Review Article | Published:

The emergence of Zika virus and its new clinical syndromes

Naturevolume 560pages573581 (2018) | Download Citation


Zika virus (ZIKV) is a mosquito-transmitted flavivirus that has emerged as a global health threat because of its potential to generate explosive epidemics and ability to cause congenital disease in the context of infection during pregnancy. Whereas much is known about the biology of related flaviviruses, the unique features of ZIKV pathogenesis, including infection of the fetus, persistence in immune-privileged sites and sexual transmission, have presented new challenges. The rapid development of cell culture and animal models has facilitated a new appreciation of ZIKV biology. This knowledge has created opportunities for the development of countermeasures, including multiple ZIKV vaccine candidates, which are advancing through clinical trials. Here we describe the recent advances that have led to a new understanding of the causes and consequences of the ZIKV epidemic.

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This work was supported by NIH grants (R01 AI073755, R01 AI104972, U19 AI083019 and R01 HD091218) and by the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH. We thank E. Tyler (NIH) for assistance with figure preparation of virion models. This publication is the responsibility of the authors and does not necessarily represent the official view of the NIH.

Reviewer information

Nature thanks J. Jung and H. Tang for their contribution to the peer review of this work.

Author information


  1. Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

    • Theodore C. Pierson
  2. Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA

    • Michael S. Diamond
  3. Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, USA

    • Michael S. Diamond
  4. Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, USA

    • Michael S. Diamond
  5. Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, USA

    • Michael S. Diamond


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T.C.P. and M.S.D. conceived and wrote the review.

Competing interests

M.S.D. is a consultant for Inbios and on the Scientific Advisory Board of Moderna. T.C.P. is a co-inventor of NIAID ZIKV vaccine candidates.

Corresponding authors

Correspondence to Theodore C. Pierson or Michael S. Diamond.

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