Zika Virus Disease in Colombia - Preliminary Report.


Journal

The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562

Informations de publication

Date de publication:
06 08 2020
Historique:
pubmed: 16 6 2016
medline: 21 8 2020
entrez: 16 6 2016
Statut: ppublish

Résumé

Colombia began official surveillance for Zika virus disease (ZVD) in August 2015. In October 2015, an outbreak of ZVD was declared after laboratory-confirmed disease was identified in nine patients. Using the national population-based surveillance system, we assessed patients with clinical symptoms of ZVD from August 9, 2015, to April 2, 2016. Laboratory test results and pregnancy outcomes were evaluated for a subgroup of pregnant women. Concurrently, we investigated reports of microcephaly for evidence of congenital ZVD. By April 2, 2016, there were 65,726 cases of ZVD reported in Colombia, of which 2485 (4%) were confirmed by means of reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay. The overall reported incidence of ZVD among female patients was twice that in male patients. A total of 11,944 pregnant women with ZVD were reported in Colombia, with 1484 (12%) of these cases confirmed on RT-PCR assay. In a subgroup of 1850 pregnant women, more than 90% of women who were reportedly infected during the third trimester had given birth, and no infants with apparent abnormalities, including microcephaly, have been identified. A majority of the women who contracted ZVD in the first or second trimester were still pregnant at the time of this report. Among the cases of microcephaly investigated from January 2016 through April 2016, four patients had laboratory evidence of congenital ZVD; all were born to asymptomatic mothers who were not included in the ZVD surveillance system. Preliminary surveillance data in Colombia suggest that maternal infection with the Zika virus during the third trimester of pregnancy is not linked to structural abnormalities in the fetus. However, the monitoring of the effect of ZVD on pregnant women in Colombia is ongoing. (Funded by Colombian Instituto Nacional de Salud and the Centers for Disease Control and Prevention.).

Sections du résumé

BACKGROUND
Colombia began official surveillance for Zika virus disease (ZVD) in August 2015. In October 2015, an outbreak of ZVD was declared after laboratory-confirmed disease was identified in nine patients.
METHODS
Using the national population-based surveillance system, we assessed patients with clinical symptoms of ZVD from August 9, 2015, to April 2, 2016. Laboratory test results and pregnancy outcomes were evaluated for a subgroup of pregnant women. Concurrently, we investigated reports of microcephaly for evidence of congenital ZVD.
RESULTS
By April 2, 2016, there were 65,726 cases of ZVD reported in Colombia, of which 2485 (4%) were confirmed by means of reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay. The overall reported incidence of ZVD among female patients was twice that in male patients. A total of 11,944 pregnant women with ZVD were reported in Colombia, with 1484 (12%) of these cases confirmed on RT-PCR assay. In a subgroup of 1850 pregnant women, more than 90% of women who were reportedly infected during the third trimester had given birth, and no infants with apparent abnormalities, including microcephaly, have been identified. A majority of the women who contracted ZVD in the first or second trimester were still pregnant at the time of this report. Among the cases of microcephaly investigated from January 2016 through April 2016, four patients had laboratory evidence of congenital ZVD; all were born to asymptomatic mothers who were not included in the ZVD surveillance system.
CONCLUSIONS
Preliminary surveillance data in Colombia suggest that maternal infection with the Zika virus during the third trimester of pregnancy is not linked to structural abnormalities in the fetus. However, the monitoring of the effect of ZVD on pregnant women in Colombia is ongoing. (Funded by Colombian Instituto Nacional de Salud and the Centers for Disease Control and Prevention.).

Identifiants

pubmed: 27305043
doi: 10.1056/NEJMoa1604037
doi:

Substances chimiques

RNA, Viral 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e44

Informations de copyright

Copyright © 2016 Massachusetts Medical Society.

Auteurs

Oscar Pacheco (O)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Mauricio Beltrán (M)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Christina A Nelson (CA)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Diana Valencia (D)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Natalia Tolosa (N)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Sherry L Farr (SL)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Ana V Padilla (AV)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Van T Tong (VT)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Esther L Cuevas (EL)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Andrés Espinosa-Bode (A)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Lissethe Pardo (L)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Angélica Rico (A)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Jennita Reefhuis (J)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Maritza González (M)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Marcela Mercado (M)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Pablo Chaparro (P)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Mancel Martínez Duran (M)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Carol Y Rao (CY)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

María M Muñoz (MM)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Ann M Powers (AM)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Claudia Cuéllar (C)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Rita Helfand (R)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Claudia Huguett (C)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Denise J Jamieson (DJ)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Margaret A Honein (MA)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

Martha L Ospina Martínez (ML)

From Instituto Nacional de Salud (O.P., M.B., N.T., A.V.P., E.L.C., L.P., A.R., M.G., M.M., P.C., M.M.D., C.H., M.L.O.M.) and Ministerio de Salud y Protección Social (M.M.M., C.C.) - both in Bogota, Colombia; and the Centers for Disease Control and Prevention, Atlanta (C.A.N., D.V., S.L.F., V.T.T., A.E.-B., J.R., C.Y.R., A.M.P., R.H., D.J.J., M.A.H.).

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