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Among the clinical manifestations associated with the recent Zika infection outbreak in South America and elsewhere are rash, conjunctivitis, Guillain-Barré syndrome (GBS) in exposed adults, and in the newborn so-called congenital Zika syndrome, especially microcephaly. 1 After accumulating epidemiological data from the French Polynesia2 outbreak, attention has now focused on Zika infection as a trigger of GBS. The case for a specific, causal association between acute Zika infection and subsequent GBS was strongly made: 42 individuals were diagnosed with GBS, of whom all had Zika neutralising antibodies.

Annelies Wilder-Smith and colleagues3 correctly highlight the public health threat posed by arboviral disease transmission beyond just Zika infection: South America shows co-circulation of several aedes mosquito-transmitted diseases, often with overlapping symptoms. In 2016, the National …