Since initial discovery of Zika virus, early virological and serological studies from the 1950s to 1980s showed that Zika virus infection is predominantly limited to African and Asian countries.
In Asia, endemic circulation of the virus (clinical disease and/or seroprevalence studies) has been reported in Indonesia, Cambodia, Thailand, The Philippines, Peninsular Malaysia, and Borneo, and among travelers returning from endemic areas.
The first major epidemic outside Africa occurred in Yap Island of the Federated States of Micronesia (in the western Pacific Ocean, north to Papua New Guinea) in 2007. Since then, Zika, dengue, and chikungunya viruses became rampant in the Pacific islands. Another major epidemic occurred in the western Pacific islands of French Polynesia and New Caledonia in 2013-2014.
The outbreak in Easter Island in 2014 heralded the incursion of the virus to mainland Latin America. Since early 2015, Brazil reported the first autochthonous case in the city of Natal and this was quickly followed by another large epidemic in Brazil and neighbouring countries in Latin America.
As of 12 February 2016, there were over 2,000 confirmed and over 118,000 suspected cases in the Americas. The exact time and route of spread of the virus to Brazil is unknown, but importation during the 2014 World Cup has been postulated.
Table 3 Outbreaks of human Zika virus infection since 2007.
| Year | Location | Estimated number of cases | Notable features |
| 2007 | Yap Island, Micronesia |
49 confirmed, 59 probable, and 72 suspected cases in one study. Estimated over 900 clinical cases, 73% of population infected in 4 months. |
Aedes hensilli implicated as the main vector. |
| 2007 | Gabon | Detected in 5 archived human samples; total number of cases unknown. |
Retrospective study of a concurrent outbreak of dengue and chikungunya; detection of virus in patient sera and Ae. albopictus pools. |
| 2013-2014 | French Polynesia |
8,723 suspected cases, over 30,000 sought medical care. |
Derived from the Asian lineage, closely related to Cambodia 2010 and Yap state 2007 strains. Association with Guillain-Barre´ syndrome and other neurological complications suspected. |
| 2014 | The Cook Islands | 932 suspected, 50 confirmed cases. | |
| 2014 | New Caledonia | 1400 confirmed cases (35 imported). | |
| 2014 | Easter Island | 51 confirmed out of 89 suspected cases from Jan e May 2014. |
Infecting strain closely related to viral strain found in French Polynesia. |
| 2015 | Latin America | Estimated 1.5 million cases in Brazil. | Association with microcephaly and maculopathy suspected. |
| a As of 10 February 2016. Includes Barbados, Bolivia, Colombia, Commonwealth of Puerto Rico, Costa Rica, Curacao, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, Mexico, Nicaragua, Panama, Paraguay, Saint Martin, Suriname, U.S. Virgin Islands, Venezuela. | |||
Wong SS-Y, et al., Zika virus infectiondthe next wave after dengue?, Journal of the Formosan Medical Association (2016), http://dx.doi.org/10.1016/j.jfma.2016.02.002
