International travelers and genomics uncover a ‘hidden’ Zika outbreak

Nathan D. Grubaugh; Sharada Saraf; Karthik Gangavarapu; Alexander Watts; Amanda L. Tan; Rachel J. Oidtman; Jason T. Ladner; Glenn Oliveira; Nathaniel L. Matteson; Moritz U.G. Kraemer; Chantal B.F. Vogels; Aaron Hentoff; Deepit Bhatia; Danielle Stanek; Blake Scott; Vanessa Landis; Ian Stryker; Marshall R. Cone; Edgar W. Kopp; Andrew C. Cannons; Lea Heberlein-Larson; Stephen White; Leah D. Gillis; Michael J. Ricciardi; Jaclyn Kwal; Paola K. Lichtenberger; Diogo M. Magnani; David I. Watkins; Gustavo Palacios; Davidson H. Hamer; Lauren M. Gardner; T. Alex Perkins; Guy Baele; Kamran Khan; Andrea Morrison; Sharon Isern; Scott F. Michael; Kristian G. Andersen

We collected air passenger volumes to calculate Zika and dengue virus travel incidence rates, to assess the potential for Zika virus importations into Cuba, and to investigate potential Zika virus spread from Cuba. From the IATA (IATA, 2018), we obtained the number of passengers traveling by air between all destinations in the Americas, plus to all global destinations from Cuba, from 2010-2017. IATA data consists of global ticket sales which account for true origins and final destinations, and represents 90% of all commercial flights. The remaining 10% of trips are modeled using airline market intelligence. One limitation of IATA data is it does not include chartered flights, which through our investigations, was only an issue for flights to and from the United States and Cuba. To make up for this, we obtained chartered flight data from Cuba to The copyright holder for this preprint (which was not peer-reviewed) is the author/funder. It . https://doi.org/10.1101/496901 doi: bioRxiv preprint available at: