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Editorials

Containing Zika while we wait for a vaccine

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j379 (Published 30 January 2017) Cite this as: BMJ 2017;356:j379
  1. Ranu S Dhillon, doctor1,
  2. Devabhaktuni Srikrishna, founder2,
  3. Ashish K Jha, director3
  1. 1Division of Global Health Equity, Brigham and Women’s Hospital and Harvard Medical School Boston, MA, USA
  2. 2Patient KnowHow San Mateo, CA, USA
  3. 3Harvard Institute for Global Health, Boston, MA, USA
  1. Correspondence to: R S Dhillon dhillon.ranu.s{at}gmail.com

Develop point-of-care diagnostics to target behavior change and prevent spread

Though no longer considered an emergency by the World Health Organization, Zika virus has reached over 70 countries and continues to spread.1 As long as each infected person infects, on average, at least one other person, the pandemic will grow. In highly affected areas, widespread infection and herd immunity could ultimately stall transmission but only after devastating consequences for new babies.2 Efforts to develop a vaccine seem promising, but it remains at least months away.34567 In the interim, measures to eliminate mosquitoes, such as aerial spraying, cannot be effectively applied across over 70 countries. Other approaches are needed to stem transmission.

Eliminating mosquitoes is absolutely necessary only if there is substantial vertical transmission from mosquitoes to their offspring. For Zika, this is rare (1 in 290)8 and insignificant compared with human mediated spread through mosquitoes and sex. About 80% of infected people are asymptomatic and therefore unaware they are propagating transmission. This “invisible” spread makes it difficult to know Zika’s …

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