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Abstract/Summary
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The Zika virus (ZIKV) has received considerable attention over the past two years. In view of its threat to the developing fetus and the absence of specific antiviral therapy, the public health response must focus on prevention. The two major preventive strategies are vaccine development and vector control, in addition to avoidance of pregnancy where transmission occurs. Logistical challenges of vaccine distribution and the epidemiology of Zika, which has so far been characterised by sporadic outbreaks, may pose challenges in the deployment of a potential ZIKV vaccine. Routine mass ZIKV vaccinations in the absence of an outbreak will have a disadvantageous cost/benefit ratio. Reactive targeted vaccinations require time to implement; by the time an outbreak has been detected and a reactive vaccination campaign is under way, the number of cases would likely have already peaked and susceptible people infected. Individuals should have the option to protect themselves through a safe and protective ZIKV vaccine, for which there will be considerable demand. From a public health perspective, targeting the mosquito vector Aedes aegypti to control and prevent ZIKV outbreaks is currently much more attractive than the vaccine approach. Besides, a potential ZIKV vaccine would only target that single virus. The recent ZIKV outbreak in many states of Brazil occurred between two other vector-borne disease outbreaks, dengue and chikungunya [1]. In contrast, vector control has the potential to prevent several mosquito-borne infections. In this issue of PLOS Medicine, Fernando Abad-Franch and colleagues describe a new method to curb the Ae. aegypti population in a city in Brazil [17].
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