Evidence of Ongoing Transmission of Zika Virus in Mérida, Mexico

James T. Earnest Department of Environmental Sciences, Emory University, Atlanta, Georgia;

Search for other papers by James T. Earnest in
Current site
Google Scholar
PubMed
Close
,
Karina Jacqueline Ciau-Carillo Laboratorio de Virologia, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán, Mérida, Mexico;

Search for other papers by Karina Jacqueline Ciau-Carillo in
Current site
Google Scholar
PubMed
Close
,
Oscar D. Kirstein Department of Environmental Sciences, Emory University, Atlanta, Georgia;

Search for other papers by Oscar D. Kirstein in
Current site
Google Scholar
PubMed
Close
,
Azael Che-Mendoza Unidad Colaborativa para Bioensayos Entomologicos, Campus de Ciencias Biológicas y Agropecurias, Universidad Autónoma de Yucatán, Mérida, Mexico;

Search for other papers by Azael Che-Mendoza in
Current site
Google Scholar
PubMed
Close
,
Daniel O. Espinoza Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia;

Search for other papers by Daniel O. Espinoza in
Current site
Google Scholar
PubMed
Close
,
Henry Puerta-Guardo Laboratorio de Virologia, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán, Mérida, Mexico;
Unidad Colaborativa para Bioensayos Entomologicos, Campus de Ciencias Biológicas y Agropecurias, Universidad Autónoma de Yucatán, Mérida, Mexico;

Search for other papers by Henry Puerta-Guardo in
Current site
Google Scholar
PubMed
Close
,
Kevin Yam-Trujillo Laboratorio de Virologia, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán, Mérida, Mexico;

Search for other papers by Kevin Yam-Trujillo in
Current site
Google Scholar
PubMed
Close
,
Manuel Parra-Cardeña Laboratorio de Virologia, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán, Mérida, Mexico;

Search for other papers by Manuel Parra-Cardeña in
Current site
Google Scholar
PubMed
Close
,
Gloria A. Barrera-Fuentes Unidad Colaborativa para Bioensayos Entomologicos, Campus de Ciencias Biológicas y Agropecurias, Universidad Autónoma de Yucatán, Mérida, Mexico;
Laboratorio de Hematologia, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán, Mérida, Mexico;

Search for other papers by Gloria A. Barrera-Fuentes in
Current site
Google Scholar
PubMed
Close
,
Norma Pavia-Ruz Laboratorio de Hematologia, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán, Mérida, Mexico;

Search for other papers by Norma Pavia-Ruz in
Current site
Google Scholar
PubMed
Close
,
Fabian Correa-Morales Centro Nacional de Programas Preventivos y Control de Enfermedades (CENAPRECE), Secretaria de Salud Mexico, Mexico City, Mexico;

Search for other papers by Fabian Correa-Morales in
Current site
Google Scholar
PubMed
Close
,
Hector Gomez-Dantes Health Systems Research Centre, National Institute of Public Health, Cuernavaca, Mexico;

Search for other papers by Hector Gomez-Dantes in
Current site
Google Scholar
PubMed
Close
,
Pilar Granja-Perez Servicios de Salud de Yucatán, Mérida, Mexico

Search for other papers by Pilar Granja-Perez in
Current site
Google Scholar
PubMed
Close
,
Salha Villanueva Servicios de Salud de Yucatán, Mérida, Mexico

Search for other papers by Salha Villanueva in
Current site
Google Scholar
PubMed
Close
,
Pablo Manrique-Saide Unidad Colaborativa para Bioensayos Entomologicos, Campus de Ciencias Biológicas y Agropecurias, Universidad Autónoma de Yucatán, Mérida, Mexico;

Search for other papers by Pablo Manrique-Saide in
Current site
Google Scholar
PubMed
Close
,
Guadalupe Ayora-Talavera Laboratorio de Virologia, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán, Mérida, Mexico;

Search for other papers by Guadalupe Ayora-Talavera in
Current site
Google Scholar
PubMed
Close
,
Matthew H. Collins Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia;

Search for other papers by Matthew H. Collins in
Current site
Google Scholar
PubMed
Close
, and
Gonzalo Vazquez-Prokopec Department of Environmental Sciences, Emory University, Atlanta, Georgia;

Search for other papers by Gonzalo Vazquez-Prokopec in
Current site
Google Scholar
PubMed
Close
Restricted access

ABSTRACT.

