Potential Research Priorities to Inform Public Health and Medical Practice for Domestic Zika Virus Workshop in Brief (2016) / Chapter Skim
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Potential Research Priorities to Inform Public Health and Medical Practice for Domestic Zika Virus - Workshop in Brief
Potential Research Priorities to Inform Public Health and Medical Practice for Domestic Zika Virus - Workshop in Brief
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, determined an urgent need for additional research to better characterize ZIKV, especially those issues related to the means of transmission and infection during pregnancy. At the request of Lurie, the National Academies of Sciences, Engineering, and Medicine convened a 1-day public workshop on February 16, 2016, to discuss and explore key factors1 associated with ZIKV, a single-stranded RNA virus of the Flaviviridae family transmitted to humans primarily through the bite of an infected Aedes species mosquito, and its emergence in the United States.
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that would provide public health officials and the general public with additional accurate information about virus transmission, mitigation of health risks, and appropriate measures to prevent the spread of disease. Specific topics that may be addressed in this workshop include: • Epidemiologic characteristics of ZIKV transmission, for example, – Virus vectors – Transmission – Natural reservoirs • Basics of disease pathogenesis, for example, – Development of relevant animal models – Sites of virus replication and consequences of infection – Mechanism of transplacental transmission – Neurotropism – Virus strains, evolution and determinants of virulence – Role of the immune response in disease and virus clearance or persistence – Cross reactivity with other flaviviruses and the role of prior infection with or vaccination for yellow fever and dengue • Clinical management and public health intervention, for example, – Risk factors for developing clinical disease (symptoms, neurologic complications, fetal infection)
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Virus Vectors and Reservoirs Scott Weaver10 and Thomas Monath11 reviewed vector distribution and vector control strategies associated with ZIKV; potential reservoir hosts; and weather and other climate effects on the virus. Weaver highlighted three hypotheses explaining the recent outbreak in the Americas.
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Disease Pathogenesis and Consequences of Infection Richard Kuhn,13 Michael Diamond,14 and William Britt15 explored what is known and unknown in the areas of viral genetics, evolution, structure, and replication of the virus; the disease pathogenesis and associated complications and immune responses; issues of virus clearance and persistence; and the need for animal models to study ZIKV. Kuhn offered a number of unanswered questions about how the specific ZIKV structure impacts the pathogenesis of ZIKV infection and disease.
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Epidemiological Characteristics Discussants Sonja Rasmussen21 and Rosenberg discussed several areas of insufficient knowledge related to the epidemiological characteristics of ZIKV and associated diseases. Participant discussion centered on six potential research priority areas: (1)
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Virus Vectors and Reservoirs Discussants Stephen Higgs23 and Thomas Scott24 gave presentations on vector transmission cycles, vector control, mosquito ecology, and the role that mathematical and simulation modeling can play in better understanding this virus. Participant discussion centered on six potential research priority areas: (1)
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Clinical Management and Public Health Interventions Discussants George Saade34 and Stephen Whitehead35 discussed clinical management and potential prevention strategies. Participant discussion centered on six potential research priority areas: (1)
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Lynn Goldman37 presented potential research priority areas discussed during the breakout session about clinical management and public health interventions that could be addressed now to inform public health and medical practice. 36 Dan Hanfling, M.D., is a contributing scholar at the University of Pittsburgh Medical Center, Center for Health Security, clinical professor of Emergency Medicine at The George Washington University, and adjunct faculty at the George Mason University School of Public Policy.
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