Table 3. Flaviviruses likely to show cross-reactivity with Zika virus under serological testing due to vaccination or endemic circulation in the population, by continent.
| Virus | Africa | Asia | Central America and the Caribbean | Europe (returning travellers) | Europe | North America | Oceania | South America |
|---|---|---|---|---|---|---|---|---|
| Vaccine-related | ||||||||
| Yellow fever virus | + | – | – | + | – | – | – | + |
| Japanese encephalitis virus | – | + | – | + | – | – | + | – |
| Tick-borne encephalitis virus | – | – | – | + | + | – | – | – |
| Dengue fever virus | – | – | +a | – | – | – | – | – |
| Endemic circulation | ||||||||
| Yellow fever virus | + | – | – | – | – | – | – | +b |
| Dengue fever virus | + | +b | +b | – | – | – | + | +b |
| West Nile virus | + | +b | + | – | + | + | + | + |
| Japanese encephalitis virus | – | +b | – | – | – | – | + | – |
| Tick-borne encephalitis virus | – | + | – | – | + | – | – | – |
| Usutu virus | + | – | – | – | + | – | – | – |
| Saint Louis encephalitis virus | – | – | + | – | – | + | – | + |
| Rocio virus | – | – | – | – | – | – | – | + |
| Ilheus virus | – | – | – | – | – | – | – | + |
| Murray valley encephalitis virus | – | – | – | – | – | – | +b | – |
| Kyasanur forest disease virus | – | + | – | – | – | – | – | – |
| Alkhurma haemorrhagic fever virus | – | +c | – | – | – | – | – | – |
| Wesselsbron virus | + | – | – | – | – | – | – | – |
+: virus circulating on continent and could be cross-reactive; –: virus not circulating on continent.
a Only in Mexico and possibly Brazil in near future (H Zeller, European Centre for Disease Prevention and Control, personal communication, February 2016).
b Highest priority based on analysis done by Cleton et al.45
c Only in countries of the Eastern Mediterranean Region.