The World Health Organisation (WHO) has launched a global response unit to fight Zika,the mosquito-borne virus and has declared the recent clusters of microcephaly and other neurological abnormalities reported in the Americas region as a Public Health Emergency of International Concern. It has said the virus could infect four million people in the Americas. The so far neglected disease has taken global epidemic proportions now.
The Zika Virus (ZIKV), linked to severe birth defects in thousands of babies in Brazil, is spreading rapidly in the Americas. The virus has been reported in more than 30 countries and linked to microcephaly, in which babies have abnormally small heads and improperly developed brains. More than 20 countries in Latin America have reported an outbreak and a rare case of the Zika virus being transmitted through sex has been reported in Texas, USA.
Until recently, ZIKV was considered a rare and seemingly benign virus. However in May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed ZIKV infection in Brazil, and since then it has spread across the Americas. In the United States, authorities have reported a locally transmitted case of Zika in Puerto Rico, with reports of cases in continental United States in returning travellers.
At a briefing session during the 138th Executive Board of the WHO, the Director General, Dr. Margaret Chan, said that the WHO was deeply concerned about ZIKV for four main reasons: the possible association of infection with birth malformations and neurological syndromes; the potential for further international spread given the wide geographical distribution of the mosquito vector; the lack of population immunity in newly affected areas; absence of vaccines, specific treatments, and rapid diagnostic tests.
Companies step up research
As the world searches for a vaccine , many global companies have stepped up research and have joined the race to develop a vaccine for Zika.
The Bharat Biotech International Ltd in Hyderabad says it has patented the Zika vaccine. In a crucial "Make in India" moment, scientists at the company say they have developed the world's first vaccine against the Zika virus. They say, in fact, that they have two.
"On Zika, we are probably the first vaccine company in the world to file a vaccine candidate patent about nine months ago," said Dr. Krishna Ella, Chairman and Managing Director, Bharat Biotech Ltd.
Using a live Zika virus imported officially, the Bharat Biotech has now developed two candidate vaccines, but taking them through animal and human trials could be a long haul. Dr Ella said he had sought the government's support on this and the Indian Council of Medical Research (ICMR)has stepped forward to help.
"We have just been informed about the Zika vaccine candidate that Bharat Biotech has. We will examine it from the scientific point of view and see the feasibility of taking it forward. It is a good example of a Make in India product," said Dr. Soumya Swaminathan, Director General, ICMR.
Dr Ella said in a best case scenario his company can make one million doses of the vaccine in four months. He has sought the direct intervention of Prime Minister Narendra Modi to ensure that the vaccine's development and delivery is fast-tracked, cutting through the red tape of regulatory clearances, pointing out that the vaccine can help countries such as Brazil, a fellow member of the Brazil, Russia, India, China and South Africa(BRICS)group.
At the same time Sanofi Pasteur, the vaccines division of Sanofi, has launched a vaccine research and development project targeting the prevention of Zika virus infection and disease.
Sanofi Pasteur leads the vaccine field for viruses in the same family as Zika virus (ZIKV), with licensed vaccines against Yellow Fever, Japanese Encephalitis and, most recently, Dengue. Importantly, Sanofi Pasteur's expertise and established R&D and industrial infrastructure for the newly licensed vaccine for dengue, Dengvaxia, can be rapidly leveraged to help understand the spread of ZIKV and potentially speed identification of a vaccine candidate for further clinical development.
"Our invaluable collaborations with scientific and public health experts, both globally and in the regions affected by the outbreaks of ZIKV, together with the mobilization of our best experts will expedite efforts to research and develop a vaccine for this disease," said Dr. John Shiver, global head of R&D, Sanofi Pasteur.
