title: Zika Virus: Medical Countermeasure Development Challenges.
abstract: BACKGROUND
  Reports of high rates of primary microcephaly and Guillain-Barré syndrome associated with Zika virus infection in French Polynesia and Brazil have raised concerns that the virus circulating in these regions is a rapidly developing neuropathic, teratogenic, emerging infectious public health threat. There are no licensed medical countermeasures (vaccines, therapies or preventive drugs) available for Zika virus infection and disease. The Pan American Health Organization (PAHO) predicts that Zika virus will continue to spread and eventually reach all countries and territories in the Americas with endemic Aedes mosquitoes. This paper reviews the status of the Zika virus outbreak, including medical countermeasure options, with a focus on how the epidemiology, insect vectors, neuropathology, virology and immunology inform options and strategies available for medical countermeasure development and deployment.
  
  
  METHODS
  Multiple information sources were employed to support the review. These included publically available literature, patents, official communications, English and Lusophone lay press. Online surveys were distributed to physicians in the US, Mexico and Argentina and responses analyzed. Computational epitope analysis as well as infectious disease outbreak modeling and forecasting were implemented. Field observations in Brazil were compiled and interviews conducted with public health officials.
authors.affiliation: RW Malone MD LLC, Scottsville, Virginia, United States of America.|Class of 2016, Harvard Medical School Global Clinical Scholars Research Training Program, Boston, Massachusetts, United States of America.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Malone
authors.affiliation: ioGenetics, Madison, Wisconsin, United States of America.
authors.forename: Jane
authors.initials: J
authors.lastname: Homan
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Callahan
authors.affiliation: RW Malone MD LLC, Scottsville, Virginia, United States of America.|Class of 2016, Harvard Medical School Global Clinical Scholars Research Training Program, Boston, Massachusetts, United States of America.
authors.forename: Jill
authors.initials: J
authors.lastname: Glasspool-Malone
authors.affiliation: Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America.
authors.forename: Lambodhar
authors.initials: L
authors.lastname: Damodaran
authors.affiliation: Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America.
authors.forename: Adriano De Bernardi
authors.initials: Ade B
authors.lastname: Schneider
authors.affiliation: University of Florida, Department of Entomology and Nematology, Florida Medical Entomology Laboratory, Vero Beach, Florida, United States of America.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Zimler
authors.affiliation: Nanotherapeutics, NANO-ADM Advanced Development and Manufacturing Center, Alachua, Florida, United States of America.
authors.forename: James
authors.initials: J
authors.lastname: Talton
authors.affiliation: Nanotherapeutics, NANO-ADM Advanced Development and Manufacturing Center, Alachua, Florida, United States of America.
authors.forename: Ronald R
authors.initials: RR
authors.lastname: Cobb
authors.affiliation: Analytical Outcomes, Washington Crossing, Pennsylvania, United States of America.
authors.forename: Ivan
authors.initials: I
authors.lastname: Ruzic
authors.affiliation: School of Community Health Sciences, University of Nevada, Reno, Nevada, United States of America.
authors.forename: Julie
authors.initials: J
authors.lastname: Smith-Gagen
authors.affiliation: Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America.
authors.forename: Daniel
authors.initials: D
authors.lastname: Janies
authors.affiliation: Nevada Center for Infectious Disease Forecasting, University of Nevada, Reno, Nevada, United States of America.
authors.forename: James
authors.initials: J
authors.lastname: Wilson
mesh_terms: D000330:Aedes / Q000254:growth & development / Q000821:virology; D000569:Americas / Q000453:epidemiology; D000818:Animals; D003140:Communicable Disease Control / Q000379:methods*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D006801:Humans; D058873:Pandemics; D011114:Polynesia / Q000453:epidemiology; D000071243:Zika Virus Infection / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control* / Q000635:transmission