In:

The New England Journal of Medicine

Authors:

Anthony S. Fauci, M.D., and David M. Morens, M.D.

The explosive pandemic of Zika virus infection occurring throughout South America, Central America, and the Caribbean (see map) a recent of four unexpected arrivals of important arthropod-borne viral diseases in the Western Hemi- sphere over the past 20 years. It follows dengue, which entered this hemisphere stealthily over decades and then more aggres- sively in the 1990s; West Nile vi- rus, which emerged in 1999; and chikungunya, which emerged in 2013. Are the successive migra- tions of these viruses unrelated, or do they reflect important new patterns of disease emergence? Furthermore, are there secondary health consequences of this arbo- virus pandemic that set it apart from others?

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