Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Zika virus (ZIKV), classified as a priority pathogen by the World Health Organization, is an Aedes -borne arbovirus that can cause neurological complications and birth defects in newborns of mothers infected during pregnancy. We conducted a systematic review of peer-reviewed studies reporting ZIKV epidemiological parameters, transmission models and outbreaks (PROSPERO CRD42023393345) to characterize its transmissibility, seroprevalence, risk factors, disease sequelae and natural history. We performed meta-analyses of the proportions of congenital Zika syndrome, pregnancy loss among ZIKV-infected mothers and symptomatic cases. We extracted information from 574 studies. Across 418 included studies assigned a high-quality score, we extracted 969 parameters, 127 outbreak records and 154 models. Using random-effects models, we estimated proportions of congenital Zika syndrome (4.65%, 95% confidence interval (CI): 3.38–6.67%), pregnancy loss (2.48%, 95% CI: 1.62–3.78%) and symptomatic cases (51.20%, 95% CI: 38.00–64.23%). Seroprevalence estimates ( n = 354) were retrieved beyond South America and French Polynesia. Basic reproduction number estimates ( n = 77) ranged between 1.12 and 7.4. We found 66 human epidemiological delay estimates, including the intrinsic incubation period ( n = 11, range: 4–12.1 days), infectious period ( n = 15, range: 3–50 days), extrinsic incubation period ( n = 22, range: 5.1–24.2 days) and serial interval ( n = 27, range: 7.4–32.9 days). These data are available in the R package ‘epireview’ (version 1.4.5). We provide a comprehensive systematic summary of ZIKV epidemiology, revealing large heterogeneities and inconsistencies in the reporting of parameter estimates, study designs and parameter definitions and underscoring the need for standardized epidemiological definitions.
Source: Nature Health
Authors: Kelly McCain, Anna Vicco, Christian Morgenstern, Thomas Rawson, Tristan M. Naidoo, Sangeeta Bhatia, Dominic P. Dee, Patrick Doohan, Keith Fraser, Anna-Maria Hartner, Sequoia I. Leuba, Shazia Ruybal-Pesántez, Richard J. Sheppard, H. Juliette T. Unwin, Kelly Charniga, Zulma M. Cucunubá, Gina Cuomo-Dannenburg, Natsuko Imai-Eaton, Edward S. Knock, Adam Kucharski, Mantra Kusumgar, Paul Liétar, Rebecca K. Nash, Sabine van Elsland, Pathogen Epidemiology Review Group, Aaron Morris, Alpha Forna, Amy Dighe, Anna-Maria Hartner, Anne Cori, Arran Hamlet, Ben Lambert, Bethan Cracknell Daniels, Charles Whittaker, Cosmo Santoni, Cyril Geismar, Dariya Nikitin, David Jorgensen, Dominic P. Dee, Edward S. Knock, Hayley Thompson, Isobel Routledge, Jack Wardle, Janetta Skarp, Joseph Hicks, Kanchan Parchani, Kieran Drake, Lily Geidelberg, Lorenzo Cattarino, Mara Kont, Marc Baguelin, Pablo N. Perez-Guzman, Paula Christen, Rebecca Nash, Richard Fitzjohn, Richard Sheppard, Rob Johnson, Sabine van Elsland, Sequoia I. Leuba, Shazia Ruybal-Pesántez, Sreejith Radhakrishnan, Tristan M. Naidoo, Zulma M. Cucunubá, Nuno R. Faria, Anne Cori, Ruth McCabe, Ilaria Dorigatti
Institutions: Imperial College London, Robert Koch Institute, London School of Hygiene & Tropical Medicine, Universidad San Francisco de Quito, University of Bristol, Pontificia Universidad Javeriana, University of Oxford, University of Georgia, Johns Hopkins University, Program for Appropriate Technology in Health, University of California, San Francisco, UK Health Security Agency, University of Glasgow
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: Bill and Melinda Gates Foundation, GAVI Alliance, Wellcome Trust, National Institute for Health Research Health Protection Research Unit, National Institute for Health and Care Research, British Heart Foundation, Department of Health and Social Care, Diabetes UK, Imperial College London, European Commission, Medical Research Council, European and Developing Countries Clinical Trials Partnership
Awards: Thanzi La Mawa: Integrated Analysis of Health System Capabilities and Effects on Population Health in Malawi and Eastern, Central and Southern Africa, G1213559922, G1260009046, G1838801258, Polymer - Carbon Nanotubes Active Systems for Photovoltaics, Reconstructing the transmission intensity of arboviruses across Africa and the impact of interventions in a changing climate, Imperial College London - to support the Vaccine Impact Modeling Consortium to provide modeling that supports efforts to reduce the burden of vaccine preventable diseases, Climate Sensitive Vector Borne Disease Intervention Tools, Global Linkage Over BroadbAnd Links, MRC Centre for Global Infectious Disease Analysis (MRC GIDA), Imperial College London - to improve the quality and timeliness of estimates of the impact of Gavi-funded vaccination programs via the establishment of a Vaccine Impact Mode..., Dengue and Zika Immunology and Genomics Multi-Country Network (DeZi Network), G7627692145, Spatiotemporal dynamics of arbovirus transmission: implications for disease control and elimination, G8605616652
OpenAlex ID: W7124974915