Although active transmission of the Zika virus (ZIKV) has not been reported in Spain, large numbers of people travel between Spain and Latin American and Caribbean countries with high incidence and prevalence of infection in recent years. Despite this risk, the incidence of travel-related and subsequent congenital ZIKV infection in Spain is currently unknown. Collaborating centres across Spain have created the PEDZIKARED and GESTZIKARED cohorts of neonates and children exposed to ZIKA virus and pregnant women exposed to ZIKA virus in order to address this knowledge gap and to study the epidemiology, clinical profile, diagnostic test, evolution and prognosis of ZIKV infection among pregnant women and children.
Major tropical infection referral centres in Barcelona and Madrid participated in these prospective studies, entering clinical and laboratory data for both pregnant women and neonates and children diagnosed with ZIKV infection, as well as children born to women testing positive for ZIKV infection during pregnancy. Data collection began in May 2016, and as of December 2017 105 children were enrolled. Four of these children presented with vector acquired ZIKV infection, three exposed during a trip to Honduras and the fourth exposed in Colombia prior to emigrating to Spain. Of the remaining 101 cases of prenatally ZIKV-exposed children, all but 2% of their mothers had arrived in Spain from Latin American or Caribbean countries during pregnancy. Prevalence of microcephaly was of 2.0% among all children born to ZIKV-infected mothers. Notably, 96% of all the children did not have a definitive laboratory diagnosis of ZIKV infection.
These cohorts are important to understand how and when improvements can be made in diagnosing, evaluating and treating women and children exposed to ZIKV. Our aim is to address the risk posed by travel-related ZIKV infection in Spain and to coordinate efforts on the national level to minimize the impact of ZIKV infection, improving both prevention efforts and care for those impacted by the virus.
Toni Soriano Arandes is Pediatricians, MSc Epidemiology LSHTM, MSc Tropical Medicine. Hospital Universitari Vall Hebron-ICS Barcelona, Spain.
