Seasonally-timing pregnancy: an ecological perspective on the prevention of mother-to-child transmission of Zika virus

Zika virus is an emerging pathogen vectored by the Aedes aegypti mosquito. Zika virus can be transmitted from mother-to-child in utero and mounting evidence suggests it is responsible for the cluster of microcephaly in newborns in Brazil. There is a great deal of uncertainty regarding the pathology of Zika virus during pregnancy. Based on 2015 birth rates, in 2016 there are expected to be > 8,600,000 births in countries with ongoing Zika virus transmission. In the face of this threat, the WHO is strategically targeting prevention of infection in pregnant women and funding contraception use in epidemic regions. In countries like Brazil, with millions of births per year, I propose that mother-to-child transmission of Zika virus can be curtailed by seasonally-timing pregnancy to minimize maternal exposure to Zika. Ae. aegypti has seasonal changes in its abundance and Flavivirus transmission competence. By seasonally planning pregnancy, this aspect of vector ecology can be leveraged to align sensitive periods of gestation with the low-transmission season.