Factors associated with infection and hospitalization of Zika cases during the 2016-2018 outbreak in Mexico

The Mexican Social Security Institute registered a significant number of suspected Zika virus (ZIKV) cases during the 2016-2018 outbreak. This study aims to describe the distribution of confirmed ZIKV cases, their correlation with rainfall and temperature, and associated factors with infection or hospitalization, considering pregnancy. A retrospective analysis was performed on 13,259 suspected ZIKV cases. Binary logistic regression was performed to determine potentially associated factors with infection or hospitalization. Correlations between positive cases and environmental factors were analyzed using the Pearson correlation and an autoregressive integrated moving average (ARIMA) test. Female sex and age > 30 were associated with ZIKV infection when excluding pregnant women. In pregnant women, a higher infection rate in the first and second trimesters compared to third trimester was observed. In Veracruz, rainfall correlated with positive cases in 2016 (n = 5; r = 0.9977, p < 0.001) and 2017 (n = 12; r = 0.7467, p = 0.005) correlated with rainfall only in 2017 (r = 0.7975, p = 0.002); this was not significant with the ARIMA analysis. Further research is suggested to elucidate factors involved in the transmission, pathogenicity and epidemiology of this and other vector-borne disease viruse.