Abstract
Zika virus is transitioning to become a long-term public health challenge, and countries should remain informed of the risk for emergence. We developed a stochastic epidemiologic model to profile risk for Zika virus emergence, including trimester-specific fetal risk across time, in all 3,208 counties in the United States, including Puerto Rico. Validation against known transmission in North America demonstrated accuracy to predict epidemic dynamics and absolute case counts across scales (R2 = 0.98). We found that, although sporadic single transmission events could occur in most US counties, outbreaks will likely be restricted to the Gulf Coast region and to late spring through autumn. Seasonal fluctuations in birth rates will confer natural population-level protection against early-trimester infections. Overall, outbreak control will be more effective and efficient than prevention, and vaccination will be most effective at >70% coverage. Our county-level risk profiles should serve as a critical resource for resource allocation.
Highlights
Zika virus is transitioning to become a long-term public health challenge, and countries should remain informed of the risk for emergence
No longer classified a global emergency by the World Health Organization (WHO), Zika virus emergence and transmission continues globally, and WHO warns that Zika virus is set to remain as a long-term public health challenge [3]
Given the critical importance of preventing Zika virus infections, especially during pregnancy, transmission anywhere requires that nations remain vigilant and informed at local, state, and national levels to prevent and control introduction and onward transmission [4,5]
Summary
Zika virus is transitioning to become a long-term public health challenge, and countries should remain informed of the risk for emergence. Given the critical importance of preventing Zika virus infections, especially during pregnancy, transmission anywhere requires that nations remain vigilant and informed at local, state, and national levels to prevent and control introduction and onward transmission [4,5]. This imperative is especially important for countries such as the United States that simultaneously harbor the Aedes vectors and maintain essentially entirely susceptible populations. Profiling Zika Virus Risk, United States behavior modification and ubiquitous technologies such as air conditioning, screens, and long clothing); depleting adult vectors (i.e., mosquito fumigation programs); and vaccination, which, should a successful candidate vaccine come to market, might reduce individual and community risk for infection once herd-immunity thresholds are achieved [11]
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