Genomic and Epidemiological Surveillance of Zika Virus in the Amazon Region.
Giovanetti M., Faria NR., Lourenço J., Goes de Jesus J., Xavier J., Claro IM., Kraemer MUG., Fonseca V., Dellicour S., Thézé J., da Silva Salles F., Gräf T., Silveira PP., do Nascimento VA., Costa de Souza V., de Melo Iani FC., Castilho-Martins EA., Cruz LN., Wallau G., Fabri A., Levy F., Quick J., de Azevedo V., Aguiar RS., de Oliveira T., Bôtto de Menezes C., da Costa Castilho M., Terra TM., Souza da Silva M., Bispo de Filippis AM., Luiz de Abreu A., Oliveira WK., Croda J., Campelo de Albuquerque CF., Nunes MRT., Sabino EC., Loman N., Naveca FG., Pybus OG., Alcantara LC.
Zika virus (ZIKV) has caused an explosive epidemic linked to severe clinical outcomes in the Americas. As of June 2018, 4,929 ZIKV suspected infections and 46 congenital syndrome cases had been reported in Manaus, Amazonas, Brazil. Although Manaus is a key demographic hub in the Amazon region, little is known about the ZIKV epidemic there, in terms of both transmission and viral genetic diversity. Using portable virus genome sequencing, we generated 59 ZIKV genomes in Manaus. Phylogenetic analyses indicated multiple introductions of ZIKV from northeastern Brazil to Manaus. Spatial genomic analysis of virus movement among six areas in Manaus suggested that populous northern neighborhoods acted as sources of virus transmission to other neighborhoods. Our study revealed how the ZIKV epidemic was ignited and maintained within the largest urban metropolis in the Amazon. These results might contribute to improving the public health response to outbreaks in Brazil.