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1.
PLoS One ; 16(3): e0243263, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33684104

RESUMO

As mobile device location data become increasingly available, new analyses are revealing the significant changes of mobility pattern when an unplanned event happened. With different control policies from local and state government, the COVID-19 outbreak has dramatically changed mobility behavior in affected cities. This study has been investigating the impact of COVID-19 on the number of people involved in crashes accounting for the intensity of different control measures using Negative Binomial (NB) method. Based on a comprehensive dataset of people involved in crashes aggregated in New York City during January 1, 2020 to May 24, 2020, people involved in crashes with respect to travel behavior, traffic characteristics and socio-demographic characteristics are found. The results show that the average person miles traveled on the main traffic mode per person per day, percentage of work trip have positive effect on person involved in crashes. On the contrary, unemployment rate and inflation rate have negative effects on person involved in crashes. Interestingly, different level of control policies during COVID-19 outbreak are closely associated with safety awareness, driving and travel behavior, and thus has an indirect influence on the frequency of crashes. Comparing to other three control policies including emergence declare, limits on mass gatherings, and ban on all nonessential gathering, the negative relationship between stay-at-home policy implemented in New York City from March 20, 2020 and the number of people involved crashes is found in our study.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo/estatística & dados numéricos , Segurança/estatística & dados numéricos , Viagem/estatística & dados numéricos , Humanos , Cidade de Nova Iorque , Política Pública , Assunção de Riscos
2.
JMIR Public Health Surveill ; 7(3): e26719, 2021 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-33759790

RESUMO

BACKGROUND: Patient travel history can be crucial in evaluating evolving infectious disease events. Such information can be challenging to acquire in electronic health records, as it is often available only in unstructured text. OBJECTIVE: This study aims to assess the feasibility of annotating and automatically extracting travel history mentions from unstructured clinical documents in the Department of Veterans Affairs across disparate health care facilities and among millions of patients. Information about travel exposure augments existing surveillance applications for increased preparedness in responding quickly to public health threats. METHODS: Clinical documents related to arboviral disease were annotated following selection using a semiautomated bootstrapping process. Using annotated instances as training data, models were developed to extract from unstructured clinical text any mention of affirmed travel locations outside of the continental United States. Automated text processing models were evaluated, involving machine learning and neural language models for extraction accuracy. RESULTS: Among 4584 annotated instances, 2659 (58%) contained an affirmed mention of travel history, while 347 (7.6%) were negated. Interannotator agreement resulted in a document-level Cohen kappa of 0.776. Automated text processing accuracy (F1 85.6, 95% CI 82.5-87.9) and computational burden were acceptable such that the system can provide a rapid screen for public health events. CONCLUSIONS: Automated extraction of patient travel history from clinical documents is feasible for enhanced passive surveillance public health systems. Without such a system, it would usually be necessary to manually review charts to identify recent travel or lack of travel, use an electronic health record that enforces travel history documentation, or ignore this potential source of information altogether. The development of this tool was initially motivated by emergent arboviral diseases. More recently, this system was used in the early phases of response to COVID-19 in the United States, although its utility was limited to a relatively brief window due to the rapid domestic spread of the virus. Such systems may aid future efforts to prevent and contain the spread of infectious diseases.


Assuntos
Doenças Transmissíveis Emergentes/diagnóstico , Registros Eletrônicos de Saúde , Armazenamento e Recuperação da Informação/métodos , Vigilância em Saúde Pública/métodos , Viagem/estatística & dados numéricos , Algoritmos , Doenças Transmissíveis Emergentes/epidemiologia , Estudos de Viabilidade , Feminino , Humanos , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Processamento de Linguagem Natural , Reprodutibilidade dos Testes , Estados Unidos/epidemiologia
3.
Epidemiol Infect ; 149: e65, 2021 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-33650470

