Seroepidemiologic Screening for Zoonotic Viral Infections, Maputo, Mozambique

Cases of Guillain-Barré syndrome were also recorded during the Zika outbreak in Brazil (6). Moreover, soon after health authorities in Brazil warned of an increase in the prevalence of microcephaly in newborns that might be associated with Zika virus infection in mothers during pregnancy, health authorities in French Polynesia confirmed that neurologic congenital abnormalities also had been observed during the Zika outbreak there (6). Other lessons learned from the emergence of CHIKV and Zika virus in small tropical islands include evidence of nonvectorborne virus transmission and its associated public health implications. Perinatal transmission of Zika virus to a neonate was first described in infected pregnant women in French Polynesia, and possible transplacental transmission was further corroborated by the detection of the virus in amniotic fluid samples of 2 pregnant women in Brazil whose fetuses had been diagnosed with microcephaly (6). Sexual transmission of Zika virus, suggested by Foy et al. (7), was corroborated by detection of virus in the semen of a patient in French Polynesia (8). To prevent transmission of CHIKV and Zika virus by blood transfusion, local blood banks in French Polynesia and the Caribbean adjusted their algorithms for blood donation and screening of blood products during outbreaks (9,10). When we observe the geographic distribution of DENV, CHIKV, and Zika virus over the past decade, DENV expansion appears to have been a continuous process. However, the emergence of CHIKV, first in the Indian Ocean and later in the Caribbean, and the emergence of Zika virus in the Pacific has dramatically expanded the reach of these viruses (Figure).