“In this study, 10,000 Latin American women will be enrolled. The study is enrolling now in Brazil and Puerto Rico. Women from other countries including Colombia will join. The impact of symptomatic and asymptomatic infections will be determined. Specimens will be collected monthly. [Researchers] will know when women become infected. They will track for maternal and fetal outcomes for up to a year after infection. This will be a really important study, I think, to get a better feel for what’s going on,” said Dr. Mulligan during the symposium.
One big goal is a vaccine to prevent infection with the Zika virus. “There is reason for optimism for a vaccine. We are not overconfident, but we are optimistic. One of the reasons is that there are a lot of other flavivirus vaccines,” said Dr. Mulligan.
Considerations for a vaccine include the effect of prior flavivirus immunity, vaccine-induced Guillain-Barré Syndrome, whether a vaccine will prevent viremia, which is important for pregnancy, and whether a vaccine can be developed in a timely manner.
Thinking ahead, in the early days after Zika vaccine development, if vaccine supplies are limited, Dr. Muligan suggested that recipients of a pre-pregnancy vaccine would include women of child-bearing age as well as their sexual partners. “We need to retool our thinking about Zika as a [sexually transmitted disease].” Once supplies became more robust, vaccination of the general population in an epidemic/endemic area could be contemplated, as could vaccination of travelers to these areas and commercial sex workers in these regions.
A phase I clinical trial is underway and is fully enrolled. The phase II VRC 705 randomized, placebo-controlled trial evaluating a DNA vaccine is slated to start at the beginning of 2017. Human studies assessing a vaccine preparation containing inactivated virus along with alum will begin soon. Other vaccines
are in development.
Efforts to refine Zika diagnosis are challenged by a brief detection window of viral RNA and antibodies and the lack of distinctive symptoms between Zika, Dengue, and Chikingunya infections. PCR and molecular tests are being explored to surmount the diagnostic hurdle.
All speakers: none
- Photos and tape of IDSA presentations
- CDC reports
- World Health Organization
- Donia MS et al. 2014. Cell 158:1402-1414
- Lee HH et al. 2010. Nature 467:82-85
Zika Symposium 1: Epidemiology, Virology & Countermeasures
- Zika Virus: Review of the Outbreak; Lyle R. Petersen, MD, MPH, Director, Division of Vector-Borne Diseases, United States Centers for Disease Control and Prevention
- Zika Virus: Virology & Pathogenic Mechanisms; Helen Lazear PhD, Department of Microbiology & Immunology, University of North Caroline School of Medicine, Chapel Hill, North Carolina
- Microbes, Infectious Disease, and the Future of Medicine; David Relman, MD, Stanford University School of Medicine, Stanford, California
Brian Hoyle, PhD, is a medical and science writer and editor from Halifax, Nova Scotia, Canada. He has been a full-time freelance writer/editor for over 15 years. Prior to that, he was a research microbiologist and lab manager of a provincial government water testing lab. He can be reached at firstname.lastname@example.org.
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