RESUMO

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) led to a significant disease burden and disruptions in health systems. We describe the epidemiology and transmission characteristics of early coronavirus disease 2019 (COVID-19) cases in Bavaria, Germany. Cases were reverse transcription polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infections, reported from 20 January-19 March 2020. The incubation period was estimated using travel history and date of symptom onset. To estimate the serial interval, we identified pairs of index and secondary cases. By 19 March, 3546 cases were reported. A large proportion was exposed abroad (38%), causing further local transmission. Median incubation period of 256 cases with exposure abroad was 3.8 days (95%CI: 3.5-4.2). For 95% of infected individuals, symptom onset occurred within 10.3 days (95%CI: 9.1-11.8) after exposure. The median serial interval, using 53 pairs, was 3.5 days (95%CI: 3.0-4.2; mean: 3.9, s.d.: 2.2). Travellers returning to Germany had an important influence on the spread of SARS-CoV-2 infections in Bavaria in early 2020. Especially in times of low incidence, public health agencies should identify holiday destinations, and areas with ongoing local transmission, to monitor potential importation of SARS-CoV-2 infections. Travellers returning from areas with ongoing community transmission should be advised to quarantine to prevent re-introductions of COVID-19.


Assuntos
/epidemiologia , /transmissão , Alemanha , Humanos , Saúde Pública , Quarentena/estatística & dados numéricos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Estações do Ano , Viagem/estatística & dados numéricos
4.
MMWR Morb Mortal Wkly Rep ; 70(8): 278-279, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33630825

RESUMO

On January 9, 2021, the Minnesota Department of Health (MDH) announced the identification of the SARS-CoV-2 variant of concern (VOC) B.1.1.7, also referred to as 20I/501Y.V1 and VOC 202012/01, in specimens from five persons; on January 25, MDH announced the identification of this variant in specimens from three additional persons. The B.1.1.7 variant, which is reported to be more transmissible than certain other SARS-CoV-2 lineages*,† (1), was first reported in the United Kingdom in December 2020 (1). As of February 14, 2021, a total of 1,173 COVID-19 cases of the B.1.1.7 variant had been identified in 39 U.S. states and the District of Columbia (2). Modeling data suggest that B.1.1.7 could become the predominant variant in the United States in March 2021 (3).


Assuntos
/diagnóstico , /genética , Adolescente , Adulto , Humanos , Minnesota/epidemiologia , Viagem/estatística & dados numéricos , Adulto Jovem
5.
PLoS One ; 16(2): e0245842, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33534857

RESUMO

BACKGROUND: Thailand is among the top five countries with effective COVID-19 transmission control. This study examines how news of presence of COVID-19 in Thailand, as well as varying levels of government restriction on movement, affected human mobility in a rural Thai population along the border with Myanmar. METHODS: This study makes use of mobility data collected using a smartphone app. Between November 2019 and June 2020, four major events concerning information dissemination or government intervention give rise to five time intervals of analysis. Radius of gyration is used to analyze movement in each interval, and movement during government-imposed curfew. Human mobility network visualization is used to identify changes in travel patterns between main geographic locations of activity. Cross-border mobility analysis highlights potential for intervillage and intercountry disease transmission. RESULTS: Inter-village and cross-border movement was common in the pre-COVID-19 period. Radius of gyration and cross-border trips decreased following news of the first imported cases. During the government lockdown period, radius of gyration was reduced by more than 90% and cross-border movement was mostly limited to short-distance trips. Human mobility was nearly back to normal after relaxation of the lockdown. CONCLUSIONS: This study provides insight into the impact of the government lockdown policy on an area with extremely low socio-economic status, poor healthcare resources, and highly active cross-border movement. The lockdown had a great impact on reducing individual mobility, including cross-border movement. The quick return to normal mobility after relaxation of the lockdown implies that close monitoring of disease should be continued to prevent a second wave.


