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Comment & Response |

Zika Virus Is More Like Rubella Than Human Immunodeficiency Virus ONLINE FIRST

Ben Z. Katz, MD1,2
[+] Author Affiliations
1Northwestern University, Feinberg School of Medicine, Chicago, Illinois
2Division of Infectious Diseases, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
JAMA Pediatr. Published online September 12, 2016. doi:10.1001/jamapediatrics.2016.2750
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To the Editor I hate to disagree with my learned colleague Dr Peter Hotez,1 but I believe some of the analogies he presents in his JAMA Pediatrics article “What Does Zika Virus Mean for the Children of the Americas?” are exaggerated and misleading.1

To compare Zika with human immunodeficiency virus (HIV) is inappropriate. Human immunodeficiency virus can lead to life-threatening illness if not treated, whereas Zika is a mild illness that requires no therapy in most cases. And while there was talk of a congenital HIV syndrome in the early days of the HIV era,2 that has not panned out. The more appropriate comparison is to rubella. Both are mild clinical illnesses that can lead to devastating congenital malformation syndromes that involve the central nervous system, although Zika seems to have a much lower penetrance (only about 1% with first-trimester infection according to the latest estimates3). And just as congenital rubella was conquered by a vaccine, I am confident Zika will also be conquered. There are already steps in that direction, as one can see by Googling Zika virus vaccines. In the meantime, mosquito control and other public health measures are paramount.

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September 12, 2016
Peter J. Hotez, MD, PhD
1Pediatrics and Molecular Virology, Baylor College of Medicine, Houston, Texas2National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas
JAMA Pediatr. Published online September 12, 2016.;():. doi:10.1001/jamapediatrics.2016.2753.
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