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Comment & Response
November 2016

Zika Virus Is More Like Rubella Than Human Immunodeficiency Virus—Reply

Author Affiliations
  • 1Pediatrics and Molecular Virology, Baylor College of Medicine, Houston, Texas
  • 2National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas
JAMA Pediatr. 2016;170(11):1116. doi:10.1001/jamapediatrics.2016.2753

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.

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