miércoles, 13 de abril de 2016

La ECDC actualiza su Rapid Risk Assesment

El día 11 de abril de 2016 la ECDC  ha publicado su quinta actualización del Rapid Risk Assesment. Me parece para leérselo del principio al final pero destacaría unos párrafos.


Situación base

Towards the end of 2014, Brazil detected a cluster of cases of febrile rash in the northeast region of the country. The diagnosis of Zika virus infection was confirmed in May 2015 by reverse transcriptase polymerase chain reaction (RT-PCR) assay. The Brazilian Ministry of Health estimated that in 2015 between 0.4 and 1.3 million cases of Zika virus infection occurred in the country, significantly exceeding the number of reported cases [26]. On 18 February 2016, Zika virus infection became a notifiable disease in Brazil [27]. As of 29 March 2016, all 27 Brazilian states report ongoing transmission of Zika virus.

No se entiende por qué no publica datos Brasil.


Datos de Europa

As of 5 April 2016, no autochthonous vector-borne Zika virus transmission has been reported in the continental EU. ECDC is collecting data regarding imported cases through the media and official government communication lines. As of 5 April 2016, ECDC has recorded 359 imported cases in 17 EU/EEA countries. Twenty-three of the imported cases are pregnant women. In addition, information about one confirmed case was published following the diagnosis in a Slovenian hospital [31].The number of imported cases reported is not based on systematic reporting through surveillance systems and hence cannot be considered exhaustive.

Several outermost regions (OMR) and overseas countries and territories (OCT) continue to report autochthonous transmission: French Guiana, Guadeloupe, Martinique, Saint Martin and Sint Maarten.

Microcephaly and congenital central nervous system malformations

Hace una revisión de la información sobre microcefalias y afectaciones neurológicas muy interesante
Habla del riesgo de transmisión mediante productos de origen humano (SoHo)


Estudio de de  seguimiento de: Zika congenital syndrome in Europe.

ECDC is developing a framework for the surveillance of Zika virus infection in EU/EEA Member States and specific surveillance of Zika congenital syndrome in Europe. EU surveillance would aim to monitor the occurrence of autochthonous Zika virus infections and support assessment of the risk of local transmission in the EU/EEA in order to trigger appropriate control measures, especially in receptive areas where the vector is present. Surveillance objectives are: i) early detection of autochthonous Zika virus infections; ii) timely detection of imported Zika virus infections in regions where the vector is established; iii) support for the assessment of the risk of local transmission in the EU/EEA

Risk related to mass gatherings  (JJOO)

Hace una previsión de riesgo para los JJOO basado en el modelo dengue, como hicimos en esta entrada con la diferencia que contábamos con poder tener datos de Brasil para poder ver si el modelo era el adecuado.

Lo compara con la Copa el Mundo de 2014:

An analysis of the 2014 World Cup in Brazil indicated the following:
  The density of dengue cases in Brazil was very low in the southern hemisphere (mid-June to mid-September). Therefore, the risk of vector-borne transmission of Zika virus infection during the Olympic Games is expected to be low – by analogy with the transmission of dengue which involves the same vectors [76]. 
 Only three exported cases of dengue fever were reported among returning travellers who attended the event [76]. The estimated expected number of dengue cases among the 600 000 foreign tourists during the World Cup was 33 (range 3 to 59) according to a modelling exercise conducted before the event

Previmos: altas incidencias en las semanas 9 a 19, caídas de la 20 a 28 y muy bajas tasas de incidencia y casos de la semana 29 a la 41.

Ahora no sabemos donde estamos, y entiendo que la ECDC tampoco lo sabe.

Al final de la corrida el asunto es que será invierno en Brasil  y habrá pocos mosquitos, aunque

Although the probability of being bitten by an infected mosquito is expected to be very low during the events, it cannot be excluded that Zika-infected travellers will return to regions of the EU where competent vectors are active. This may create an opportunity for local vector-borne transmission.

Risk of importation and transmission in the continental EU

The risk of transmission of Zika virus infection is extremely low in the EU during the early spring season as the climatic conditions are not suitable for the activity of the Aedes albopictus mosquitoes. 

The suitable conditions for Aedes albopictus activity will increase progressively during the spring (April to June) especially in southern Europe. For the months April to June, the International Research Institute for Climate and Society of the Earth Institute (University of Colombia, US) predicts above-normal temperatures in western Europe coinciding with a normal precipitation pattern, which might result in an early start of the mosquito activity season in southern Europe [86].

 During the summer season most likely from July by analogy with other mosquito-borne disease transmission in the EU, autochthonous transmission in the continental EU following the introduction of the virus by a viraemic traveller is possible in areas where Aedes albopictus is established

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