the United States of America.
As of 15 June, Cabo Verde has reported a total of six cases of microcephaly and/or other neurological abnormalities with serological indication of previous Zika infection.
In the context of Zika virus circulation, 13 countries and territories worldwide have reported an increased incidence of Guillain-Barré syndrome (GBS) and/or laboratory confirmation of a Zika virus infection among GBS cases (Table 4).
Zika infection was diagnosed in 3 patients with a severe neurological condition in Guadeloupe.
Sequencing of the virus that causes the Zika outbreak in Cabo Verde showed that the virus is of the Asian lineage and the same as the one that circulates in Brazil. The precise implication of this finding is yet to be determined.
Based on research to date, there is scientific consensus that Zika virus is a cause of microcephaly and GBS.
The global Strategic Response Framework launched by the World Health Organization (WHO) in February 2016 encompasses surveillance, response activities and research. An interim report4 has been published on some of the key activities being undertaken jointly by WHO and international, regional and national partners in response to this public health emergency. A revised strategy for the period July 2016 to December 2017 is currently being developed with partners and will be published in mid-June.
WHO has developed new advice and information on diverse topics in the context of Zika virus.5 WHO’s latest information materials, news and resources to support corporate and programmatic risk communication, and community engagement are available online.