Part 1: The Zika Virus Threat and Prevention Challenges: An AllHazards and One Health Approach to Pandemic and Global Epidemic Prevention and Mitigation

To characterize the severity of the Zika virus (ZIKV) threat from an all-hazards perspective, we used the 2002 West Nile virus epidemic and epizootic as a comparator. Comparing these two threats allowed us to consider existing vulnerabilities and expected and uncertain consequences: infants born into disability, neurological symptoms across age groups, disease transmission pathways, national surveillance and control systems, and vaccine availability. We found that 1) human sexual ZIKV disease transmission, specifically the complexities of asymptomatic transmission and 2) verification that humans are the primary disease amplification reservoir are significant indicators of ZIKV threat severity. Novel public health messaging that describes disease transmission pathways in plain language must be developed to assure the health of all populations, not only those covered by protective legislation and defined as at-risk. Surveillance and mosquito control systems must be reestablished nationally and globally to enable a One Health approach to pandemic and global epidemic prevention and mitigation in a time of increasing climate change.