Market2013–2014 Zika virus outbreaks in Oceania
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2013–2014 Zika virus outbreaks in Oceania

In October 2013, there was an outbreak of Zika fever in French Polynesia, the first outbreak of several Zika outbreaks across Oceania. With 8,723 cases reported, it was the largest outbreak of Zika fever before the outbreak in the Americas that began in April 2015. An earlier outbreak occurred on Yap Island in the Federated States of Micronesia in 2007, but it is thought that the 2013–2014 outbreak involved an independent introduction of the Zika virus from Southeast Asia. Investigators suggested that the outbreaks of mosquito-borne diseases in the Pacific from 2012 to 2014 were "the early stages of a wave that will continue for several years", particularly because of their vulnerability to infectious diseases stemming from isolation and immunologically naive populations.

Epidemiology
French Polynesia . In December 2013, an American traveler to Mo'orea was diagnosed with Zika virus infection in New York after an 11-day history of symptoms, becoming the first American tourist to be diagnosed with Zika. A Japanese tourist returning to Japan was also diagnosed with Zika virus infection by the National Institute of Infectious Diseases after visiting Bora Bora, becoming the first imported case of Zika fever in Japan. By February 2014, it was estimated that more than 29,000 people with Zika-like symptoms had sought medical care, roughly 11.5% of the population, and on 25 February, the Norwegian Institute of Public Health reported that a traveler returning to Norway from Tahiti was confirmed to have a Zika virus infection. New Caledonia Zika spread westwards from French Polynesia to New Caledonia, where imported cases from French Polynesia were reported from November 2013 onwards. The first indigenous case was confirmed in January 2014 by the Pasteur Institute. On 10 February, there were 64 reported cases of Zika in the communities of Greater Nouméa, Dumbéa, and Ouvéa, of which 30 were imported from French Polynesia. By 26 February 2014, there were 140 confirmed cases of Zika in New Caledonia, including 32 imported cases. Nearly 40 other cases of Zika virus infection were imported into New Zealand. By 29 May, the outbreak had ended, with 50 confirmed and 932 suspected cases of Zika virus infection. By the end of the year, 173 cases of Zika had been reported, but all of the cases were described as "mild". On 24 September 2014, a Belgian woman flying to Easter Island from Tahiti was diagnosed with Zika virus infection after having previously received ambulatory care in Tahiti, and was taken to Hanga Roa Hospital for evaluation. LAN Airlines undertook operations to ensure other people on the woman's flight were not infected, and local health authorities stated that Zika was not a risk for people on the island. ==Transmission==
Transmission
'' mosquito, a vector or carrier of the Zika virus Zika is a mosquito-borne disease. Four aedine species of mosquito are found in the Pacific, including Aedes aegypti, widespread across the South Pacific, and Aedes polynesiensis, found between Fiji and French Polynesia. Aedes aegypti has previous been identified as a wild vector of the Zika virus, and preliminary results from the Institut Louis-Malardé have supported the main role of Aedes aegypti and probable role of Aedes polynesiensis in spreading the Zika virus. A study conducted between November 2013 and February 2014 in French Polynesia found that 2.8% of blood donors tested positive for the Zika virus, of which 3% were asymptomatic at the time of blood donation. 11 of the infected donors studied subsequently reported symptoms of Zika virus infection within 10 days. == Possible links to neurological syndromes, infant microcephaly and other disorders ==
Possible links to neurological syndromes, infant microcephaly and other disorders
A concurrent increase in neurological syndromes and autoimmune complications was first reported in early 2014. However, there was only one laboratory confirmation of Zika virus infection using RT-PCR in patients with GBS. Among the initial 38 cases of GBS found in suspected Zika cases, 73% were male and infected individuals were aged between 27 and 70. This was highly unusual, as prior to the Zika outbreak there had only been 21 cases of GBS in French Polynesia between 2009 and 2012. 18 people newly diagnosed with GBS were admitted to the local rehabilitation centre, putting heavy strain on the limited intensive care resources available. The two cases of Zika virus infection imported into Japan from French Polynesia in February 2014 showed signs of leukopenia (decreased levels of white blood cells) and moderate thrombocytopenia (decreased levels of platelets). == Aftermath ==
Aftermath
Brazilian researchers have suggested that a traveler infected with the Zika virus arrived in Brazil from French Polynesia, leading to the ongoing Zika virus outbreak that began in 2015. This may have occurred during the 2014 FIFA World Cup tournament, or shortly after, based on phylogenetic DNA analysis of the virus. French researchers have speculated that the virus arrived in August 2014, when canoeing teams from French Polynesia, New Caledonia, the Cook Islands and Easter Island attended the Va'a World Sprint Championships in Rio de Janeiro. Between 1 January and 20 May 2015, a further 82 confirmed cases of Zika were reported in New Caledonia, including ten imported cases. On 27 April 2015, the Ministry of Health of Vanuatu announced that blood samples collected prior to Cyclone Pam in March were confirmed to contain the Zika virus. The Ministry of Health advised people to consult medical aid if they experienced a high fever with no obvious cause, and recommended communities clean up places where mosquitoes could lay eggs. The introduction of the Zika virus was thought to be linked to frequent travel between New Caledonia and Vanuatu. Cases of Zika virus infection have subsequently been confirmed in American Samoa, Samoa, Tonga, and the Marshall Islands. ==See also==
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