Skip Navigation
Skip to contents

Epidemiol Health : Epidemiology and Health


Author index

Page Path
HOME > Browse articles > Author index
Cristina Possas 1 Article
Zika: what we do and do not know based on the experiences of Brazil
Cristina Possas
Epidemiol Health. 2016;38:e2016023.   Published online May 31, 2016
  • 18,047 View
  • 380 Download
  • 17 Web of Science
  • 21 Crossref
AbstractAbstract PDF
Zika virus, which was first discovered in 1947, has become a global threat to human health as it is rapidly spreading through Latin America, the Caribbean, the US and Asia, after causing a large outbreak in the Northeast region of Brazil in 2015. There is ample evidence to support that Zika virus is associated with neurological complications such as microcephaly. The review aims to provide an overview on the complex issues involved in the emergence of Zika virus’s neurological disorders and to discuss possible explanations of Zika virus introduction and dissemination in Brazil. We also suggest national and global strategies to adequately respond to the Zika virus emergence.
We provide an analytical evaluation of the main issues related to the Zika outbreak in Brazil, based on available scientific literature, including government documents, and on epidemiological information from national surveillance databases.
The studies on the clinical manifestations of the Zika virus infection coupled with the epidemiological surveillance information in Brazil have provided significant evidence that the Zika virus is associated with neurological disorders such as microcephaly and Guillain-Barré syndrome. Based on phylogenetic and molecular analysis, the hypothesis regarding the introduction of Zika virus in the country is that it took place following international events in 2013 and 2014, when many foreign visitors could have brought Zika virus into Brazil. The immunologically naïve status of populations in the Americas, previous infection with dengue virus, and the increased activity of Aedes aegypti might be the contributing factors for such an outbreak in Brazil. The Zika virus emergence emphasized the importance of cross-disciplinary perspective. Besides the scientific-based vector control strategies, it is important to understand the nature of the evolutionary processes involved in the viral evolution in complex ecosystems and to have social and anthropological knowledge on the conditions related to the spread of the disease in order to properly respond to the spread of the Zika virus.
The experiences of Brazil have demonstrated the significance of multi-disciplinary approach in response to new and resurgent arboviral diseases and provided important lessons that could be applied to other developing countries.


