Zika in Puerto Rico, 2016-2017: I Perspectives on the Social Crisis and Health Care Concerns.

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 I describes the social and sanitary environment, the first three months of the epidemic, and the debates related to religious, demographic, economic, political, and health care concerns.