Risk of Globalization of the Disease in Europe

Risk of dissemination of ZIKV disease is based on multiple factors, including environmental (climate, socioeconomically, deforestation or industrialization) and travel/traveller factors. Both the disease (viremic travellers) and vector movement to mosquito-free area contributes to the introduction and establishment of autochthonous ZIKV transmission. Mass gathering events can contribute to magnify transmission due to close crowd life in a confined area. Also, multitudinary events can promote the introduction of an infectious disease to a previously naïve area when returning home. Although mathematical models estimate a low risk for introduction of ZIKV in Europe, specific European regions (mainly Portuguese Island of Madeira) account with suitable and efficient vector and opportune climate conditions to harbour the disease. Clinicians should be aware to enable early detection of autochthonous ZIKV cases. International and local guidelines can help clinicians on how to handle suspicious cases, how to confirm the infection and how to report suspected and confirmed cases. In case of autochthonous ZIKV detection, public authorities should perform surveillance and provide adequate resources to sustain enhanced mosquito control.