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An estimated 73% of Yap residents over three years of age were infected with Zika virus.

No deaths, hospitalizations, or neurological complications are reported.

In the absence of any evidence that viral mutation can explain changes in epidemic behaviour, several other explanations are suggested including a lack of population immunity; that is, regular exposure to infection in Africa and Asia may have prevented the large outbreaks eventually seen on Pacific Islands and in the Americas.

Under-reporting may also be a reason for missing previous outbreaks of infection, due to the clinical similarities of (mild) illness associated with Zika, dengue, and chikungunya infections, and the frequent co-circulation of all three viruses.2008: A US scientist conducting field work in Senegal falls ill with Zika infection upon his return home to Colorado and infects his wife in what is probably the first documented case of sexual transmission of an infection usually transmitted by insects.2012: Researchers publish findings on the characterization of Zika virus strains collected in Cambodia, Malaysia, Nigeria, Senegal, Thailand and Uganda, and construct phylogenetic trees to assess the relationships.

To illustrate the spread of Zika virus, and associated neurological complications, we constructed a timeline through a literature search, using “Zika” and “ZIKV” as the search terms in Pub Med.In October 2015 Brazil reported an association between Zika virus infection and microcephaly. In February 2016, as infection moved rapidly through the range occupied by Aedes mosquitos in the Americas, WHO declared that Zika infection associated with microcephaly and other neurological disorders constitutes a Public Health Emergency of International Concern (PHEIC).By the start of February 2016, local transmission of Zika infection had been reported from more than 20 countries and territories in the Americas, and an outbreak numbering thousands of cases was under way in Cabo Verde, western Africa.Please note: This document is a historical rendering of the Zika virus disease up until 7 February 2016.WHO continuously adds to Zika virus: News and updates with the latest information available on this public health emergency.These reports indicate a possible association between Zika virus infection and congenital malformations and severe neurological and autoimmune complications.