Title: #Incidence of #Zika Virus Disease by #Age and #Sex — #PuertoRico, November 1, 2015–October 20, 2016.
Subject: Zika Virus, epidemiological report.
Source: US Centers for Disease Control and Prevention (CDC), MMWR Morbidity and Mortality Weekly Report, full page: (LINK). Abstract.
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Incidence of Zika Virus Disease by Age and Sex — Puerto Rico, November 1, 2015–October 20, 2016
Weekly / November 11, 2016 / 65(44);1219–1223
Format: [ PDF [253 KB] ]
Matthew Lozier, PhD1; Laura Adams, DVM1; Mitchelle Flores Febo, MS1,2; Jomil Torres-Aponte, MS2; Melissa Bello-Pagan, MS2; Kyle R. Ryff, MPH2; Jorge Munoz-Jordan, PhD1; Myriam Garcia3,4; Aidsa Rivera, MS1; Jennifer S. Read, MD1; Stephen H. Waterman, MD1; Tyler M. Sharp, PhD1; Brenda Rivera-Garcia, DVM2
Corresponding author: Matthew Lozier, email@example.com, 787-706-2264.
1 Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC; 2Office of Epidemiology and Research, Puerto Rico Department of Health; 3Biological and Chemical Emergencies Laboratory, Office of Public Health Preparedness and Response, Puerto Rico Department of Health; 4Public Health Laboratory, Puerto Rico Department of Health.
Suggested citation for this article: Lozier M, Adams L, Febo MF, et al. Incidence of Zika Virus Disease by Age and Sex — Puerto Rico, November 1, 2015–October 20, 2016. MMWR Morb Mortal Wkly Rep 2016;65:1219–1223. DOI: http://dx.doi.org/10.15585/mmwr.mm6544a4.
- What is already known about this topic?
- Zika virus has been circulating in Puerto Rico since November 2015.
- Previous reports from Brazil and El Salvador have demonstrated higher rates of infection in females, and suggested that Zika virus disease incidence is higher among persons aged 20–49 years.
- What is added by this report?
- Among 28,219 nonpregnant persons with laboratory evidence of Zika virus disease identified in Puerto Rico during November 1, 2015–October 20, 2016, incidence was highest among women aged 20–49 years.
- Women aged 40–79 years with suspected cases were more likely to test positive for Zika virus infection than those in males in the same age group.
- What are the implications for public health practice?
- Serosurveys are needed to identify the rates of Zika virus infection among males and females of all ages in Puerto Rico to determine whether observed differential disease rates reflect differential rates of infection, development of disease, or seeking medical care.
- Accurate information on disease burden will enable identification of populations most affected to target health messaging and interventions.
- Residents of and travelers to Puerto Rico should remove or cover standing water, employ mosquito bite avoidance behaviors, take precautions to reduce the risk for sexual transmission, and seek medical care for any acute illness with rash or fever.
Zika virus is a flavivirus transmitted primarily by Aedes species mosquitoes; symptoms of infection include rash, arthralgia, fever, and conjunctivitis.*,† Zika virus infection during pregnancy can cause microcephaly and other serious brain anomalies (1), and in rare cases, Zika virus infection has been associated with Guillain-Barré syndrome (2) and severe thrombocytopenia (3). This report describes the incidence of reported symptomatic Zika virus disease in the U.S. territory of Puerto Rico by age and sex. During November 1, 2015–October 20, 2016, 62,500 suspected Zika virus disease cases were reported to the Puerto Rico Department of Health (PRDH); 29,345 (47%) were confirmed by reverse transcription–polymerase chain reaction (RT-PCR) testing, or were presumptively diagnosed based on serological testing. The highest incidence among confirmed or presumptive cases occurred among persons aged 20–29 years (1,150 cases per 100,000 residents). Among 28,219 (96.2%) nonpregnant patients with confirmed or presumptive Zika virus disease, incidence was higher among women (936 per 100,000 population) than men (576 per 100,000) for all age groups ≥20 years, and the majority (61%) of reported Zika virus disease cases occurred in females. Among suspected Zika virus disease cases in nonpregnant adults aged ≥40 years, the percentage that tested positive among females (52%) was higher than that among males (47%) (p<0.01). Reasons for the higher incidence of Zika virus disease among women aged ≥20 years are not known; serosurveys of persons living near confirmed Zika virus disease cases might help to elucidate these findings. Residents of and travelers to Puerto Rico should remove or cover standing water, practice mosquito abatement, employ mosquito bite avoidance behaviors, take precautions to reduce the risk for sexual transmission, and seek medical care for any acute illness with rash or fever.
Keywords: US CDC; USA; Updates; Zika Virus; Puerto Rico.