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  • We did a qualitative analysis to

    2019-05-09

    We did a qualitative analysis to estimate the potential risk of Zika atp gamma s introduction into the country. We used the circlize statistical package for R software to visualise incoming traffic (logarithm of relative passenger volume) to Pakistani airports from countries characterised as Zika-virus-infected by the as of Sept 1, 2016. In a given country, only infected areas were considered (eg, Miami, FL, in the USA). Data on incoming passenger travel volume were obtained from the International Air Transport Association for 2015 (direct and indirect routes with stopovers). We found that the highest proportion of high-risk travellers arrived from Singapore (). Miami, FL, USA, and Brazil were the next two largest contributors to arrivals. While fewer in numbers, travellers to Pakistan converged from an additional 23 Zika-virus-infected regions. All international Pakistani airports are possible entry routes for Zika virus, and all are located in areas where moquitoes breed (), indicating the potential for onward transmission. The presence of in the local environment, together with the multiple modes of Zika virus introduction and spread, highlight the urgent need: to (i) develop an active vector surveillance and early Zika virus detection system, (ii) introduce public health awareness campaigns, and (iii) establish national preparedness and management guidelines for the local population, especially pregnant women and international travellers, to mitigate the risk of Zika virus introduction and spread in Pakistan, and a subsequent nationwide epidemic. A regional approach is also urgently needed to harmonise surveillance and vector control approaches, and share epidemiological information.
    Lancet Glob Health —In this Comment (October, 2016) the last sentence of the second paragraph should have read: “The IMCI assessment relies on general appearance, ability to drink, , and sunken eyes…”. The third, fourth, and fifth sentences of the third paragraph should have been deleted. The penultimate sentence of the third paragraph should have read: “The DHAKA score has not been validated in under-nourished children or those with hyponatraemia or hypernatraemia dehydration.” These corrections were made on Nov 9, 2016.