Vector Control Approaches for Immediate Response to Zika Outbreaks

The propagation Zika virus in the Americas has unveiled acute limitations of current urban vector control programs. While vaccines may ultimately represent the first line of defense against Zika, vector control targeted on Aedes aegypti will remain as a foundational approach for disease prevention, particularly given the geographic overlap of multiple Aedes-borne diseases (dengue, chikungunya, Zika, mayaro viruses). We will present results from Cairns, Australia, showing dramatic protection against disease (86-96% effectiveness) of indoor residual spraying and recent findings from Mexico outlining the entomological and epidemiological impacts of screening doors and windows using insecticide-treated nets. Scalability of any of these costly interventions will be dependent on coverage of deployment and temporal window for actions. We analyzed data from passive surveillance in the city of Merida, Mexico, to show that dengue, chikungunya and zika viruses show strong spatio-temporal coherence in their within-city distribution, leading to the practical implementation of indoor residual spraying or screening within a spatially targeted framework. Precision public health—using existing information and powerful analytical tools to direct interventions to those at higher risk of infection — can become a central pillar of an integrated vector management plan of Aedes-borne diseases in urban areas.