Since the Zika virus (ZIKV) pandemic in 2015–2017, there has been a near absence of reported cases in the Americas outside of Brazil. However, the conditions for Aedes-borne transmission persist in Latin America, and the threat of ZIKV transmission is increasing as population immunity wanes. Mexico has reported only 70 cases of laboratory-confirmed ZIKV infection since 2020, with no cases recorded in the Yucatán peninsula. Here, we provide evidence of active ZIKV transmission, despite the absence of official case reports, in the city of Mérida, Mexico, the capital of the state of Yucatán. Capitalizing on an existing cohort, we detected cases in participants with symptoms consistent with flavivirus infection from 2021 to 2022. Serum samples from suspected cases were tested for ZIKV RNA by polymerase chain reaction or ZIKV-reactive IgM by ELISA. To provide more specific evidence of exposure, focus reduction neutralization tests were performed on ELISA-positive samples. Overall, we observed 25 suspected ZIKV infections for an estimated incidence of 2.8 symptomatic cases per 1,000 persons per year. Our findings emphasize the continuing threat of ZIKV transmission in the setting of decreased surveillance and reporting.

    • Supplemental Materials (PDF 1970.6 KB)

Author Notes

Financial support: This study was funded by the National Institutes of Health, National Institute of Allergy and Infectious Diseases (U01AI148069; Vazquez-Prokopec, PI). The funders have not had a role in the study’s design and will not be involved in the collection, analysis, or interpretation of the data.

Disclosure: The trial protocol was approved by Emory University (IRB00108666) and the Autonomous University of Yucatán (CEI-05-2020) and received endorsement by the Ministry of Health of the State of Yucatán and the Federal Ministry of Health of Mexico. Written consent/assent was obtained from the parents of all participants in their native Spanish language. The trial was registered in ClinicalTrials.gov (identifier NCT04343521; registered on April 13, 2020) and complied with the WHO International Clinical Trials Registry Platform requirements. An independent external monitor reviews consents, adverse effects, and other trial performance metrics yearly.

Authors’ addresses: James T. Earnest, Oscar D. Kirstein, and Gonzalo Vazquez-Prokopec, Department of Environmental Sciences, Emory University, Atlanta, GA, E-mails: jtearne@emory.edu, odkirstein@emory.edu, and gmvazqu@emory.edu. Karina Jacqueline Ciau-Carillo, Kevin Yam-Trujillo, Manuel Parra-Cardeña, and Guadalupe Ayora-Talavera, Laboratorio de Virologia, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán, Mérida, Mexico, E-mails: jciauca@gmail.com, jorge.yam@correo.uady.mx, manuelparra9789@gmail.com, and talavera@correo.uady.mx. Azael Che-Mendoza and Pablo Manrique-Saide, Unidad Colaborativa para Bioensayos Entomologicos, Campus de Ciencias Biológicas y Agropecurias, Universidad Autónoma de Yucatán, Mérida, Mexico, E-mails: achemendoza_vectores@hotmail.com and pablo_manrique2000@hotmail.com. Daniel O. Espinoza and Matthew H. Collins, Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, E-mails: daniel.omar.espinoza@emory.edu and matthew.collins@emory.edu. Henry Puerta-Guardo, Laboratorio de Virologia, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán, Mérida, Mexico, and Unidad Colaborativa para Bioensayos Entomologicos, Campus de Ciencias Biológicas y Agropecurias, Universidad Autónoma de Yucatán, Mérida, Mexico, E-mail: hpuertaguardo@gmail.com. Gloria A. Barrera-Fuentes, Unidad Colaborativa para Bioensayos Entomologicos, Campus de Ciencias Biológicas y Agropecurias, Universidad Autónoma de Yucatán, Mérida, Mexico, and Laboratorio de Hematologia, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán, Mérida, Mexico, E-mail: gloria.barrera@correo.uady.mx. Norma Pavia-Ruz, Laboratorio de Hematologia, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán, Mérida, Mexico, E-mail: norma_pavia_ruz@hotmail.com. Fabian Correa-Morales, Centro Nacional de Programas Preventivos y Control de Enfermedades (CENAPRECE), Secretaria de Salud Mexico, Mexico City, Mexico, E-mail: fabian.correa@salud.gob.mx. Hector Gomez-Dantes, Health Systems Research Centre, National Institute of Public Health, Cuernavaca, Mexico, E-mail: hector.gomez@insp.mx. Pilar Granja-Perez and Salha Villanueva, Servicios de Salud de Yucatán, Mérida, Mexico, E-mails: pilar.granja@ssy.gob.mx and salha.villanueva@ssy.gob.mx.

