WHO warns Zika virus may spread into Europe

Ireland considered at ‘very low’ risk of outbreak due to climate and control measures

A file image of a female Aedes aegypti mosquito takes flight as she leaves her host’s skin surface with newly-obtained red blood visible through her now transparent abdomen. The WHO said on Wednesday that there was a risk that the Zika virus could spread to Europe.

The Zika virus, an infectious disease linked to severe birth defects in babies, may spread into Europe as the weather gets warmer, although the risk is low, senior health officials said on Wednesday.

In its first assessment of the threat Zika poses to the region, the World Health Organization’s European office said the overall risk was small to moderate. It is highest in areas where Aedes mosquitoes thrive, in particular on the island of Madeira and the north-eastern coast of the Black Sea.

Ireland is deemed to have a “very low” risk of an outbreak.

“There is a risk of spread of Zika virus disease in the European Region and ... this risk varies from country to country, said Zsuzsanna Jakab, the WHO’s regional director for Europe.

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“We call particularly on countries at higher risk to strengthen their national capacities and prioritize the activities that will prevent a large Zika outbreak.”

The WHO’s European region covers 53 countries and a population of nearly 900 million. It stretches from the Arctic Ocean in the north to the Mediterranean Sea in the south and from the Atlantic in the west to the Pacific in the east. A large and spreading outbreak of Zika that began in Brazil has caused global alarm.

The virus has been linked to thousands of cases of a birth defect known as microcephaly in babies of women who become infected with Zika while pregnant. The WHO has said there is strong scientific consensus that

Zika can also cause Guillain-Barre, a rare neurological syndrome that causes temporary paralysis in adults. The WHO’s Geneva headquarters in February declared the Zika outbreak a public health emergency of international concern (PHEIC), warning it was spreading “explosively” in the Americas .

The WHO’s European office said that if no measures are taken to mitigate the threat, the presence of the Aedes aegypti mosquitoes that can carry the virus mean the likelihood of local

Zika transmission is moderate in 18 countries in the region. A further 36 countries have low, very low or no likelihood, the assessment found. Aedes mosquitoes are not found in those countries and their climates would not be suitable for the mosquitoes to establish themselves. Countries with high and moderate risk of

Zika should improve vector-control measures to prevent the spread of mosquitoes and reduce their density, WHO Europe said.

They also should equip health workers to detect cases early, report them swiftly, and help people at risk - notably pregnant women - protect themselves from infection, it said. The WHO’s European risk analysis took in multiple factors, among them the presence of

Zika-transmitting mosquitoes, suitable climates for the mosquito, previous history of transmission of dengue or chikungunya, ship and flight connections, and population density and urbanization. It also considered the capacity of the country to contain transmission at an early stage, based on four main factors: vector control, clinical surveillance, laboratory capacity and emergency risk communications. The WHO’s regional office is convening a meeting of European health experts in Portugal from June 22-24 to discuss the Zika threat further.

“The WHO Europe warning about the risk of Zika virus in Europe is timely and real,” said Paul Hunter, professor of health protection and infectious disease expert from University of East Anglia’s medical school.

“There have already been indigenous European outbreaks of two closely related viruses - Dengue and Chikungunya - that are spread by mosquitos. For example an outbreak of Chikungunya occurred in the North East of Italy in 2007 and affected some 217 people and there have been several reports of dengue fever in France in people who had not previously travelled overseas.

“As highlighted by the WHO Europe statement the risk is mostly in southern Europe and especially around the Mediterranean coast. However, even if Zika did start to spread in Europe, it is unlikely to become established as an outbreak is very unlikely to continue over winter. Any outbreak would be relatively short-lived.

“Nevertheless an outbreak occurring in the Mediterranean area could still have repercussions throughout Europe if pregnant holidaymakers acquire the infection or if males then pass the infection sexually to their pregnant partners.

“If and when the disease does come to Europe it will be essential that people are very careful about using insect repellents and use condoms during sex if they think they have been exposed.”

Here is a list of countries in Europe and surrounding regions that have been assessed for their risk of a Zika virus outbreak.

There are three localised areas which have been categorised as having a “high likelihood” of Zika virus transmission:

There are three localised areas which have been categorised as having a “high likelihood” of Zika virus transmission:

  • Madeira
  • Black Sea coastal area of Georgia
  • Black Sea coastal area of Russia

Those deemed to have “moderate” risk include:

France, Italy, Malta, Croatia, Israel, Spain, Monaco, San Marino, Turkey, Greece, Switzerland, Bulgaria, Romania, Slovenia, Georgia, Albania, Bosnia and Herzegovina, Montenegro,

Those deemed to have low risk include:

Portugal, Russia, Azerbaijan, Cyprus, Macedonia, Belgium, Germany, Luxembourg, Ukraine, Hungary, Austria, Serbia, Moldova, The Netherlands, United Kingdom, Denmark, Sweden, Czech Republic, Andorra, Norway, Slovakia, Liechtenstein,

Those deemed to have a “very low” risk include:

Armenia, Poland, Ireland, Lithuania, Uzbekistan, Kazakhstan, Turkmenistan, Tajikistan, Kyrgyzstan

Those with no risk include:

Finland, Estonia, Iceland, Latvia, Belarus