Colón-González Felipe J, Peres Carlos A, Steiner São Bernardo Christine, Hunter Paul R, Lake Iain R
School of Environmental Sciences, University of East Anglia, Norwich, Norfolk, United Kingdom.
Universidade do Estado de Mato Grosso, Rua São Pedro s/n, Cavalhada, Cáceres, Mato Grosso, Brazil.
PLoS Negl Trop Dis. 2017 Nov 1;11(11):e0006007. doi: 10.1371/journal.pntd.0006007. eCollection 2017 Nov.
Zika is one of the most challenging emergent vector-borne diseases, yet its future public health impact remains unclear. Zika was of little public health concern until recent reports of its association with congenital syndromes. By 3 August 2017 ∼217,000 Zika cases and ∼3,400 cases of associated congenital syndrome were reported in Latin America and the Caribbean. Some modelling exercises suggest that Zika virus infection could become endemic in agreement with recent declarations from the The World Health Organisation.
METHODOLOGY/PRINCIPAL FINDINGS: We produced high-resolution spatially-explicit projections of Zika cases, associated congenital syndromes and monetary costs for Latin America and the Caribbean now that the epidemic phase of the disease appears to be over. In contrast to previous studies which have adopted a modelling approach to map Zika potential, we project case numbers using a statistical approach based upon reported dengue case data as a Zika surrogate. Our results indicate that ∼12.3 (0.7-162.3) million Zika cases could be expected across Latin America and the Caribbean every year, leading to ∼64.4 (0.2-5159.3) thousand cases of Guillain-Barré syndrome and ∼4.7 (0.0-116.3) thousand cases of microcephaly. The economic burden of these neurological sequelae are estimated to be USD ∼2.3 (USD 0-159.3) billion per annum.
CONCLUSIONS/SIGNIFICANCE: Zika is likely to have significant public health consequences across Latin America and the Caribbean in years to come. Our projections inform regional and federal health authorities, offering an opportunity to adapt to this public health challenge.
寨卡病毒病是最具挑战性的新出现的媒介传播疾病之一，但其未来对公共卫生的影响仍不明确。在近期有关寨卡病毒与先天性综合征关联的报道出现之前，它几乎未引起公共卫生领域的关注。截至2017年8月3日，拉丁美洲和加勒比地区报告了约21.7万例寨卡病毒病病例以及约3400例相关先天性综合征病例。一些模型研究表明，寨卡病毒感染可能会成为地方病，这与世界卫生组织最近的声明一致。
方法/主要发现：鉴于该疾病的流行阶段似乎已经结束，我们针对拉丁美洲和加勒比地区制作了寨卡病毒病病例、相关先天性综合征以及货币成本的高分辨率空间明确预测。与以往采用建模方法来绘制寨卡病毒潜在风险地图的研究不同，我们使用基于报告的登革热病例数据作为寨卡病毒替代指标的统计方法来预测病例数。我们的结果表明，拉丁美洲和加勒比地区每年预计可能出现约1230万（070 - 16230万）例寨卡病毒病病例，导致约6.44万（0.2 - 5159.3万）例吉兰 - 巴雷综合征病例和约4700（0.0 - 116.3万）例小头畸形病例。这些神经后遗症的经济负担估计每年约为23亿美元（0 - 159.3亿美元）。
结论/意义：未来几年，寨卡病毒病可能会在拉丁美洲和加勒比地区造成重大的公共卫生后果。我们的预测为区域和联邦卫生当局提供了信息，为应对这一公共卫生挑战提供了契机。
