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In Reply It’s always good to hear from my friend, respected colleague, and former Yale University mentor Ben Katz. However, I disagree with some of his assessments. While it’s true that in adults there is no comparison between the disease severity of Zika and human immunodeficiency virus (HIV)/AIDS, as a severe and devastating congenital infection, Zika is on an equal playing field and arguably worse than HIV/AIDS. Both Zika virus and HIV are neurotropic viruses, and in the case of Zika, it is a virus that blocks the development of the fetal brain. My key point is that given how widespread Zika is projected to become in the Americas (upwards of 4 million cases), we are facing the prospect of thousands of neurodevastated newborns in the Americas. The 1% estimate Dr Katz cites for French Polynesia may turn out to be much higher in Brazil (13%) and elsewhere.1 A second point is that beyond microcephaly, we are just at the beginning of understanding the full neurologic manifestations of congenital and pediatric Zika virus infection.
Hotez PJ. Zika Virus Is More Like Rubella Than Human Immunodeficiency Virus—Reply. JAMA Pediatr. Published online September 12, 2016. doi:10.1001/jamapediatrics.2016.2753