Keeping pace with changing demographics, environmental and social issues as well as advancements in technology is becoming more challenging. In addition to the evolving landscape, we are faced not only with existing infectious diseases but also the rise of new ones.1-2
Zika Virus, an enduring public health concern
Infectious diseases represent a major cause of death worldwide. Every year, more than 1.2 million people die from viral hepatitis and over 1 million from Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDSs).3-5 Following the 2014 Ebola outbreak, Zika virus became the next virus to create a significant public health concern. Since then, Zika virus has spread widely throughout South and Central America and the Caribbean, and continues to proliferate today, despite no longer being classified as a public health emergency by the World Health Organization (WHO).6-7
Whilst the number of cases of Zika infection dropped to fewer than 14,000 in 2017, from 206,000 in the previous year, experts at the National Institute of Allergy and Infectious Diseases (NIAI) predict that Zika virus, as with other vector-borne diseases, is a threat that should not be dismissed entirely.8-9 There is currently no approved vaccine available to protect against the virus
Although Zika virus is mainly spread by the bite of infected mosquitoes, transmission through sexual intercourse and from pregnant mothers to fetuses has also been documented.10 The Centers for Disease Control and Prevention (CDC) has recorded Zika virus infection during pregnancy as a cause of congenital microcephaly and severe brain abnormalities, known as congenital Zika syndrome. Zika virus has also been linked to other problems in pregnancies such as miscarriages, stillbirths, and other birth defects.11-12 Therefore, it is increasingly important to diagnose and manage these conditions with speed and accuracy.
An urgent need for accurate testing
The diagnosis of Zika virus infection can only be confirmed through laboratory tests of blood or other body fluids, such as urine, saliva or semen. However, there are frequent cases in which testing of different fluids gives discrepant results, and additional studies are needed to assess diagnostic accuracy.13 Whilst assays such as Reverse Transcription Polymerase Chain Reaction (RT-PCR) can confirm Zika virus infection if the result is positive, a negative result cannot rule out infection, as this viral Ribonucleic acid (RNA) is only detectable in serum during the acute phase of infection. Therefore, additional testing, such as serology is required in order to obtain an accurate interpretation.14
Furthermore, as Zika virus is from the same family as Dengue and Yellow Fever viruses, which can potentially induce cross reaction, and may produce similar symptoms to Chikungunya virus, it is critical that the diagnostic tests are highly specific to Zika virus to avoid a misinterpretation and reduce the potential risk of false-positive results.15
“Infectious diseases are evolving at a fast pace and we need to remain ahead of the curve to keep up, especially where a vast public health risk is concerned,” said Thomas Schinecker, Head of Centralised and Point of Care Solutions (CPS) at Roche. “It is important now more than ever to have the right expertise in place to swiftly develop accurate and tailored diagnostic solutions to reduce the risk of infections worldwide.”
What this means for patients and health providers
An accurate and swift diagnosis of Zika virus infection in pregnant women, women who are planning a pregnancy, as well as their respective partners, is especially important to give healthcare professionals the knowledge to initiate additional testing, if necessary.16 It can also help give women the confidence to make an informed decision about their care and that of their unborn child.
An accurate diagnosis is also important in safely reducing the risk of contaminated blood and providing patients and healthcare providers with the confidence and reassurance of safe transfusions.17 Zika can be devastating for patients with weaker immune systems such as the elderly, or people living with cancer (also people who are more likely to receive a blood transfusion).18 Therefore, safely reducing the risk of contaminated blood is critical to provide patients and healthcare systems with the confidence and reassurance of safe transfusions.
It is important as well, to have a very specific Zika virus assay to perform epidemiological studies to help judge when a population is at risk from herd immunity.19
Meeting today’s emerging healthcare needs quickly and efficiently is important to reduce and contain the proliferation of infectious diseases. Roche Diagnostics understands the urgent need to respond quickly to global healthcare concerns and emergencies and to initiate integrated solutions and tailored diagnostic solutions for patients. It is only through a collaborative effort that we are able to provide needed diagnostic solutions for complex infectious diseases like Zika.
