The 2016 Earthquake in Ecuador: Zika Outbreak After a Natural Disaster.

The objective of this work was to examine the spread of the Zika virus after the destructive impact of the earthquake of April 2016 along the coast of Ecuador. Using a difference-in-difference estimation method and a unique dataset to track Zika cases at the national level, we estimated the impact of the earthquake on the reported cases of Zika in the affected region. Our results suggest that the earthquake increased the reported cases of Zika by 0.509 per epidemiologic week (data per 10,000 population), and we argue that the destroyed built environment along with other factors created a disease focus, where the virus spread easily. Because of its potential complications and devastating long-term effects, Zika represents a national threat. After a natural disaster, the health authorities, together with a multidisciplinary team and the wider community, all have an urgent responsibility to collaborate to minimize the health risks to the population.