#zikasummit in Paris hosted by Institut Pasteur: New pathways

Zika summit ParisLucky attendee of the zika summmit in Paris hosted by Institut Pasteur, fully committed in Zika study and on the way for producing a new vaccine; but first starting by discovering Zika virus, its environment, its vector and its morbidity. Nice opening then scientific Lectures followed by some good news by presenting previews of scientific works and studies. At the end of the first day on Public Health and epidemiology of Zika, no speaker declared Zika as causative microcephaly but Zika as involved in the process of microcephaly; that makes a huge difference…

Historical then clinical review of Zika virus discovered in 1947 in Uganda then traveling worldwide, first west then moving back to east before reaching South America in 2015. A timeline of Zika in Americas compared with other outbreaks occurring at the same time or/and at the same location, like Dengue, Chikungunya.

A good reminder on the neurological damages due to CMV and feedbacks.

What are the lessons learned (from French Polynesia) and new trends about Zika virus and microcephaly or Guillain-Barré Syndrome (GBS)?

  • Ecosystem:Possible several Vectors for Zika virus
  • Zika virus among Flavivirus family including Dengue
  • Role and responsibility of immunity:
    • Ab, IgM, IgG and autoimmune system
    • enhancement of Zika virus by acquired immunity
    • Co-infection with Dengue or Chikungunya
  • Specs and conditions related to Zika in Americas:
    1. naive population
    2. several waves of outbreaks:
      • Dengue
      • Zika
      • Chikungunya
    3. to be at the wrong place at the wrong time
  • Neurotropism of Zika
  • Co-factors, aggravating factors suspected
  • Timeline for pregnancy impacting fetus
  • Zika virus crossing placental and blood brain barriers

No more but no less to be happy by attending this meeting entirely dedicated to Zika by gathering scientists working in both Research Lab or Public Health departments, what is called now Global Health and by sharing in real time critical previews of new studies and preliminary results.

Structure 3D Zika virusNo doubt, PHEIC was declared by WHO on February 1st 2016 in order to cope with microcephaly, not Zika virus, as the emergence of an unexplained neurological complications related to a Neglected Tropical Disease (NTD) like Zika. Knowing that almost 80% of Zika cases are unknown due to lack of clinical symptoms, it is a great importance for improving knowledge of pathogenicity and physiopathology. How immune system, autoimmune reaction are connected and if there are cause related to co-infection.

Far from the “politically correct” speaking but always based on evidence, the panel of speakers gave us an optimistic orientated overview with new vision and perspectives for the on coming future. Instead of focusing on what we know, it was effectively more interesting to address the questions about what we don’t know about Zika and microcephaly + GBS. If you see what I mean…

#zika as causative for #microcephaly: Has CDC jumped the gun?

April 18th 2016

Following both WHO statement and press release of NEJM, CDC declared last week that Zika virus is cause for microcephaly and other neural collateral damages. What a stress related to this short shrift by US CdC for science. In other words, Game is over and time to go back to R&D for searching and developing, producing asap new vaccine, new drugs to fight Zika, keeping an eye on vector control, more specifically Aedes aegypti and albopictus (mosquitoes carrier of DENV, CHIKV and ZIKV).

Forget the root causes analysis; don’t mind whatever co-factors are responsible for occurrence and emergence of microcephaly beside Zika virus; CDC says that Zika is cause of microcephaly and that might be enough to agree. Don’t You? But Why? US National Health Agencies are seeking for Funds (1.9 BN $) in order to cope with an outbreak preparedness plan, classified as likely; Congress is still refusing to raise and allocate this funds waiting for more conclusive evidence of Home security threat. No doubt, there is a conflicting situation between White House and Congress (Republicans) with regards the on coming presidential election. May be too far from Public/Global Health issues?….

NTD_zikaWe have to raise this question, right now: is the Zika threat overestimated? and if yes, why? Is the risk related to microcephaly over reported by exaggerating alarming numbers? Is there a link between false reporting of Zika cases (just suspected but not tested) and politics at a time where Brazilian government is facing an Impeachment procedure? The PHEIC declared by WHO is addressing unanswered questions about microcephaly observed and recorded in Brazil; surprisingly, only states of North-East regions are concerned so far, raising interest about causative of microcephaly beyond Zika virus, through co-factors or different risk factors as previously explained; mostly pointing out the role and responsibility of DENV or IgM,IgG immunization reaction following infection or co-infection with Zika virus.

Colombia appears to play the role of a control group by comparing stats with Brazil. Fortunately, a few microcephaly cases are related to Zika virus so far: only 2 cases as of today, when we are observing fewer microcephaly cases related to Zika than cases related to the other viral causes (Rubella, CMV). Surprise, surprise…

Q: What is the predictive value of Brazilian numbers? The first estimates have been reviewed and reduced from 600.000 to 200.000 cases. Do you remember the estimates for Ebola at the beginning of the outbreak in West Africa? How credible are these forecasts based on maths modeling and far away from the front line?