- Biodiversity and Infectious Diseases. Available at: https://chge.hsph.harvard.edu/biodiversity-and-infectious-diseases Last accessed: February 2018
- Patz J.A., Githeko, A.K., McCarty, J.P., et al. WHO Climate Change and Human Health. Chapter 6: Climate change and infectious diseases. Available at: http://www.who.int/globalchange/publications/climchange.pdf. Last accessed: February 2018.
- World Health Organization. Hepatitis B Factsheet. 2017. Available at: http://www.who.int/mediacentre/factsheets/fs204/en/. Last accessed: February 2018.
- World Health Organization. Hepatitis C Factsheet. 2017. Available at: http://www.who.int/mediacentre/factsheets/fs164/en/. Last accessed: February 2018.
- World Health Organization. HIV/AIDS Factsheet. 2017. Available at: http://www.who.int/mediacentre/factsheets/fs360/en/. Last accessed: February 2018.
- Fauci A.S., Morens D.M. Zika virus in the Americas: Yet another arbovirus threat. N. Engl. J. Med. 2016; 374: 601–604.
- World Health Organization. WHO statement on the Fifth Meeting of the emergency committee under the International Health Regulations (2005) regarding microcephaly, other neurological disorders and Zika virus. Available at: http://www.who.int/mediacentre/news/statements/2016/zika-fifth-ec/en. Last accessed February 2018.
- Centers for Disease Control and Prevention. Zika Virus: 2017 Case Counts in the US. Available at: https://www.cdc.gov/zika/reporting/2017-case-counts.html. Last accessed: February 2018.
- National Institute of Allergy and Infectious Disease. Zika remains a research and a public health challenge, says NIAID Scientists. Available at: https://www.niaid.nih.gov/news-events/zika-remains-research-and-public-health-challenge-say-niaid-scientists. Last accessed: February 2018.
- World Health Organization. Zika Virus Fact Sheet. 2016. Available at: http://www.who.int/mediacentre/factsheets/zika. Last accessed: February 2018.
- Centers for Disease Control and Prevention. Zika Virus: Sexual Transmission & Prevention. Available at: https://www.cdc.gov/zika/prevention/sexual-transmission-prevention.html. Last accessed: February 2018.
- Centers for Disease Control and Prevention. Zika Virus: Effects during Pregnancy. Available at: https://www.cdc.gov/zika/hc-providers/pregnant-women/effects-during-pregnancy.html. Last accessed: February 2018.
- Musso D., Roche C., Nhan T.X., Robin E., Teissier A., Cao-Lormeau V.M. Detection of Zika virus in saliva. J. Clin. Virol. 2015; 68: 53–55.
- Centers for Disease Control and Prevention. Zika Virus: Diagnostic Tests for Zika Virus. Available at: https://www.cdc.gov/zika/hc-providers/types-of-tests.html. Last accessed: February 2018.
- Duffy M.R., Chen T.H., Hancock W.T., et al. Zika virus outbreak on Yap Island, federated states of Micronesia. NEJM. 2009; 360: 2536-2543
- Centers for Disease Control and Prevention. Caring for Pregnant Women. Available at: https://www.cdc.gov/pregnancy/zika/testing-follow-up/pregnant-woman.html. Last accessed: February 2018.
- Centers for Disease Control and Prevention. Zika and Blood Transfusion. Available at: https://www.cdc.gov/zika/transmission/blood-transfusion.html. Last accessed: February 2018.
- Busch M.P. Zika and the safety of the US blood supply. Clin Adv Hematol Oncol. 2016; 14(9): 677.
- Rather I.A., Lone J.B., Bajpai V.K., Paek W.K., Lim J.. Zika virus: an emerging worldwide threat. Front Microbiol. 2017; 8: 1417.