Assuntos
/patologia , Telefone Celular , Viagem/estatística & dados numéricos , /virologia , Humanos , População Rural , Tailândia
6.
Sci Rep ; 11(1): 3109, 2021 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-33542248

RESUMO

The international spread of COVID-19 infection has attracted global attention, but the impact of local or domestic travel restriction on public transportation network remains unclear. Passenger volume data for the domestic public transportation network in Japan and the time at which the first confirmed COVID-19 case was observed in each prefecture were extracted from public data sources. A survival approach in which a hazard was modeled as a function of the closeness centrality on the network was utilized to estimate the risk of importation of COVID-19 in each prefecture. A total of 46 prefectures with imported cases were identified. Hypothetical scenario analyses indicated that both strategies of locking down the metropolitan areas and restricting domestic airline travel would be equally effective in reducing the risk of importation of COVID-19. While caution is necessary that the data were limited to June 2020 when the pandemic was in its initial stage and that no other virus spreading routes have been considered, domestic travel restrictions were effective to prevent the spread of COVID-19 on public transportation network in Japan. Instead of lockdown that might seriously damage the economy, milder travel restrictions could have the similar impact on controlling the domestic transmission of COVID-19.


Assuntos
Viagem/estatística & dados numéricos , /epidemiologia , Humanos , Japão , Pandemias , Transportes/estatística & dados numéricos
7.
Bull Math Biol ; 83(4): 25, 2021 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-33594478

RESUMO

We present a classic SEIR model taking into account the daily movements of individuals in different places. The model also takes into account partial confinement of individuals. This model is coupled with a model of protection against the epidemic by the use of masks. We are studying the effects of combined confinement and protection measures on the dynamics of the epidemic. We consider a constant proportion of asymptomatic people. We assume that symptomatic infected people may change their urban travel behavior due to the disease which causes them to travel less to places where they used to move and to stay at home more often. We present a sensitivity study with respect to the parameters. We show that the combination of the use of masks with almost complete release of confinement makes it possible to avoid the occurrence of a secondary peak of the epidemic. The model predicts that a total release of confinement can be successful for an epidemic of [Formula: see text] if on average a proportion of [Formula: see text] of the population wears masks of [Formula: see text] efficacy. However, if [Formula: see text] of the population remains confined, the same goal can be achieved with a proportion of [Formula: see text] of the population wearing masks with efficacy of the order of [Formula: see text].


Assuntos
/epidemiologia , Epidemias/prevenção & controle , Epidemias/estatística & dados numéricos , Modelos Biológicos , Infecções Assintomáticas/epidemiologia , Suscetibilidade a Doenças , Humanos , Máscaras/estatística & dados numéricos , Conceitos Matemáticos , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Quarentena/estatística & dados numéricos , Viagem/estatística & dados numéricos , População Urbana
8.
N Z Med J ; 134(1529): 10-25, 2021 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-33582704

RESUMO

AIMS: We developed a model, updated daily, to estimate undetected COVID-19 infections exiting quarantine following selectively opening New Zealand's borders to travellers from low-risk countries. METHODS: The prevalence of infectious COVID-19 cases by country was multiplied by expected monthly passenger volumes to predict the rate of arrivals. The rate of undetected infections entering the border following screening and quarantine was estimated. Level 1, Level 2 and Level 3 countries were defined as those with an active COVID-19 prevalence of up to 1/105, 10/105 and 100/105, respectively. RESULTS: With 65,272 travellers per month, the number of undetected COVID-19 infections exiting quarantine is 1 every 45, 15 and 31 months for Level 1, Level 2 and Level 3 countries, respectively. The overall rate of undetected active COVID-19 infections exiting quarantine is expected to increase from the current 0.40 to 0.50 per month, or an increase of one extra infection every 10 months. CONCLUSIONS: Loosening border restrictions results in a small increase in the rate of undetected COVID-19 infections exiting quarantine, which increases from the current baseline by one infection every 10 months. This information may be useful in guiding decision-making on selectively opening of borders in the COVID-19 era.


