Zika in Puerto Rico, 2016-2017: II Perspectives on Epidemic Surveillance and Control, Health Communication, Outcomes and Lessons.

The social reaction to the Zika epidemic in Puerto Rico reached a confrontational climax regarding aerial fumigation with an organophosphate insecticide. The public drama has obscured multiple simultaneous controversies. This and a companion paper, based mostly on print and digital news reports, provide a context and description of the major controversies and examine the outcomes and their lessons for the protection of the public's health. Part II covers the questions on disease surveillance (what is going on?); health communication and epidemic control (what is an epidemic? is there a way to control an epidemic transmitted by Aedes aegypti?), and the outcomes and lessons from the debates.