Understanding the burden of ZIKV disease in Brazil, and anticipating further spread (or even decline) of infection are crucial requirements for policy makers, regarding vaccine decisions, prioritizing interventions and allocating resources.

Overall Objectives

  • Prospectively assess the evolution of the ZIKV outbreak in 17,000 subjects aged 2-59 in 14 different locations in Brazil over 3 years,
  • Strengthen the surveillance of birth defects in Latin America in order to facilitate rapid response to infectious disease outbreaks, in particular Zika, and to analyse and report data collected by regional and national birth defect surveillance systems on congenital Zika syndrome/microcephaly over 3 years in Latin America,
  • Document and anticipate regional and global geographic spread of Zika infections,
  • Estimate the burden of Zika in international travellers to Zika affected countries.

Read about the latest activities of the Birth Defect Surveillance Group

Specific Objectives

  • Determine the annual incidence and describe the full spectrum from mild to severe disease of ZIKV infection in a prospective cohort study of 17,000 subjects aged 2-59 in 14 different geographic locations in Brazil (active febrile episode surveillance over 3 years),
  • Document the seroprevalence of ZIKV infection stratified by age, gender, prior dengue exposure, and geographic distribution in 17,000 subjects in 14 different geographic locations in Brazil at baseline, with repeat seroprevalence one year later,
  • Calculate the Basic Reproduction Number and force of infection of ZIKV in this cohort,
  • Determine the ratio of asymptomatic to symptomatic ZIKV infections,
  • Model the optimum age to vaccinate in case of the advent of an effective vaccine against ZIKV based on above findings,
  • Describe spatio-temporal and demographic factors associated with ZIKV infections in Brazil,
  • Inventory and develop tools for birth defects surveillance, with particular attention to congenital Zika syndrome,
  • Develop and implement a model for networking birth defect surveillance across Latin America, including harmonisation of data and monitoring, which could detect a new outbreak of congenital Zika syndrome and monitor its evolution over time,
  • Analyse and report data on microcephaly and congenital Zika syndrome from Latin American birth defects surveillance systems over a period of 3 years,
  • Conduct sentinel surveillance and a prospective cohort study in travellers to Latin America and other Zika affected countries in order to assess the risk of Zika to travellers.

Participating Organisations

Group leader: Prof. Annelies Wilder-Smith, Umeå University

  • London School of Hygiene & Tropical Medicine
  • Queen Mary University of London
  • Ulster University
  • Fundação de Apoio à Universidade de São Paulo
  • Instituto Butantan
  • Associação Técnica–Científica de Estudo Colaborativo Latino Americano de Malformações Congênitas
  • Schweizerisches Tropen- und Public Health-Institut
Prospective cohort study of 17,000 subjects aged 2-59

Prospective cohort study of 17,000 subjects aged 2-59 in 14 clinical sites in Brazil (Aracajú, Belo Horizonte, Boa Vista, Brasília, Campo Grande, Cuiabá, Fortaleza, Mananus, São José do Rio Preto, São Paulo (2): Hospital das Clínicas – FMUSP and Santa Casa de Misericóridua, Porto Alegre, Porto Velho and Recife)