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BACKGROUND: Zika virus (ZIKV) was initially responsible for a limited number of punctual epidemics throughout Africa and Asia. Recently, large epidemics occurred in French Polynesia, Brazil and Pan-America. These outbreaks were associated with severe outcomes such as Guillain-Barré Syndrome and microcephaly of in-utero infected newborns. Previous studies demonstrated that ZIKV was introduced in Brazil from French Polynesia but failed to identify a founding event. METHOD: All publicly available ZIKV full-genome sequences (n = 182) were phylogenetically analyzed, using Bayesian method, to estimate the introduction date of ZIKV into Brazil. RESULTS: Introduction date into Brazil was estimated between 8th of July 2013 and 4th of November 2013, encompassing the Beach Soccer World Cup held in French Polynesia, in September 2013, which gathered Brazilian athletes and supporters. We also observed that ZIKV sequences from travelers infected in South-East Asia or in Pacific islands were closely related to viruses identified prior to the French Polynesian epidemic, underlining an endemic circulation of ZIKV in those countries since 2007, at least. CONCLUSION: This work provides a narrower estimation of ZIKV introduction into Brazil and illustrates the need for a better exploration of ZIKV circulation and endemicity in South-East Asia, while epidemiological and prevention efforts have been mainly focused on the Pan-American epidemic.

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The timing and origin of Zika virus (ZIKV) introduction in Brazil has been the subject of controversy. Initially, it was assumed that the virus was introduced during the FIFA World Cup in June-July 2014. Then, it was speculated that ZIKV may have been introduced by athletes from French Polynesia (FP) who competed in a canoe race in Rio de Janeiro in August 2014. We attempted to apply mathematical models to determine the most likely time window of ZIKV introduction in Brazil. Given that the timing and origin of ZIKV introduction in Brazil may be a politically sensitive issue, its determination (or the provision of a plausible hypothesis) may help to prevent undeserved blame. We used a simple mathematical model to estimate the force of infection and the corresponding individual probability of being infected with ZIKV in FP. Taking into account the air travel volume from FP to Brazil between October 2013 and March 2014, we estimated the expected number of infected travellers arriving at Brazilian airports during that period. During the period between December 2013 and February 2014, 51 individuals travelled from FP airports to 11 Brazilian cities. Basing on the calculated force of ZIKV infection (the per capita rate of new infections per time unit) and risk of infection (probability of at least one new infection), we estimated that 18 (95% CI 12-22) individuals who arrived in seven of the evaluated cities were infected. When basic ZIKV reproduction numbers greater than one were assumed in the seven evaluated cities, ZIKV could have been introduced in any one of the cities. Based on the force of infection in FP, basic reproduction ZIKV number in selected Brazilian cities, and estimated travel volume, we concluded that ZIKV was most likely introduced and established in Brazil by infected travellers arriving from FP in the period between October 2013 and March 2014, which was prior to the two aforementioned sporting events.

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BACKGROUND AND PURPOSE: The epidemiological characteristics of hypertension and obesity in French overseas territories (FOTs) have never been compared. METHODS: This cross-sectional survey included representative population-based samples of 602, 601, 620 and 605 men and women aged more than 15 years, respectively, from four FOTs of Guadeloupe, Martinique, French Guiana, and French Polynesia. Hypertension was defined as blood pressure (BP) at least 140/90mmHg or the current use of antihypertensive treatment. RESULTS: The prevalence of hypertension was 29.2% in Guadeloupe, 17.9% in French Guiana, 27.6% in Martinique and 24.5% in French Polynesia. Considering the Guadeloupe population as the reference group, prevalence of hypertension was significantly lower in French Guiana (P<0.001), even after controlling for age and sex (PU0.006). Awareness and treatment of hypertension were similar in French Guiana, Martinique and Guadeloupe (68.8-75.1% and 69.0-73.4%, respectively). Awareness was lower in French Polynesia (50.0%, adjusted P value U0.04), as was treatment of hypertension (32.4%, adjusted P value U0.001). Control of hypertension was also lower in French Polynesia (8.8%, adjusted P value U0.001) compared with the other territories (29.7-31.8%). French Polynesia had the highest prevalence of obesity (33.1%, adjusted P value<0.001) as compared with the other territories (17.9-22.8%). It had also the largest population attributable fraction of hypertension due to obesity (35.5%) compared with Guadeloupe (13.3%), Martinique (12.3%) and French Guiana (23.6%). CONCLUSION: Wide variations were observed in the prevalence and the management of hypertension between these FOTs, and an especially challenging low control of hypertension was found in French Polynesia. Obesity appears a key target to prevent hypertension, particularly in French Polynesia.

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PIP: Tahiti, situated in the Society Islands of the South Pacific among the 130 islands in the five archipelagos of French Polynesia, has very few indigenous populations. Population growth has been rapid under the conditions of military development and increasing immigration. When nuclear testing was approved in 1966, 18,000 troops arrived as did foreign migrants seeking work. Per capita income was high for the Pacific island countries, but distribution was very uneven. The transfers of administrative systems and law resulted in the loss of lands for some, who could not adjust to a foreign system. Today urban youth are confronted with high unemployment, malnutrition, disease, and overcrowding. The once beautiful lagoons have been contaminated with sewage and pesticides from soil erosion, caused in part by the careless construction along coastal areas. The most serious health problem is irradiation caused cancers: leukemia, thyroid infection, and brain tumors. There are also high levels of miscarriages. Lagoon fish have become contaminated by the disruptions to their habitat from detonation in two atolls. On the Mangareva Islands, all 600 residents died from ciguatera fish poisoning. Anti-nuclear groups have had very little impact. Polynesian women have suffered from these conditions and from the view that women are unclean and inferior. Women do not have access to political or economic power. The first effective women's group was formed in 1975 after Tahitian women's participation in the first Pacific Women's Conference held in Suva, Fiji. Tahitian women exchanged information with other women of similar background, and valuable international contacts were made. The movement to stop nuclear testing gained momentum from these interactions, from subsequent conferences, and better press coverage at home. Knowledge of environmental issues has been hampered by language barriers and literacy. The suspension of testing in April 1992 will benefit the health of Tahitians in the long term, but loss of jobs and housing will be a difficult adjustment in the short term.^ieng

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