Assuntos
Controle de Doenças Transmissíveis , Doenças Transmissíveis Importadas , Transmissão de Doença Infecciosa , Regulamento Sanitário Internacional , Quarentena , /epidemiologia , /transmissão , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/prevenção & controle , Doenças Transmissíveis Importadas/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Transmissão de Doença Infecciosa/estatística & dados numéricos , Previsões , Saúde Global , Humanos , Regulamento Sanitário Internacional/organização & administração , Regulamento Sanitário Internacional/tendências , Nova Zelândia/epidemiologia , Prevalência , Política Pública , Quarentena/organização & administração , Quarentena/estatística & dados numéricos , Viagem/legislação & jurisprudência , Viagem/estatística & dados numéricos
9.
Emerg Infect Dis ; 27(4): 1249-1251, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33567246

RESUMO

We report an imported case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant P.1 detected in an asymptomatic traveler who arrived in Italy on an indirect flight from Brazil. This case shows the risk for introduction of SARS-CoV-2 variants from indirect flights and the need for continued SARS-CoV-2 surveillance.


Assuntos
Doenças Transmissíveis Importadas , Programas de Triagem Diagnóstica , Glicoproteína da Espícula de Coronavírus/genética , Adulto , Brasil/epidemiologia , /epidemiologia , /virologia , Portador Sadio/diagnóstico , Portador Sadio/epidemiologia , Doenças Transmissíveis Importadas/diagnóstico , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/virologia , Programas de Triagem Diagnóstica/organização & administração , Programas de Triagem Diagnóstica/normas , Humanos , Itália/epidemiologia , Masculino , Mutação , /isolamento & purificação , Viagem/estatística & dados numéricos , Doença Relacionada a Viagens
10.
BMC Public Health ; 21(1): 226, 2021 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-33504339

RESUMO

BACKGROUND: As COVID-19 continues to spread around the world, understanding how patterns of human mobility and connectivity affect outbreak dynamics, especially before outbreaks establish locally, is critical for informing response efforts. In Taiwan, most cases to date were imported or linked to imported cases. METHODS: In collaboration with Facebook Data for Good, we characterized changes in movement patterns in Taiwan since February 2020, and built metapopulation models that incorporate human movement data to identify the high risk areas of disease spread and assess the potential effects of local travel restrictions in Taiwan. RESULTS: We found that mobility changed with the number of local cases in Taiwan in the past few months. For each city, we identified the most highly connected areas that may serve as sources of importation during an outbreak. We showed that the risk of an outbreak in Taiwan is enhanced if initial infections occur around holidays. Intracity travel reductions have a higher impact on the risk of an outbreak than intercity travel reductions, while intercity travel reductions can narrow the scope of the outbreak and help target resources. The timing, duration, and level of travel reduction together determine the impact of travel reductions on the number of infections, and multiple combinations of these can result in similar impact. CONCLUSIONS: To prepare for the potential spread within Taiwan, we utilized Facebook's aggregated and anonymized movement and colocation data to identify cities with higher risk of infection and regional importation. We developed an interactive application that allows users to vary inputs and assumptions and shows the spatial spread of the disease and the impact of intercity and intracity travel reduction under different initial conditions. Our results can be used readily if local transmission occurs in Taiwan after relaxation of border control, providing important insights into future disease surveillance and policies for travel restrictions.


Assuntos
/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Surtos de Doenças , Viagem/estatística & dados numéricos , Previsões , Humanos , Modelos Biológicos , Risco , Mídias Sociais , Taiwan/epidemiologia , Viagem/legislação & jurisprudência
11.
Nat Commun ; 12(1): 311, 2021 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-33436574

RESUMO

Early in the COVID-19 pandemic, predictions of international outbreaks were largely based on imported cases from Wuhan, China, potentially missing imports from other cities. We provide a method, combining daily COVID-19 prevalence and flight passenger volume, to estimate importations from 18 Chinese cities to 43 international destinations, including 26 in Africa. Global case importations from China in early January came primarily from Wuhan, but the inferred source shifted to other cities in mid-February, especially for importations to African destinations. We estimate that 10.4 (6.2 - 27.1) COVID-19 cases were imported to these African destinations, which exhibited marked variation in their magnitude and main sources of importation. We estimate that 90% of imported cases arrived between 17 January and 7 February, prior to the first case detections. Our results highlight the dynamic role of source locations, which can help focus surveillance and response efforts.