Address correspondence to James T. Earnest, Department of Environmental Sciences, Emory University, 400 Dowman Dr. W507, Atlanta, GA 30307. E-mail: jtearne@emory.edu
  • 1.

    de Oliveira WK , de França GVA , Carmo EH , Duncan BB , de Souza Kuchenbecker R , Schmidt MI , 2017. Infection-related microcephaly after the 2015 and 2016 Zika virus outbreaks in Brazil: a surveillance-based analysis. Lancet 390: 861870.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Gulland A , 2016. Zika virus is a global public health emergency, declares WHO. BMJ 352: i657.

  • 3.

    Yakob L , 2022. Zika virus after the public health emergency of international concern period, Brazil. Emerg Infect Dis 28: 837840.

  • 4.

    2017–2023. Boletín Epidemiológico Sistema Nacional de Vigilancia Epidemiológica Sistema Único de Información. Salud Sd Mexico City, Mexico. Available at: https://www.gob.mx/salud/acciones-y-programas/historico-boletin-epidemiologico. Accessed February 5, 2024.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Henderson AD et al., 2020. Zika seroprevalence declines and neutralizing antibodies wane in adults following outbreaks in French Polynesia and Fiji. eLife 9: e48460.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Zepeda O et al., 2023. Antibody immunity to Zika virus among young children in a flavivirus-endemic area in Nicaragua. Viruses 15: 796.

  • 7.

    Dick GW , Kitchen SF , Haddow AJ , 1952. Zika virus. I. Isolations and serological specificity. Trans R Soc Trop Med Hyg 46: 509520.

  • 8.

    Premkumar L et al., 2018. Development of envelope protein antigens to serologically differentiate Zika virus infection from dengue virus infection. J Clin Microbiol 56: e01504-17.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Priyamvada L , Suthar MS , Ahmed R , Wrammert J , 2017. Humoral immune responses against Zika virus infection and the importance of preexisting flavivirus immunity. J Infect Dis 216: S906S911.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Stettler K et al., 2016. Specificity, cross-reactivity, and function of antibodies elicited by Zika virus infection. Science 353: 823826.

  • 11.

    Cardenas VM , Paternina-Caicedo AJ , Salvatierra EB , 2019. Underreporting of fatal congenital Zika syndrome, Mexico, 2016–2017. Emerg Infect Dis 25: 15601562.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Bisanzio D et al., 2018. Spatio-temporal coherence of dengue, chikungunya and Zika outbreaks in Merida, Mexico. PLoS Negl Trop Dis 12: e0006298.

  • 13.

    Pavía-Ruz N , Diana Patricia R , Salha V , Granja P , Balam-May A , Longini IM , Halloran ME , Manrique-Saide P , Gómez-Dantés H , 2018. Seroprevalence of dengue antibodies in three urban settings in Yucatan, Mexico. Am J Trop Med Hyg 98: 12021208.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Rojas DP , Barrera-Fuentes GA , Pavia-Ruz N , Salgado-Rodriguez M , Che-Mendoza A , Manrique-Saide P , Vazquez-Prokopec GM , Halloran ME , Longini IM , Gomez-Dantes H , 2018. Epidemiology of dengue and other arboviruses in a cohort of school children and their families in Yucatan, Mexico: baseline and first year follow-up. PLoS Negl Trop Dis 12: e0006847.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Manrique-Saide P et al., 2020. The TIRS trial: protocol for a cluster randomized controlled trial assessing the efficacy of preventive targeted indoor residual spraying to reduce Aedes-borne viral illnesses in Merida, Mexico. Trials 21: 839.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Pan American Health Organization , World Health Organization , 2023. Epidemiological Update: Dengue, Chikungunya, and Zika – 10 June 2023. Washington, DC: Pan American Health Organization.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Instituto Nacional de Estadística y Geografía (INEGI) México , 2015. Principales Resultados de la Encuesta Intercensal 2015: Yucatán. Available at: http://internet.contenidos.inegi.org.mx/contenidos/productos/prod_serv/contenidos/espanol/bvinegi/productos/nueva_estruc/inter_censal/estados2015/702825080051.pdf. Accessed August 5, 2023.

