Epidemiology of the First Zika Virus Outbreak in the United States Virgin Islands, 2016–2017 Open Access

Abstract

Zika virus was first identified in the Americas in Brazil in March 2015 and the first case of Zika virus in the United States Virgin Islands (USVI) was reported on January 19, 2016. This investigation describes the epidemiology of Zika virus in a susceptible island population, including clinical features, demographic characteristics, and geospatial patterns. Data were from the USVI Zika surveillance system; the study population consists of 4,139 persons, of which 1,251 were laboratory-positive Zika cases. Prevalence ratios were calculated using log-binomial regression to evaluate the association between Zika virus disease and several demographic characteristics and clinical features. The physical home addresses of laboratory-positive Zika cases were geocoded to identify estates with increased Zika virus transmission. Contact with a recently ill household member was associated with laboratory-positive Zika virus infection (adjusted PR= 1.39, 95% CI: 1.04, 1.86) and pregnancy was associated with not being a case (adjusted PR= 0.17, 95% CI: 0.11, 0.25). Rash (adjusted PR= 3.70, 95% CI: 3.33, 4.12), conjunctivitis (adjusted PR= 1.13, 95% CI: 1.04, 1.22), and arthralgia or arthritis (adjusted PR= 1.31, 95% CI: 1.19, 1.44) were associated with laboratory-positive Zika virus infection, whereas cold-like symptoms (adjusted PR: 0.85, 95% CI: 0.76, 0.94) and gastrointestinal symptoms (adjusted PR: 0.83, 95% CI: 0.74, 0.94) were associated with not being a case. Based on the geospatial patterns of Zika cases, increased transmission occurred in and around cities and seaports. These results enhance our knowledge of the effect of Zika virus in a susceptible island population, highlight the importance of timely public health intervention, and aid in public health planning for future Zika outbreaks in the USVI. Specifically, the USVI Department of Health can utilize these results to: (1) strengthen public health surveillance by implementing syndromic surveillance for increased rash, conjunctivitis, and arthralgia or arthritis, (2) target vector control efforts in areas with increased Zika virus transmission, and (3) increase messaging for personal protection against mosquitoes, especially among those who are ill.

 

 

 

Table of Contents

Introduction............................................................................................................................................................................ 1

 

Methods................................................................................................................................................................................... 3

 

Results..................................................................................................................................................................................... 5

 

Discussion................................................................................................................................................................................ 8

 

References.............................................................................................................................................................................. 14

 

Tables...................................................................................................................................................................................... 18

 

Figures.................................................................................................................................................................................... 19

 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Global Epidemiology
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	Virgin Islands Zika Caribbean Zika virus
Committee Chair / Thesis Advisor	Kitron, Uriel, Emory University
Committee Members	Ellis, Esther, U.S. Virgin Islands Department of Health
Partnering Agencies	State or local health department (not in Georgia)

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