Citations to this article as recorded by  
  • Ações educativas de enfrentamento ao Aedes Aegypti: revisão integrativa
    Ítala Keane Rodrigues Dias, Rosa Maria Grangeiro Martins, Cicera Luciana da Silva Sobreira, Rhavena Maria Gomes Sousa Rocha, Maria do Socorro Vieira Lopes
    Ciência & Saúde Coletiva.2022; 27(1): 231.     CrossRef
  • Survival and Replication of Zika Virus in Diapause Eggs of Aedes Albopictus From Beijing, China
    Qianghui Zhang, Yuting Jiang, Chaojie Li, Jian Gao, Teng Zhao, Hengduan Zhang, Chunxiao Li, Dan Xing, Yande Dong, Tongyan Zhao, Xiaoxia Guo
    Frontiers in Microbiology.2022;[Epub]     CrossRef
  • Decline in head circumference growth and associated factors in congenital Zika syndrome
    Eliana Harumi Morioka Takahasi, Maria Teresa Seabra Soares de Britto e Alves, Marizélia Rodrigues Costa Ribeiro, Alcione Miranda dos Santos, Marcos Adriano Garcia Campos, Vanda Maria Ferreira Simões, Gláucio Andrade Amaral, Patrícia da Silva Sousa, Demócr
    Cadernos de Saúde Pública.2022;[Epub]     CrossRef
  • Entry of dengue virus serotypes and their geographic distribution in Brazilian federative units: a systematic review
    Juliana Maria Trindade Bezerra, Selma Costa de Sousa, Pedro Luiz Tauil, Mariângela Carneiro, David Soeiro Barbosa
    Revista Brasileira de Epidemiologia.2021;[Epub]     CrossRef
  • COVID-19 and Future Disease X in Circular Economy Transition: Redesigning Pandemic Preparedness to Prevent a Global Disaster
    Cristina Possas, Ernesto T. A. Marques, João Baptista Risi, Akira Homma
    Circular Economy and Sustainability.2021; 1(4): 1463.     CrossRef
  • The Politics of Disease Epidemics: a Comparative Analysis of the SARS, Zika, and Ebola Outbreaks
    Lydia Kapiriri, Alison Ross
    Global Social Welfare.2020; 7(1): 33.     CrossRef
  • Solidarity, vulnerability and mistrust: how context, information and government affect the lives of women in times of Zika
    Ana Rosa Linde-Arias, Maria Roura, Eduardo Siqueira
    BMC Infectious Diseases.2020;[Epub]     CrossRef
  • Establishment of an Alphavirus-Specific Neutralization Assay to Distinguish Infections with Different Members of the Semliki Forest complex
    Lisa Henss, Constanze Yue, Joshua Kandler, Helen M. Faddy, Graham Simmons, Marcus Panning, Lia Laura Lewis-Ximenez, Sally A. Baylis, Barbara S. Schnierle
    Viruses.2019; 11(1): 82.     CrossRef
  • Diagnostic Value of Platelet and Leukocyte Counts in the Differential Diagnosis of Fever in the Returning Traveler
    Elisa Rubio, Izaskun Alejo-Cancho, Cristian Aylagas, Daniel Camprubí, Roser Ferré, Ma Rosa Albarracín, Verónica Gonzalo, Josep Barrachina, Míriam José Álvarez-Martínez, Maria Eugenia Valls, Jordi Mas, Jordi Vila, Irene Losada, Miguel J. Martínez, Climent
    The American Journal of Tropical Medicine and Hygiene.2019; 100(2): 470.     CrossRef
  • Molecular Epidemiology and Genetic Diversity of Zika Virus from Field-Caught Mosquitoes in Various Regions of Thailand
    Atchara Phumee, Rome Buathong, Rungfar Boonserm, Proawpilart Intayot, Nucharat Aungsananta, Akanitt Jittmittraphap, Yutthana Joyjinda, Supaporn Wacharapluesadee, Padet Siriyasatien
    Pathogens.2019; 8(1): 30.     CrossRef
  • Dilemma in the Brazilian Tropical Medicine: ‘Is speed more important than direction?’
    Marcus V.G. Lacerda, Fernando F.A. Val, Wuelton M. Monteiro
    Anais da Academia Brasileira de Ciências.2019;[Epub]     CrossRef
  • The prevention of arboviral diseases using mobile devices: a preliminary study of the attitudes and behaviour change produced by educational interventions
    Francisco Fernandes Abel Mangueira, Roberta Smania‐Marques, Izabelly Dutra Fernandes, Victor Alves Albino, Ricardo Olinda, Tais Acácia Santos‐Silva, John Traxler, David Matheson, Silvana Santos
    Tropical Medicine & International Health.2019; 24(12): 1411.     CrossRef
  • Zika Virus Alters DNA Methylation of Neural Genes in an Organoid Model of the Developing Human Brain
    Sylvie Janssens, Michael Schotsaert, Rahul Karnik, Vinod Balasubramaniam, Marion Dejosez, Alexander Meissner, Adolfo García-Sastre, Thomas P. Zwaka, Jack A. Gilbert
    mSystems.2018;[Epub]     CrossRef
  • Zika Virus Infection and Microcephaly in Infants: Is the Association Casual or Causal?
    Joseph L. Mathew, Suvasini Sharma, Satinder Aneja
    Indian Pediatrics.2018; 55(4): 326.     CrossRef
  • Zika virus incidence, preventive and reproductive behaviors: Correlates from new survey data
    Climent Quintana-Domeque, José Raimundo Carvalho, Victor Hugo de Oliveira
    Economics & Human Biology.2018; 30: 14.     CrossRef
  • Zika virus: - a review of the main aspects of this type of arbovirosis
    Ítala Keane Rodrigues Dias, Cicera Luciana da Silva Sobreira, Rosa Maria Grangeiro Martins, Kelly Fernanda Silva Santana, Maria do Socorro Vieira Lopes, Emanuella Silva Joventino, Maria Corina Amaral Viana
    Revista da Sociedade Brasileira de Medicina Tropical.2018; 51(3): 261.     CrossRef
  • Zika virus epidemiology: from Uganda to world pandemic, an update
    C. Talero-Gutiérrez, A. Rivera-Molina, C. Pérez-Pavajeau, I. Ossa-Ospina, C. Santos-García, M. C. Rojas-Anaya, A. de-la-Torre
    Epidemiology and Infection.2018; 146(6): 673.     CrossRef
  • A Pregnant Teen Living in an Area With Active Zika Virus Transmission
    Jane Cox
    Journal of Pediatric Health Care.2017; 31(2): 232.     CrossRef
  • Arbovirus epidemics and blood safety in Brazil
    J. E. Levi
    ISBT Science Series.2017; 12(1): 233.     CrossRef
  • Competence of Aedes aegypti, Ae. albopictus, and Culex quinquefasciatus Mosquitoes as Zika Virus Vectors, China
    Zhuanzhuan Liu, Tengfei Zhou, Zetian Lai, Zhenhong Zhang, Zhirong Jia, Guofa Zhou, Tricia Williams, Jiabao Xu, Jinbao Gu, Xiaohong Zhou, Lifeng Lin, Guiyun Yan, Xiao-Guang Chen
    Emerging Infectious Diseases.2017; 23(7): 1085.     CrossRef
  • Zika puzzle in Brazil: peculiar conditions of viral introduction and dissemination - A Review
    Cristina Possas, Patricia Brasil, Mauro CA Marzochi, Amilcar Tanuri, Reinaldo M Martins, Ernesto TA Marques, Myrna C Bonaldo, Antonio GP Ferreira, Ricardo Lourenço-de-Oliveira, Rita Maria R Nogueira, Patricia C Sequeira, Keyla BF Marzochi, Akira Homma
    Memórias do Instituto Oswaldo Cruz.2017; 112(5): 319.     CrossRef

Epidemiol Health : Epidemiology and Health