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It has come to light that Zika virus (ZIKV) infection during pregnancy can result in trans-placental transmission to the fetus along with fetal death, congenital microcephaly and/or Central Nervous System (CNS) malformations. There are projected to be > 9, 200, 000 births annually in countries with ongoing ZIKV transmission. In response to the ZIKV threat, the World Health Organization (WHO) is strategically targeting prevention of infection in pregnant women and funding contraception in epidemic regions. I propose that the damaging effects of ZIKV can be reduced by timing pregnancy seasonally to minimize maternal exposure. Like other acute viral infections—including the related flavivirus, dengue virus (DENV)—the transmission of ZIKV is anticipated to be seasonal. By seasonally planning pregnancy, this aspect of pathogen ecology can be leveraged to align sensitive periods of gestation with the low-transmission season.
This article was revised after peer review. I heavily revised the manuscript to frame the key knowledge gaps in ZIKV epidemiology and the caveats of timing pregnancy seasonally. As reviewers noted, my manuscript needed to place less emphasis on using mosquito abundance as a predictor of ZIKV transmission seasonality. I have now included information about the types of data and models that would be required to quantify ZIKV transmission seasonality in the future, and I have also included DENV data from Puerto Rico as a complement to the mosquito abundance data. I have rewritten the article with emphasis on the unknown.