Zika virus (ZIKV) is an emerging flavivirus which has been linked to a number of neurologic manifestations such as Guillain-Barré syndrome (GBS), transverse myelitis, and meningo-encephalitis. Ophthalmologic manifestations are increasingly being reported; however, ocular dyskinesias have not been described in this context to date. Herein, we report a case of a 22-year-old female who presented with ocular flutter and associated Guillain-Barré syndrome following acute ZIKV infection. We speculate that although such symptoms may have originated from a direct viral insult, a post-infectious autoimmune mechanism may not be excluded. Physicians should include ZIKV as well as other flaviviruses in their diagnostic workup for all patients with ocular flutter/opsoclonus, after excluding other non-infectious causes of central nervous system pathology. To the best of our knowledge, this is the first report on the association of ocular flutter, GBS, and ZIKV infection.

Diverse sources have constructed a common narrative of individual and isolated responses by countries and their leaders to the global coronavirus pandemic, akin to sálvese quien pueda (every man for himself). This article suggests that this is a simplification of the governance of the COVID‐19 pandemic in Peru. Peru's governance story is one of domestic public and private action closely interwoven with crucial elements of transnational administration out of sheer necessity. The struggle against the pandemic has generated a domestic and transnational administrative symbiosis, involving authorities at multiple levels in efforts to fill a series of interconnected domestic, regional, and global governance gaps.