Assuntos
/epidemiologia , Pandemias , Viagem , África/epidemiologia , Aeronaves , China/epidemiologia , Humanos , Modelos Teóricos , Prevalência , Viagem/estatística & dados numéricos
13.
Sci Rep ; 11(1): 1661, 2021 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-33462369

RESUMO

A better understanding of how the COVID-19 pandemic responds to social distancing efforts is required for the control of future outbreaks and to calibrate partial lock-downs. We present quantitative relationships between key parameters characterizing the COVID-19 epidemiology and social distancing efforts of nine selected European countries. Epidemiological parameters were extracted from the number of daily deaths data, while mitigation efforts are estimated from mobile phone tracking data. The decrease of the basic reproductive number ([Formula: see text]) as well as the duration of the initial exponential expansion phase of the epidemic strongly correlates with the magnitude of mobility reduction. Utilizing these relationships we decipher the relative impact of the timing and the extent of social distancing on the total death burden of the pandemic.


Assuntos
/transmissão , /epidemiologia , /virologia , Telefone Celular , Europa (Continente)/epidemiologia , Sistemas de Informação Geográfica , Humanos , Pandemias , Quarentena , Viagem/estatística & dados numéricos
15.
Healthc Q ; 23(4): 6-8, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33475484

RESUMO

Early in the first wave of the COVID-19 pandemic, many older adult Canadians who routinely spend the winter months in warmer regions (colloquially known as "snowbirds") returned to Canada. While numerous infections were attributed to travel-related exposure at that time, little is known about the impact of COVID-19 on returning snowbirds. This population-based analysis from Ontario suggests that snowbirds were not disproportionately impacted by the pandemic. However, as older adults, they remain at high risk of complications once infected. These findings underscore the need for continued caution in this older adult population.


Assuntos
/epidemiologia , Viagem , Idoso , Feminino , Humanos , Masculino , Ontário/epidemiologia , Fatores de Risco , Estações do Ano , Viagem/estatística & dados numéricos
16.
Nat Microbiol ; 6(1): 112-122, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33349681

RESUMO

Coronavirus disease 2019 (COVID-19) was first diagnosed in Scotland on 1 March 2020. During the first month of the outbreak, 2,641 cases of COVID-19 led to 1,832 hospital admissions, 207 intensive care admissions and 126 deaths. We aimed to identify the source and number of introductions of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into Scotland using a combined phylogenetic and epidemiological approach. Sequencing of 1,314 SARS-CoV-2 viral genomes from available patient samples enabled us to estimate that SARS-CoV-2 was introduced to Scotland on at least 283 occasions during February and March 2020. Epidemiological analysis confirmed that early introductions of SARS-CoV-2 originated from mainland Europe (the majority from Italy and Spain). We identified subsequent early outbreaks in the community, within healthcare facilities and at an international conference. Community transmission occurred after 2 March, 3 weeks before control measures were introduced. Earlier travel restrictions or quarantine measures, both locally and internationally, would have reduced the number of COVID-19 cases in Scotland. The risk of multiple reintroduction events in future waves of infection remains high in the absence of population immunity.


