Introduction

The Zika virus, a mosquito-borne disease previously considered mild, has been implicated in an increasing number of microcephaly cases in infants whose mothers were infected during pregnancy. The urgency of addressing its pandemic spread through the Tropics has become acute.

Large scale responses need time to be developed as there is no cure, no vaccine, and no readily available test for the disease. The strategy for responding to Zika may be adapted from those for other mosquito-borne viruses, including the Dengue virus, which is a leading cause of serious illness and death among children in some Asian and Latin American countries, and is transmitted by the same mosquito.

Public health interventions for mosquito borne diseases focus either on large scale actions, such as spraying large areas with pesticide, or recommendations to the public that focus on individual health, such as wearing protective clothing, using insecticide and installing screens on windows and doors. One common recommendation, draining standing water in and around homes, inhibits insect breeding and thus protects not just the individual but also helps protect neighbors. The near eradication of the mosquito in South America during the 1950s was accomplished through a combination of DDT spraying and eliminating standing water.

Here we propose a set of community-level strategies for reducing mosquito reproduction, reducing exposure to the virus, and constraining its geographical spread. The benefits of collective effects leads to the importance of Strategies in which multiple individuals perform actions which mutually reinforce each other. The rapid two to four week generation time of the primary mosquito species carrying the virus, Aedes aegypti, means that reducing its reproduction rate may confine it to smaller areas, halting its spread and subsequently enabling more targeted efforts to eliminate the virus in those areas.

The severe nature of the current epidemic and its connection to birth defects implies that the public will be energized to become involved in the eradication of the disease. This makes it possible to engage the community and will enhance effectiveness of community efforts. Grass roots organizations with local neighborhood leadership can be enlisted to organize urban areas, including in the favelas that are often hard to reach for public health efforts.