Among 28,219 (96.2%) nonpregnant patients with confirmed or presumptive Zika virus disease, incidence was higher among women (936 per 100,000 population) than men (576 per 100,000) for all age groups ≥20 years, and the majority (61%) of reported Zika virus disease cases occurred in females. The highest incidence among confirmed or presumptive cases occurred among persons aged 20–29 years (1,150 cases per 100,000 residents). During November 1, 2015–October 20, 2016, 62,500 suspected Zika virus disease cases were reported to the Puerto Rico Department of Health (PRDH) 29,345 (47%) were confirmed by reverse transcription–polymerase chain reaction (RT-PCR) testing, or were presumptively diagnosed based on serological testing.
This report describes the incidence of reported symptomatic Zika virus disease in the U.S. Zika virus is a flavivirus transmitted primarily by Aedes species mosquitoes symptoms of infection include rash, arthralgia, fever, and conjunctivitis.*, † Zika virus infection during pregnancy can cause microcephaly and other serious brain anomalies ( 1), and in rare cases, Zika virus infection has been associated with Guillain-Barré syndrome ( 2) and severe thrombocytopenia ( 3). Residents of and travelers to Puerto Rico should remove or cover standing water, employ mosquito bite avoidance behaviors, take precautions to reduce the risk for sexual transmission, and seek medical care for any acute illness with rash or fever. Accurate information on disease burden will enable identification of populations most affected to target health messaging and interventions. Serosurveys are needed to identify the rates of Zika virus infection among males and females of all ages in Puerto Rico to determine whether observed differential disease rates reflect differential rates of infection, development of disease, or seeking medical care. What are the implications for public health practice? Women aged 40–79 years with suspected cases were more likely to test positive for Zika virus infection than those in males in the same age group. Previous reports from Brazil and El Salvador have demonstrated higher rates of infection in females, and suggested that Zika virus disease incidence is higher among persons aged 20–49 years.Īmong 28,219 nonpregnant persons with laboratory evidence of Zika virus disease identified in Puerto Rico during November 1, 2015–October 20, 2016, incidence was highest among women aged 20–49 years. Zika virus has been circulating in Puerto Rico since November 2015.
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