New England Journal of Medicine
October 10, 2019 Vol. 381 No. 15
Zika Virus Infection — After the Pandemic
Didier Musso, M.D., Albert I. Ko, M.D., and David Baud, M.D., Ph.D.
Zika virus (ZIKV) was discovered in Africa in 1947 and was first detected in Asia in 1966, yet its potential effect on public health was not recognized until the virus caused outbreaks in the Pacific from 2007 to 2015 and began spreading throughout the Americas in 2015.1,2 The ability of ZIKV to cause congenital defects in fetuses and infants, as exemplified by the microcephaly epidemic in Brazil, is an unprecedented feature in a mosquito-borne viral infection.2-4 Although transmission of ZIKV has declined in the Americas, outbreaks and infection clusters continue to occur in some regions, such as India and Southeast Asia, where there are large populations of women of childbearing age who are susceptible to the virus.5 We review the body of information that was acquired during the pandemic and discuss the epidemiologic trends, current knowledge about the transmission and natural history of ZIKV infection and its sequelae, and the principles of diagnosis and clinical management.