title: Outbreak of Zika Virus Infection, Chiapas State, Mexico, 2015, and First Confirmed Transmission by Aedes aegypti Mosquitoes in the Americas.
abstract: BACKGROUND
  After decades of obscurity, Zika virus (ZIKV) has spread through the Americas since 2015 accompanied by congenital microcephaly and Guillain-Barré syndrome. Although these epidemics presumably involve transmission by Aedes aegypti, no direct evidence of vector involvement has been reported, prompting speculation that other mosquitoes such as Culex quinquefasciatus could be involved.
  
  
  METHODS
  We detected an outbreak of ZIKV infection in southern Mexico in late 2015. Sera from suspected ZIKV-infected patients were analyzed for viral RNA and antibodies. Mosquitoes were collected in and around patient homes and tested for ZIKV.
  
  
  RESULTS
  Of 119 suspected ZIKV-infected patients, 25 (21%) were confirmed by RT-PCR of serum collected 1-8 days after the onset of signs and symptoms including rash, arthralgia, headache, pruritus, myalgia, and fever. Of 796 mosquitoes collected, A. aegypti yielded ZIKV detection by RT-PCR in 15 of 55 pools (27.3%). No ZIKV was detected in C. quinquefasciatus ZIKV sequences derived from sera and mosquitoes showed a monophyletic relationship suggestive of a point source introduction from Guatemala.
  
  
  CONCLUSIONS
  These results demonstrate the continued, rapid northward progression of ZIKV into North America with typically mild disease manifestations, and implicate A. aegypti for the first time as a principal vector in North America.
authors.affiliation: Institute for Human Infections and Immunity.|Department of Microbiology and Immunology.|Department of Pathology.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Guerbois
authors.affiliation: Centro Regional de Salud Pública, Instituto Nacional de Salud Pública, Tapachula.
authors.forename: Ildefonso
authors.initials: I
authors.lastname: Fernandez-Salas
authors.affiliation: Institute for Human Infections and Immunity.|Department of Microbiology and Immunology.|Department of Pathology.
authors.forename: Sasha R
authors.initials: SR
authors.lastname: Azar
authors.affiliation: Centro Regional de Salud Pública, Instituto Nacional de Salud Pública, Tapachula.
authors.forename: Rogelio
authors.initials: R
authors.lastname: Danis-Lozano
authors.affiliation: Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca.
authors.forename: Celia M
authors.initials: CM
authors.lastname: Alpuche-Aranda
authors.affiliation: Institute for Human Infections and Immunity.|Department of Microbiology and Immunology.|Department of Pathology.
authors.forename: Grace
authors.initials: G
authors.lastname: Leal
authors.affiliation: Centro Regional de Salud Pública, Instituto Nacional de Salud Pública, Tapachula.
authors.forename: Iliana R
authors.initials: IR
authors.lastname: Garcia-Malo
authors.affiliation: Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey.|Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza.
authors.forename: Esteban E
authors.initials: EE
authors.lastname: Diaz-Gonzalez
authors.affiliation: Centro Regional de Salud Pública, Instituto Nacional de Salud Pública, Tapachula.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Casas-Martinez
authors.affiliation: Institute for Human Infections and Immunity.|Department of Microbiology and Immunology.|Department of Pathology.
authors.forename: Shannan L
authors.initials: SL
authors.lastname: Rossi
authors.affiliation: Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza.
authors.forename: Samanta L
authors.initials: SL
authors.lastname: Del Río-Galván
authors.affiliation: Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey.|Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Nuevo León, Escobedo, Mexico.
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Sanchez-Casas
authors.affiliation: Institute for Human Infections and Immunity.|Department of Microbiology and Immunology.|Department of Pathology.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Roundy
authors.affiliation: Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Wood
authors.affiliation: Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Widen
authors.affiliation: Institute for Human Infections and Immunity.|Department of Microbiology and Immunology.|Department of Pathology.
authors.forename: Nikos
authors.initials: N
authors.lastname: Vasilakis
authors.affiliation: Institute for Human Infections and Immunity.|Department of Microbiology and Immunology.|Department of Pathology.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Weaver
mesh_terms: D000330:Aedes / Q000821:virology*; D000569:Americas / Q000453:epidemiology; D000818:Animals; D003465:Culex / Q000821:virology; D009033:Culicidae / Q000821:virology*; D004196:Disease Outbreaks; D006166:Guatemala / Q000453:epidemiology; D007303:Insect Vectors / Q000821:virology; D008800:Mexico / Q000453:epidemiology; D000071244:Zika Virus / Q000302:isolation & purification*; D000071243:Zika Virus Infection / Q000453:epidemiology* / Q000635:transmission*
keywords: Zika; arbovirus; flavivirus; mosquito; transmission