Epidemiological and ecological determinants of Zika virus transmission in an urban setting
- University of Oxford, United Kingdom
- FIOCRUZ, Brazil
- Université de Montpellier, France
- Centre of PostGraduation in Collective Health, Universidade Estadual de Feira de Santana, Brazil
- University of Exeter, United Kingdom
Abstract
The Zika virus has emerged as a global public health concern. Its rapid geographic expansion is attributed to the success of Aedes mosquito vectors, but local epidemiological drivers are still poorly understood. Feira de Santana played a pivotal role in the Chikungunya epidemic in Brazil and was one of the first urban centres to report Zika infections. Using a climate-driven transmission model and notified Zika case data, we show that a low observation rate and high vectorial capacity translated into a significant attack rate during the 2015 outbreak, with a subsequent decline in 2016 and fade-out in 2017 due to herd-immunity. We find a potential Zika-related, low risk for microcephaly per pregnancy, but with significant public health impact given high attack rates. The balance between the loss of herd-immunity and viral re-importation will dictate future transmission potential of in this urban setting.
Article and author information
Author details
Nuno Rodrigues Faria
Christian Julian Villabona-Arenas
Funding
European Research Council (614725-PATHPHYLODYN)
- Oliver G Pybus
Royal Society
- Mario Recker
Wellcome Trust & Royal Society (204311/Z/16/Z)
- Nuno Rodrigues Faria
Engineering and Physical Sciences Research Council
- Ben Lambert
European Research Council (268904 - DIVERSITY)
- José Lourenço
- Andrew Walker
International Development Emerging Pandemic Threats Program-2 (AID-OAA-A-14-00102)
- Moritz UG Kraemer
Labex EpiGenMed (ANR-10-LABX-12-01)
- Christian Julian Villabona-Arenas
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Reviewing Editor
- Mark Jit, London School of Hygiene & Tropical Medicine, and Public Health England, United Kingdom
Publication history
- Received: June 21, 2017
- Accepted: September 4, 2017
- Accepted Manuscript published: September 9, 2017 (version 1)
- Version of Record published: October 12, 2017 (version 2)
Copyright
© 2017, Lourenço et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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Epidemiological and ecological determinants of Zika virus transmission in an urban setting
eLife 6:e29820.
https://doi.org/10.7554/eLife.29820
Further reading
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- Epidemiology and Global Health
- Microbiology and Infectious Disease
eLife has published papers on many tropical diseases, including malaria, Ebola, leishmaniases, Dengue and African sleeping sickness.
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- Epidemiology and Global Health
- Medicine
Background:
The association between cardiovascular disease (CVD) and selected psychiatric disorders has frequently been suggested while the potential role of familial factors and comorbidities in such association has rarely been investigated.
Methods:
We identified 869,056 patients newly diagnosed with CVD from 1987 to 2016 in Sweden with no history of psychiatric disorders, and 910,178 full siblings of these patients as well as 10 individually age- and sex-matched unrelated population controls (N = 8,690,560). Adjusting for multiple comorbid conditions, we used flexible parametric models and Cox models to estimate the association of CVD with risk of all subsequent psychiatric disorders, comparing rates of first incident psychiatric disorder among CVD patients with rates among unaffected full siblings and population controls.
Results:
The median age at diagnosis was 60 years for patients with CVD and 59.2% were male. During up to 30 years of follow-up, the crude incidence rates of psychiatric disorder were 7.1, 4.6, and 4.0 per 1000 person-years for patients with CVD, their siblings and population controls. In the sibling comparison, we observed an increased risk of psychiatric disorder during the first year after CVD diagnosis (hazard ratio [HR], 2.74; 95% confidence interval [CI], 2.62–2.87) and thereafter (1.45; 95% CI, 1.42–1.48). Increased risks were observed for all types of psychiatric disorders and among all diagnoses of CVD. We observed similar associations in the population comparison. CVD patients who developed a comorbid psychiatric disorder during the first year after diagnosis were at elevated risk of subsequent CVD death compared to patients without such comorbidity (HR, 1.55; 95% CI, 1.44–1.67).
Conclusions:
Patients diagnosed with CVD are at an elevated risk for subsequent psychiatric disorders independent of shared familial factors and comorbid conditions. Comorbid psychiatric disorders in patients with CVD are associated with higher risk of cardiovascular mortality suggesting that surveillance and treatment of psychiatric comorbidities should be considered as an integral part of clinical management of newly diagnosed CVD patients.
Funding:
This work was supported by the EU Horizon 2020 Research and Innovation Action Grant (CoMorMent, grant no. 847776 to UV, PFS, and FF), Grant of Excellence, Icelandic Research Fund (grant no. 163362-051 to UV), ERC Consolidator Grant (StressGene, grant no. 726413 to UV), Swedish Research Council (grant no. D0886501 to PFS), and US NIMH R01 MH123724 (to PFS).
