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EPIDEMIOLOGY AND EVOLUTION OF ZIKA VIRUS IN MINAS GERAIS, SOUTHEAST BRAZIL
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Abstract
Autochthonous Zika virus (ZIKV) transmission in Brazil was first identified in April 2015 in Brazil, with the first
ZIKV-associated microcephaly cases detected in October 2015. Despite efforts on understanding ZIKV trans mission in Brazil, little is known about the virus epidemiology and genetic diversity in Minas Gerais (MG), the
second most populous state in the country. We report molecular and genomic findings from the main public
health laboratory in MG. Until January 2020, 26,817 ZIKV suspected infections and 86 congenital syndrome
cases were reported in MG state. We tested 8552 ZIKV and microcephaly suspected cases. Ten genomes were
generated on-site directly from clinical samples. A total of 1723 confirmed cases were detected in Minas Gerais,
with two main epidemic waves; the first and larger epidemic wave peaked in March 2016, with the second
smaller wave that peaked in March 2017. Dated molecular clock analysis revealed that multiple introductions
occurred in Minas Gerais between 2014 and 2015, suggesting that the virus was circulating unnoticed for at least
16 months before the first confirmed laboratory case that we retrospectively identified in December 2015. Our
findings highlight the importance of continued genomic surveillance strategies combined with traditional
epidemiology to assist public health laboratories in monitoring and understanding the diversity of circulating
arboviruses, which might help attenuate the public health impact of infectious diseases.
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