Unless you have been living off the grid/under a rock/been asleep for the last 6 months or more, you know that the previously little-known Zika virus is tearing through South and Central America. Despite being discovered almost 80 years ago in Africa, Zika was essentially a quirky “so what” flavivirus in until recently when questions about association with microcephaly and Guillain Barré Syndrome began to arise. Couple these horrifying potential sequelae with the current footprint of disease (via HealthMap) and potential spread through the mosquito vector Aedes aegypti, and we are in the soup AGAIN. Like the last Ebola outbreak, MERS, SARS, HIV, etc. we were slow to see the signal and are now chasing the disease instead of trying to contain it.
I am not going to try to perform a comprehensive literature search here, but there are excellent online resources at CIDRAP and the CDC that are being updated constantly with a plethora of information. I will point out one study in the New England Journal of Medicine that seems to start to bridge the gap between correlation of Zika infection and causation of microcephaly. I do not disagree with science purists that this is not “proof” of a causative role of Zika, but we are well past the point where this data set and others has reached operational significance requiring education and vector/infection control measures.
Our work at TMG Biosciences focuses on implementation of active surveillance projects using the best available technology. I just landed in Brazil, and will be working with Dr. Paolo Zanotto at the University of São Paulo to set up high throughput, high content mosquito-borne disease detection. I will be using DEET spray liberally, permethrin on my clothes, and sleeping under a mosquito net. After joking with friends and colleagues on Twitter that this would be going way overboard in this regard, but I do NOT want to import another case to the US where host range of the primary vector makes local transmission a certainty. Dengue and Chikungunya are frankly more of a personal worry right now, and are both circulating with Zika concurrently.
More to come as we start cranking sample through the lab. This is my first blog in quite some time but will be much more active in the coming weeks as we roll our sleeves up for the surveillance effort.
Many thanks to colleagues for helpful and intersting discussions on Twitter: Caitlin Rivers (@cmyeaton), Ian Mackay (@MackayIM), Audi Byrne (@audibyrneheama), and Maia Majumder (@maiamajumder).