Projecting the end of the Zika virus epidemic in Latin America: a modelling analysis

Kathleen M O’Reilly; Rachel Lowe; W John Edmunds; Philippe Mayaud; Adam Kucharski; Rosalind M Eggo; Sebastian Funk; Deepit Bhatia; Kamran Khan; Moritz U Kraemar; Annelies Wilder-Smith; Laura C Rodrigues; Patricia Brasil; Eduardo Massad; Thomas Jaenisch; Simon Cauchemez; Oliver J Brady; Laith Yakob

Major questions on the epidemiology of ZIKV remain unanswered. 7 Whilst the impact of sexual transmission on ZIKV emergence is likely to be minimal, 35, 46 it may increase the magnitude of an epidemic 36 and this would be difficult to test using the available surveillance data. There are large differences in the incidence of congenital Zika syndrome across LAC, 38 with an epicentre reported within northeast Brazil, that remain largely unexplained. In particular, the analysis here suggests increased incidence of Zika throughout Brazil in 2016, but the expected increase in congenital malformations within newborns were not observed. 47 This and other modelling studies suggest that ZIKV has been widespread, and the finding of geographically variable rates of congenital defects is discordant with the more consistent rates of ZIKV infection predicted by our model.