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Zika

March 25, 2016 By Evan Skowronski Leave a Comment

A Few Generic Thoughts on How Zika is Being Discussed

After almost a week in the lab setting up, running samples, and discussing high throughput operations with students and faculty, a few key themes seem to be emerging.

First, the situation is very dire, so much more so than is being portrayed in the US media. Zika is a hard surveillance target, present for only short times and at low titer in serum. Duration might be longer in saliva and urine, although these are not regularly taken and may not be appropriate for other potential viral targets. The serology is a mess because of co-circulating Flavivirus Dengue and syndromic look-alike Chikungunya. Watching so many samples fly around from so many sick and terrified people (especially mothers!) really tugs at the heart strings.

Second, the amount of misinformation and speculation labeled as fact is appalling. For example, a recent molecular clock analysis of Zika in Brazil has been bandied about in the media (not by the authors, who make very reasonable claims in with an admittedly fluid data environment), suggesting that the virus was introduced during a specific event in late 2013.  The science is good within its known limitations, but the idea that it came from the right fullback of a soccer team from Country X is nothing short of absurd.  Similarly, an article in The Globe and Mail seems to try to refute (with no facts in evidence) the well-established fact that Aedes aegypti mosquito is in fact a competent vector for Zika.  It also seems to imply that there is little or no investigation in Brazil on the front of other potential competent vectors of the disease, which is interesting since I am working with an interdisciplinary group of scientists doing exactly that.

Can we please have a hype-free discourse on the subject, appropriately labeled by strength of proof to separate conjecture from hypothesis from fact?  Kindly resist the temptation increase your social media footprint with increasingly salacious  articles and tweets.  This really needs to be a data-driven response, and right know nearly identical “what we know” articles outnumber actual scientific articles. And while we are at it, can we acknowledge that there really are no “Zika experts” outside of places like the Institut Pasteur de Dakar in Senegal who have been working with the virus for decades?

Filed Under: Biosurveillance, Uncategorized, Zika

March 20, 2016 By Evan Skowronski Leave a Comment

Zika Operational Biosurveillance

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).

 

 

 

Filed Under: Biosurveillance, Zika

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