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© Research
Publication : American journal of epidemiology

Reassessing Serosurvey-Based Estimates of the Symptomatic Proportion of Zika Virus Infections

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in American journal of epidemiology - 01 Jan 2019

Mitchell PK, Mier-Y-Teran-Romero L, Biggerstaff BJ, Delorey MJ, Aubry M, Cao-Lormeau VM, Lozier MJ, Cauchemez S, Johansson MA

Link to Pubmed [PMID] – 30165474

Am. J. Epidemiol. 2019 Jan;188(1):206-213

Since the 2007 Zika epidemic in the Micronesian state of Yap, it has been apparent that not all people infected with Zika virus (ZIKV) experience symptoms. However, the proportion of infections that result in symptoms remains unclear. Existing estimates have varied in their interpretation of symptoms due to other causes and the case definition used, and they have assumed perfect test sensitivity and specificity. Using a Bayesian model and data from ZIKV serosurveys in Yap (2007), French Polynesia (2013-2014), and Puerto Rico (2016), we found that assuming perfect sensitivity and specificity generally led to lower estimates of the symptomatic proportion. Incorporating reasonable assumptions for assay sensitivity and specificity, we estimated that 27% (95% credible interval (CrI): 15, 37) (Yap), 44% (95% CrI: 26, 66) (French Polynesia), and 50% (95% CrI: 34, 92) (Puerto Rico) of infections were symptomatic, with variation due to differences in study populations, study designs, and case definitions. The proportion of ZIKV infections causing symptoms is critical for surveillance system design and impact assessment. Here, we accounted for key uncertainties in existing seroprevalence data and found that estimates for the symptomatic proportion ranged from 27% to 50%, suggesting that while the majority of infections are asymptomatic or mildly symptomatic, symptomatic infections might be more common than previously estimated.

https://www.ncbi.nlm.nih.gov/pubmed/30165474