2013–2014 zika virus outbreaks in oceania 2013–2014 zika virus outbreaks in oceania in october 2013, there was an outbreak of zika fever in french polynesia, the first outbreak of several zika outbreaks across oceania. with 8,723 cases reported, it was the largest outbreak of zika fever before the outbreak in the americas that began in april 2015. an earlier outbreak occurred on yap island in the federated states of micronesia in 2007, but it is thought that the 2013–2014 outbreak involved an independent introduction of the zika virus from southeast asia. investigators suggested that the outbreaks of mosquito-borne diseases in the pacific from 2012 to 2014 were "the early stages of a wave that will continue for several years", particularly because of their vulnerability to infectious diseases stemming from isolation and immunologically naive populations. epidemiology french polynesia outbreaks of zika virus, dengue and chikungunya in oceania from january 2012 to september 2014. the first zika outbreak started in french polynesia in october 2013, with cases reported in the society, marquesas and tuamotu islands on tahiti, mo'orea, raiatea, tahaa, bora bora, nuku hiva and arutua. the outbreak ran concurrently with an outbreak of dengue fever. in december 2013, an american traveler to mo'orea was diagnosed with zika virus infection in new york after an 11-day history of symptoms, becoming the first american tourist to be diagnosed with zika. a japanese tourist returning to japan was also diagnosed with zika virus infection by the national institute of infectious diseases after visiting bora bora, becoming the first imported case of zika fever in japan. by february 2014, it was estimated that more than 29,000 people with zika-like symptoms had sought medical care, roughly 11.5% of the population, with 8,503 suspected cases. of 746 samples tested at the institut louis-malardé in tahiti by 7 february, 396 (53.1%) were confirmed as containing the zika virus by rt-pcr. two further cases of zika virus infection were imported into japan, and on 25 february, the norwegian institute of public health reported that a traveler returning to norway from tahiti was confirmed to have a zika virus infection. by march 2014, the outbreak was declining in the majority of the islands, and by october the outbreak had abated. a total of 8,723 suspected cases of zika virus infection were reported, as well as more than 30,000 estimated clinical visits and medical consultations due to concerns about zika. the true number of zika cases was estimated at more than 30,000. new caledonia zika spread westwards from french polynesia to new caledonia, where imported cases from french polynesia were reported from november 2013 onwards. the first indigenous case was confirmed in january 2014 by the pasteur institute. on 10 february, there were 64 reported cases of zika in the communities of greater nouméa, dumbéa, and ouvéa, of which 30 were imported from french polynesia. by 26 february 2014, there were 140 confirmed cases of zika in new caledonia, including 32 imported cases. the outbreak peaked in april, and by 17 september, the number of confirmed cases had gone up to 1,400, of which 35 were imported. during the same time period, there were also outbreaks of chikungunya fever and dengue fever. cook islands in february 2014, an outbreak of zika was reported in the cook islands, to the southwest of french polynesia. in march, an australian woman was diagnosed with a zika virus infection by queensland health following a recent trip to the cook islands, becoming the second reported case of zika diagnosed in australia. nearly 40 other cases of zika virus infection were imported into new zealand. by 29 may, the outbreak had ended, with 50 confirmed and 932 suspected cases of zika virus infection. easter island by march 2014, there were one confirmed and 40 suspected cases of zika virus infection on easter island. the zika virus was suspected to have been carried to the island by a tourist from french polynesia during the annual tapati festival, held between january and february. chilean health authorities decided against issuing a health alert, saying that the outbreak had been contained and was under control, and advised travelers to take precautions against mosquito bites. by the end of the year, 173 cases of zika had been reported, but all of the cases were described as "mild". on 24 september 2014, a belgian woman flying to easter island from tahiti was diagnosed with zika virus infection after having previously received ambulatory care in tahiti, and was taken to hanga roa hospital for evaluation. lan airlines undertook operations to ensure other people on the woman's flight were not infected, and local health authorities stated that zika was not a risk for people on the island. transmission