Invasion Dynamics of Teratogenic Infections in Light of Rubella Control: Implications for Zika Virus

Discussion Our analysis indicates similarities with core predictions that emerge from the existing body of work on rubella across the two major scenarios for ZIKV transmission. Is ZIKV more like dengue (scenario 1) or WNV (scenario 2)? The rarity of human ZIKV isolates compared to the number of infected individuals (Lanciotti et al.20 failed to make any isolates during the Yap outbreak) suggests a low and/or transient viremia, making onward transmission seem unlikely, suggestive more of a similarity with WNV. This accords with historic evidence of the importance of zoonotic reservoirs, e.g., in many parts of West Africa 15. Conversely, models fitted to more recent outbreaks17 suggest greater similarity with dengue. Overall, there is still much to be done to understand the transmission cycle of ZIKV in the Americas. In both scenarios, however, a rapidly changing burden over the course of the early phase of the invasion, followed by endemic establishment of relatively lower burden of disease is suggested by simple modeling, and analogy with rubella. Quantifying both magnitude and timing of this shifting burden will require a deeper understanding of the underlying magnitude of transmission as well as the size of the susceptible population which is at risk, likely to be a function of both the landscape of immunity, and vector dynamics11. Our model illustrates that for ZIKV, as for rubella, the potential paradoxical effects associated with control efforts could also be observed ...
Source: PLOS Currents Outbreaks - Category: Epidemiology Authors: Source Type: research