First discovered in 1947, Zika virus (ZIKV) infection remained a little-known tropical disease until 2015, when its apparent association with a considerable increase in the incidence of microcephaly in Brazil raised alarms worldwide. There is limited information on the key factors that determine the extent of the global threat from ZIKV infection and resulting complications. This review describes what is known about the epidemiology, natural history, and public health effects of ZIKV infection, the empirical basis for this knowledge, and the critical knowledge gaps that need to be filled.
“The evidence highlighted in this review is both encouraging and disheartening. On the one hand, the speed with which the global community has collected and disseminated clinical, epidemiologic, and laboratory information on ZIKV after identification of the threat is impressive. But the development of therapeutics and diagnostics is hampered by our ignorance, despite knowing of ZIKV’s existence for more than half a century. Consequently, we have been able to do little to contain the virus’s rapid spread across the Americas. New threats from infectious diseases may emerge from unexpected places, and we need strategies in place that we can roll out to rapidly gain an understanding of the transmission, pathogenesis, and control of previously little-known pathogens to protect global public health.”