    • PubMed
    • Export Citation
  • 18.

    Bisanzio D et al., 2018. Spatio-temporal coherence of dengue, chikungunya and Zika outbreaks in Merida, Mexico. PLoS Negl Trop Dis 12: e0006298.

  • 19.

    Rojas DP , Barrera-Fuentes GA , Pavia-Ruz N , Salgado-Rodriguez M , Che-Mendoza A , Manrique-Saide P , Vazquez-Prokopec GM , Halloran ME , Longini IM , Gomez-Dantes H , 2018. Epidemiology of dengue and other arboviruses in a cohort of school children and their families in Yucatan, Mexico: baseline and first year follow-up. PLoS Negl Trop Dis 12: e0006847.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Pavia-Ruz N et al., 2018. Dengue seroprevalence in a cohort of schoolchildren and their siblings in Yucatan, Mexico (2015–2016). PLoS Negl Trop Dis 12: e0006748.

  • 21.

    Pavia-Ruz N , Diana Patricia R , Salha V , Granja P , Balam-May A , Longini IM , Halloran ME , Manrique-Saide P , Gomez-Dantes H , 2018. Seroprevalence of dengue antibodies in three urban settings in Yucatan, Mexico. Am J Trop Med Hyg 98: 12021208.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Crisp AM , Halloran ME , Longini IM , Vazquez-Prokopec G , Dean NE , 2023. Covariate-constrained randomization with cluster selection and substitution. Clin Trials 20: 284292.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Basile AJ , Ao J , Horiuchi K , Semenova V , Steward-Clark E , Schiffer J , 2019. Performance of InBios ZIKV Detect 2.0 IgM Capture ELISA in two reference laboratories compared to the original ZIKV Detect IgM Capture ELISA. J Virol Methods 271: 113671.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Lanciotti RS , Kosoy OL , Laven JJ , Velez JO , Lambert AJ , Johnson AJ , Stanfield SM , Duffy MR , 2008. Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect Dis 14: 12321239.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Roehrig JT , Hombach J , Barrett AD , 2008. Guidelines for plaque-reduction neutralization testing of human antibodies to dengue viruses. Viral Immunol 21: 123132.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Bivand R , Pebesma EJ , Gómez-Rubio V , 2013. Applied Spatial Data Analysis with R. New York, NY: Springer.

  • 27.

    Pan American Health Organization , 2010. Dengue: Guías de Atención para Enfermos en la Región de las Américas. La Paz, Bolivia: Organización Panamericana de la Salud.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Griffin I et al., 2019. Zika virus IgM 25 months after symptom onset, Miami-Dade County, Florida, USA. Emerg Infect Dis 25: 22642265.

  • 29.

    Stone M et al., 2020. Zika virus RNA and IgM persistence in blood compartments and body fluids: a prospective observational study. Lancet Infect Dis 20: 14461456.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Waller LA , Gotway CA , 2004. Applied Spatial Statistics for Public Health Data. Hoboken, NJ: Wiley Publishing.

  • 31.

    Haby MM , Pinart M , Elias V , Reveiz L , 2018. Prevalence of asymptomatic Zika virus infection: a systematic review. Bull World Health Organ 96: 402413D.

  • 32.

    Montoya M et al., 2018. Longitudinal analysis of antibody cross-neutralization following Zika virus and dengue virus infection in Asia and the Americas. J Infect Dis 218: 536545.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 658 658 191
Full Text Views 36 36 11
PDF Downloads 36 36 11
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save