In 2015, Brazil experienced an unprecedented epidemic of zika virus infection. Concurrently, there was an increased incidence of children born with primary congenital microcephaly. Researchers quickly suspected a link between the zika virus infection in pregnant women and congenital microcephaly due to the so-called congenital Zika syndrome (CZS). With the impending threat of a second outbreak, Marcio Leyser from the University of Iowa proposes a multilevel-based research framework for CZS, based on the multifaceted aspects of the disease.