dc.contributor.authorLeder, Karin
dc.contributor.authorGrobusch, Martin P.
dc.contributor.authorGautret, Philippe
dc.contributor.authorChen, Lin H.
dc.contributor.authorKuhn, Susan
dc.contributor.authorLim, Poh Lian
dc.contributor.authorYates, Johnnie
dc.contributor.authorMcCarthy, Anne E.
dc.contributor.authorRothe, Camilla
dc.contributor.authorKato, Yasuyuki
dc.contributor.authorBottieau, Emmanuel
dc.contributor.authorHuber, Kristina
dc.contributor.authorSchwartz, Eli
dc.contributor.authorStauffer, William
dc.contributor.authorMalvy, Denis
dc.contributor.authorShaw, Marc T. M.
dc.contributor.authorRapp, Christophe
dc.contributor.authorBlumberg, Lucille
dc.contributor.authorJensenius, Mogens
dc.contributor.authorvan Genderen, Perry J. J.
dc.contributor.authorHamer, Davidson H.
dc.contributor.editorJin, Xia*
dc.date.accessioned2017-12-14T04:25:34Z
dc.date.available2017-12-14T04:25:34Z
dc.date.issued2017
dc.identifier.citationLeder, K., Grobusch, M. P., Gautret, P., Chen, L. H., Kuhn, S., Lim, P. L., et al. (2017). Zika beyond the Americas: Travelers as sentinels of Zika virus transmission. A GeoSentinel analysis, 2012 to 2016. PLOS ONE, 12(10), e0185689-.en_US
dc.identifier.urihttp://hdl.handle.net/10220/44147
dc.description.abstractBackground : Zika virus (ZIKV) was first isolated in Africa; decades later, caused large outbreaks in the Pacific, and is considered endemic in Asia. We aim to describe ZIKV disease epidemiology outside the Americas, the importance of travelers as sentinels of disease transmission, and discrepancies in travel advisories from major international health organizations. Methods and findings : This descriptive analysis using GeoSentinel Surveillance Network records involves sixty-four travel and tropical medicine clinics in 29 countries. Ill returned travelers with a confirmed or probable diagnosis of ZIKV disease acquired in Africa, Asia and the Pacific seen between 1 January 2012 and 31 December 2016 are included, and the frequencies of demographic, trip, and diagnostic characteristics described. ZIKV was acquired in Asia (18), the Pacific (10) and Africa (1). For five countries (Indonesia, Philippines, Thailand, Vietnam, Cameroon), GeoSentinel patients were sentinel markers of recent Zika activity. Additionally, the first confirmed ZIKV infection acquired in Kiribati was reported to GeoSentinel (2015), and a probable case was reported from Timor Leste (April 2016), representing the only case known to date. Review of Zika situation updates from major international health authorities for country risk classifications shows heterogeneity in ZIKV country travel advisories. Conclusions : Travelers are integral to the global spread of ZIKV, serving as sentinel markers of disease activity. Although GeoSentinel data are collected by specialized clinics and do not capture all imported cases, we show that surveillance of imported infections by returned travelers augments local surveillance system data regarding ZIKV epidemiology and can assist with risk categorization by international authorities. However, travel advisories are variable due to risk uncertainties.en_US
dc.format.extent23 p.en_US
dc.language.isoenen_US
dc.relation.ispartofseriesPLOS ONEen_US
dc.rights© 2017 Leder et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_US
dc.subjectZIKAen_US
dc.subjectTransmissionen_US
dc.titleZika beyond the Americas: Travelers as sentinels of Zika virus transmission. A GeoSentinel analysis, 2012 to 2016en_US
dc.typeJournal Article
dc.contributor.schoolLee Kong Chian School of Medicineen_US
dc.identifier.doihttp://dx.doi.org/10.1371/journal.pone.0185689
dc.description.versionPublished versionen_US


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