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<p>Zika virus (ZIKV), classified as a priority pathogen by the World Health Organization, is an <i>Aedes</i>-borne arbovirus that can cause neurological complications and birth defects in newborns of mothers infected during pregnancy. We conducted a systematic review of peer-reviewed studies reporting ZIKV epidemiological parameters, transmission models and outbreaks (PROSPERO CRD42023393345) to characterize its transmissibility, seroprevalence, risk factors, disease sequelae and natural history. We performed meta-analyses of the proportions of congenital Zika syndrome, pregnancy loss among ZIKV-infected mothers and symptomatic cases. We extracted information from 574 studies. Across 418 included studies assigned a high-quality score, we extracted 969 parameters, 127 outbreak records and 154 models. Using random-effects models, we estimated proportions of congenital Zika syndrome (4.65%, 95% confidence interval (CI): 3.38–6.67%), pregnancy loss (2.48%, 95% CI: 1.62–3.78%) and symptomatic cases (51.20%, 95% CI: 38.00–64.23%). Seroprevalence estimates (<i>n</i> = 354) were retrieved beyond South America and French Polynesia. Basic reproduction number estimates (<i>n</i> = 77) ranged between 1.12 and 7.4. We found 66 human epidemiological delay estimates, including the intrinsic incubation period (<i>n</i> = 11, range: 4–12.1 days), infectious period (<i>n</i> = 15, range: 3–50 days), extrinsic incubation period (<i>n</i> = 22, range: 5.1–24.2 days) and serial interval (<i>n</i> = 27, range: 7.4–32.9 days).</p><p>These data are available in the R package ‘epireview’ (version 1.4.5). We provide a comprehensive systematic summary of ZIKV epidemiology, revealing large heterogeneities and inconsistencies in the reporting of parameter estimates, study designs and parameter definitions and underscoring the need for standardized epidemiological definitions.</p>

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A systematic review and meta-analysis of Zika virus epidemiology

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月13日

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  • Kelly McCain,
  • Anna Vicco,
  • Christian Morgenstern,
  • Thomas Rawson,
  • Tristan M. Naidoo,
  • Sangeeta Bhatia,
  • Dominic P. Dee,
  • Patrick Doohan,
  • Keith Fraser,
  • Anna-Maria Hartner,
  • Sequoia I. Leuba,
  • Shazia Ruybal-Pesántez,
  • Richard J. Sheppard,
  • H. Juliette T. Unwin,
  • Kelly Charniga,
  • Zulma M. Cucunubá,
  • Gina Cuomo-Dannenburg,
  • Natsuko Imai-Eaton,
  • Edward S. Knock,
  • Adam Kucharski,
  • Mantra Kusumgar,
  • Paul Liétar,
  • Rebecca K. Nash,
  • Sabine van Elsland,
  • Aaron Morris,
  • Alpha Forna,
  • Amy Dighe,
  • Anna-Maria Hartner,
  • Anne Cori,
  • Arran Hamlet,
  • Ben Lambert,
  • Bethan Cracknell Daniels,
  • Charles Whittaker,
  • Cosmo Santoni,
  • Cyril Geismar,
  • Dariya Nikitin,
  • David Jorgensen,
  • Dominic P. Dee,
  • Edward S. Knock,
  • Hayley Thompson,
  • Isobel Routledge,
  • Jack Wardle,
  • Janetta Skarp,
  • Joseph Hicks,
  • Kanchan Parchani,
  • Kieran Drake,
  • Lily Geidelberg,
  • Lorenzo Cattarino,
  • Mara Kont,
  • Marc Baguelin,
  • Pablo N. Perez-Guzman,
  • Paula Christen,
  • Rebecca Nash,
  • Richard Fitzjohn,
  • Richard Sheppard,
  • Rob Johnson,
  • Sabine van Elsland,
  • Sequoia I. Leuba,
  • Shazia Ruybal-Pesántez,
  • Sreejith Radhakrishnan,
  • Tristan M. Naidoo,
  • Zulma M. Cucunubá,
  • Nuno R. Faria,
  • Anne Cori,
  • Ruth McCabe,
  • Ilaria Dorigatti

摘要

Zika virus (ZIKV), classified as a priority pathogen by the World Health Organization, is an Aedes-borne arbovirus that can cause neurological complications and birth defects in newborns of mothers infected during pregnancy. We conducted a systematic review of peer-reviewed studies reporting ZIKV epidemiological parameters, transmission models and outbreaks (PROSPERO CRD42023393345) to characterize its transmissibility, seroprevalence, risk factors, disease sequelae and natural history. We performed meta-analyses of the proportions of congenital Zika syndrome, pregnancy loss among ZIKV-infected mothers and symptomatic cases. We extracted information from 574 studies. Across 418 included studies assigned a high-quality score, we extracted 969 parameters, 127 outbreak records and 154 models. Using random-effects models, we estimated proportions of congenital Zika syndrome (4.65%, 95% confidence interval (CI): 3.38–6.67%), pregnancy loss (2.48%, 95% CI: 1.62–3.78%) and symptomatic cases (51.20%, 95% CI: 38.00–64.23%). Seroprevalence estimates (n = 354) were retrieved beyond South America and French Polynesia. Basic reproduction number estimates (n = 77) ranged between 1.12 and 7.4. We found 66 human epidemiological delay estimates, including the intrinsic incubation period (n = 11, range: 4–12.1 days), infectious period (n = 15, range: 3–50 days), extrinsic incubation period (n = 22, range: 5.1–24.2 days) and serial interval (n = 27, range: 7.4–32.9 days).

These data are available in the R package ‘epireview’ (version 1.4.5). We provide a comprehensive systematic summary of ZIKV epidemiology, revealing large heterogeneities and inconsistencies in the reporting of parameter estimates, study designs and parameter definitions and underscoring the need for standardized epidemiological definitions.