Burdens on Society
Although very different diseases, the burden of both HIV and Zika on the societies affected by them are tremendous. They are affected not only in terms of the financial expenses that need to be allocated by the government to combat these diseases, but also in terms of the societal fear of being infected, the physical and emotional burden of being an HIV carrier, as well as the possibility of losing or having a child with complications that will last a lifetime due to Zika/HIV infection. All of these reasons remind us that we must work on prevention to avoid a future where inefficient response scenarios continue to repeat themselves.
The response to these outbreaks, remind us that although we are now able to identify the symptoms, host, location, and the infectious agent responsible by the disease in a timely manner, we have not learned much in the last 30 years in terms of the timing for medical countermeasures to avoid outbreaks to spread. Fortunately, different from HIV, Zika is not expected to stay within the population, nor reemerge at full strength every year. This is due to the seasonality of the disease and an expected period of latency due to the in-creasing immune resistance on the population. An outbreak of Zika virus will come again and as well as other not well-known viruses, such as Mayaro, which is predicted to be in the next wave of arboviruses that we will have to combat. (Brazil is currently facing another arbovirus outbreak, yellow fever, which, if not contained, could spill over to other countries and eventually reach the United States again.)
Therefore, time is of the essence, and to enable researchers to respond better and faster to outbreaks, changes must be made in the way we conduct viral research. Strategies to change the way we deal with disease response are slowly evolving. For example, the US Army Medical Research Institute of Infectious Diseases worked with real-time sequencing of Zika samples in Florida, which enabled them to identify multiple populations of the virus and predict that the outbreak was coming from multiple transmissions of the virus into the United States.12
Fundação Oswaldo Cruz in Brazil is working on real-time sequencing for Zika and the current Yellow Fever outbreak, which has been valuable.
Although extremely important for current outbreaks, these approaches are treating the consequence and not the cause—they are attempting to understand what is happening with the current outbreaks, and not trying to prevent the next one.
Current efforts to change how we respond are being attempted in different formats by different research groups, such as Project Prophecy,13
an international surveillance and clinical trials network designed to provide an immediate deployment of clinical research on an infectious diseases outbreak. Another example is the Global Virome Project, which seek to install a surveillance system for researchers to evaluate viral evolution overtime, not only during an outbreak, which can assist virologists and epidemiologists in planning to avoid outbreaks.14
As science advances and the world grows more linked, viruses are being tracked faster, and are spreading faster. As concerned scientists, we must push for changes to secure a safer future and prepare for these outbreaks appropriately and effectively to ensure the safety and positive health outcomes of the global population.
Mr. Schneider is a Brazilian biologist and researcher. He received his Master of Science degree in crop science from the Federal University of Rio Grande do Sul, Brazil in 2012 and is currently pursuing a PhD in bioinformatics and computational biology at the University of North Carolina at Charlotte.
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