Assuntos
/epidemiologia , /genética , Adulto , Idoso , Europa (Continente)/epidemiologia , Genoma Viral , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Filogenia , Espanha/epidemiologia , Viagem/estatística & dados numéricos
18.
J R Soc Interface ; 17(173): 20200344, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33323055

RESUMO

One approach to delaying the spread of the novel coronavirus (COVID-19) is to reduce human travel by imposing travel restriction policies. Understanding the actual human mobility response to such policies remains a challenge owing to the lack of an observed and large-scale dataset describing human mobility during the pandemic. This study uses an integrated dataset, consisting of anonymized and privacy-protected location data from over 150 million monthly active samples in the USA, COVID-19 case data and census population information, to uncover mobility changes during COVID-19 and under the stay-at-home state orders in the USA. The study successfully quantifies human mobility responses with three important metrics: daily average number of trips per person; daily average person-miles travelled; and daily percentage of residents staying at home. The data analytics reveal a spontaneous mobility reduction that occurred regardless of government actions and a 'floor' phenomenon, where human mobility reached a lower bound and stopped decreasing soon after each state announced the stay-at-home order. A set of longitudinal models is then developed and confirms that the states' stay-at-home policies have only led to about a 5% reduction in average daily human mobility. Lessons learned from the data analytics and longitudinal models offer valuable insights for government actions in preparation for another COVID-19 surge or another virus outbreak in the future.


Assuntos
/prevenção & controle , Computadores de Mão , Pandemias , Viagem , /epidemiologia , Interpretação Estatística de Dados , Sistemas de Informação Geográfica , Humanos , Estudos Longitudinais , Modelos Estatísticos , Pandemias/prevenção & controle , Viagem/legislação & jurisprudência , Viagem/estatística & dados numéricos , Viagem/tendências , Estados Unidos/epidemiologia
19.
BMC Med ; 18(1): 399, 2020 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-33327961

RESUMO

BACKGROUND: Zika virus (ZIKV) emerged as a global epidemic in 2015-2016 from Latin America with its true geographical extent remaining unclear due to widely presumed underreporting. The identification of locations with potential and unknown spread of ZIKV is a key yet understudied component for outbreak preparedness. Here, we aim to identify locations at a high risk of cryptic ZIKV spread during 2015-2016 to further the understanding of the global ZIKV epidemiology, which is critical for the mitigation of the risk of future epidemics. METHODS: We developed an importation simulation model to estimate the weekly number of ZIKV infections imported in each susceptible spatial unit (i.e. location that did not report any autochthonous Zika cases during 2015-2016), integrating epidemiological, demographic, and travel data as model inputs. Thereafter, a global risk model was applied to estimate the weekly ZIKV transmissibility during 2015-2016 for each location. Finally, we assessed the risk of onward ZIKV spread following importation in each susceptible spatial unit to identify locations with a high potential for cryptic ZIKV spread during 2015-2016. RESULTS: We have found 24 susceptible spatial units that were likely to have experienced cryptic ZIKV spread during 2015-2016, of which 10 continue to have a high risk estimate within a highly conservative scenario, namely, Luanda in Angola, Banten in Indonesia, Maharashtra in India, Lagos in Nigeria, Taiwan and Guangdong in China, Dakar in Senegal, Maputo in Mozambique, Kinshasa in Congo DRC, and Pool in Congo. Notably, among the 24 susceptible spatial units identified, some have reported their first ZIKV outbreaks since 2017, thus adding to the credibility of our results (derived using 2015-2016 data only). CONCLUSION: Our study has provided valuable insights into the potentially high-risk locations for cryptic ZIKV circulation during the 2015-2016 pandemic and has also laid a foundation for future studies that attempt to further narrow this key knowledge gap. Our modelling framework can be adapted to identify areas with likely unknown spread of other emerging vector-borne diseases, which has important implications for public health readiness especially in resource-limited settings.


Assuntos
Mapeamento Geográfico , Infecção por Zika virus/epidemiologia , Aedes/fisiologia , Aedes/virologia , Animais , Surtos de Doenças/história , Ecologia , Epidemias , Geografia , História do Século XXI , Humanos , Viagem/estatística & dados numéricos , Zika virus/fisiologia , Infecção por Zika virus/história
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