The ZIKV is closely related to Dengue; it belongs to the same Flavivirus genus, is spread by the same species of mosquito and has a similar acute clinical presentation. Common symptoms caused by a Zika infection include fever, rash, joint swelling, conjunctivitis and headaches. However, there is a growing body of evidence linking Zika infection in pregnant women with an increased risk of a severe congenital complication at birth called microcephaly. Normally a rare condition, microcephaly results in an abnormally small head impairing brain development.
"Sanofi Pasteur is responding to the global call to action to develop a Zika vaccine given the disease's rapid spread and possible medical complications," says Dr Nicholas Jackson, global head of research for Sanofi Pasteur who will be driving the new ZIKV vaccine project. "In addition to the serious possibility of congenital complications associated with Zika, investigations are also underway to assess another reported connection between Zika and a dangerous neurological disorder".
The University of South Australia said it was working on a Zika vaccine with Australian biotech Sementis Ltd. The U.S. drug developer NewLink Genetics Corp said it has started a project to develop Zika treatment options. Experts have said a Zika vaccine for widespread use is months if not years away.
Strengthening surveillance
WHO South-East Asia Regional Director Dr Poonam Khetrapal Singh has urged countries in the region to strengthen surveillance and take preventive measures against the Zika Virus disease.
The Zika Virus is a cause for concern in the WHO South-East Asia Region as the Aedes aegyptii mosquito, responsible for its spread, is found in many areas and there is no evidence of immunity to the Zika virus in many populations of the region. In the past sporadic Zika virus cases were reported from Thailand and Maldives.
The Zika Virus, first discovered in Uganda in 1947, is spread through bites from Aedes aegypti mosquito, the vector for dengue. The most common symptoms of Zika Virus disease are fever, rash, joint pain, and conjunctivitis. The illness is usually mild with the symptoms lasting a week. .
The Regional Director has recommended countries to build capacity of their laboratories to detect the virus and strengthen surveillance for cases of fever and rash, neurological syndromes and birth defects.
Countries should intensify their vector control program and prepare health services for managing Zika Virus disease.
All sectors that can assist, should be engaged, and the public informed of the risks and preventive measures against Zika Virus disease. People can protect themselves against mosquito bites by using insect repellent, wearing clothes that cover as much of the body as possible, and using physical barriers such as screens, closed doors and windows. Everyone should help prevent breeding of mosquitoes by emptying containers that hold standing water in and around their houses.
Dr Khetrapal Singh urged countries to share information on suspected Zika Virus disease to enable early detection and containment of any outbreak in the WHO South-East Asia Region.
In the region, WHO is providing support to countries to step up surveillance and preventive measures against the Zika Virus disease.
WHO has activated its new incident management system, established under the Organization’s emergency reform programme. WHO is supporting countries to reduce the international spread of the disease and in countries where the disease has been detected, to help understand the potential link between the Zika Virus and birth defects.
The American Red Cross has asked blood donors who have travelled to Zika Virus outbreak areas such as Mexico, the Caribbean, or Central or South America to wait at least 28 days before donating. However, the risk of transmitting the virus through blood donations remained "extremely" low in the continental United States, the disaster relief agency said.
"Most important, we need to set up surveillance sites in low- and middle-income countries so that we can detect any change in the reporting patterns of microcephaly at an early stage," Dr. Anthony Costello,WHO's director for maternal, child and adolescent health.
Twenty to 30 sites could be established worldwide, mainly in poor countries without robust healthcare systems, Costello said.
Brazilian efforts
Brazil is the country hardest hit by Zika. In an address to a joint session of Brazil's Congress, President Dilma Rousseff said her government will spare no resources in mobilizing to combat the mosquito that transmits the virus. With no vaccine or treatment for Zika, efforts to curb its spread have focused on eradicating mosquito breeding sites.
Brazil, which has more than 4,000 suspected cases of microcephaly that may be linked to Zika, is scheduled to host the Olympics in Rio de Janeiro in August. Rousseff also said Brazil and the United States will enter a partnership to develop a Zika vaccine as soon as possible to stem the spread of the virus.