 It looks like Scientists and Health agencies running a race against the time to get money and budget just before publishing evidence for a multi-causal model explaining microcephaly in Brazil; budget which could not be voted without stressing on Congressmen and before a “Name and Shame” procedure for Republicans refusing to allocate the resources to fight the Tiger; knowing the race for Presidential is at its final stage. Some writers tried to compare with a terrorist threat, even if a bit rude but efficient.

Dilma RousseffWho has interests to hide  the truth in Brazil? Not to report how many People living in NE are impacted in areas outside of basic sanitation and running water? Dilma Roussef is now involved in a process leading to Impeachment following lower chamber’s decision. The increase of microcephaly cases, whatever the cause is, are reflecting the poor management of Public/Global Health concerns: lack of waste management, no access to drinkable water, black and grey waters surrounding at community level. No resources (human and equipment) to fight mosquito, except recently by committing the Army forces but pesticide is no longer available in some areas. No tests performed; just report of suspected cases based on clinical symptoms (not specific). No medico-social support for mothers of newborns with microcephaly, abandoned, without long term help and follow-up implemented. The failure and bankruptcy of a Democracy which expected to conduct a social economy but in fact corrupted at its highest level.

Definitively, it is legitimate questioning CDC who has jumped the gun by convicting Zika for microcephaly.

#Microcephaly et #zika: Les dernières nouvelles et les questions en suspens.

Le printemps apporte son lot de nouvelles études et découvertes en attendant la recherche et le développement de produits en tous genres: vaccin, insecticides pour lutter contre le virus Zika  et son vecteur, le moustique Aedes aegypti surnommé “tigre”…sans oublier les manipulations génétiques ou la stérilisation des moustiques.

research on Zika virus

 Effectivement, les preuves commencent à parvenir pour envisager la responsabilité du virus Zika dans les malformations neurologiques observées chez les nouveau-nés voire les foetus in utero; la présence du virus est également rapportée dans des cas de microcéphalies au Brésil et tout récemment au Panama et au Cap Vert; reste à établir un lien formel et causal, unique entre Zika et la microcéphalie…

Parmi les explications avancées jusqu’à peu, concernant la prévalence élevée de microcéphalie dans les régions du Nord-Est du Brésil, il était fait référence à la date d’arrivée du virus dans ces régions par comparaison au reste du pays mais aussi à la Colombie. Aujourd’hui, les naissances avec malformations survenues au Panama et au Cap Vert ne font pas l’objet des mêmes restrictions et pourtant une grossesse dure toujours neuf mois! Il faudra donc nous expliquer pourquoi on observe déjà des cas de microcéphalie hors du Brésil sauf en Colombie?…

 Zika Map BrzailPlusieurs rapports ou études d’experts en santé publique et environnementale, européens ou d’amérique du sud, mettent en avant le rôle et la responsabilité des conditions déplorables d’hygiène dans les régions du Brésil touchées par Zika, expliquant à la fois, la prolifération des moustiques Aedes dans les décharges et eaux usées (mécanisme d’adaptation du moustique) ainsi que l’apparition de malformations neurologiques à un taux anormalement élevé. Plusieurs facteurs de risque y sont identifiés dont les pesticides et l’épidémie de Dengue (anticorps) qui agiraient comme catalyseurs ou par synergie avec le virus Zika.

Ainsi et loin de souscrire ou soutenir une quelconque et obscure théorie du complot, des voix se font de plus en plus entendre sur la nécessité d’étudier d’autres composants socio-économiques et environnementaux pour appréhender les mécanismes responsables de la microcéphalie au Brésil. Cela devient un devoir de conscience en plus de la démarche scientifique indispensable qui doit guider l’analyse des causes des maladies en lien avec le virus Zika.

L’OMS étudie sérieusement la possibilité de jouer les apprentis sorciers en autorisant des lachers de moustiques génétiquement modifiés ou l’utilisation de bactéries incapacitantes dans le cadre de nouvelles technologies/stratégies de lutte contre les maladies vectorielles.

#Zika:Do we really understand the Public health risk?

Zika virus is responsible for a vector borne disease which means that Aedes aegyptiaedes-aegypti-vs-aedes-albopictus (left) is the vector capable to transmit the viral disease from human to human. Elsewhere and specifically for Southern Europe, it is unsure that Aedes Albopictus might be able to transmit zika virus…

Looking at the natural history of zika, starting from Uganda in 1947, then moving east to Asia then French Polynesia before reaching South America in 2015, we are observing and reporting during the last years (since 2013) new symptoms related to the central nervous (CNS) system like Guillain-Barré Syndrome.

With the outbreak occurring in Brazil, a new question is raised about a possible link between zika and microcephalymicrocephaly as more than 4000 babies are born with this malformation which would lead to definitive disability. We can imagine the impact of such an outcome which concerns young women in childbearing age or pregnant. More studies are required to understand if and how the virus is acting during pregnacy; but an Ethical and political, cultural and religious issue is also raised for the pregnant women exposed to and diagnosed for microcephaly: the right of abortion.

Here we are no longer talking about a vector borne disease but about the risk of giving birth to a disable new born with no chance to live normally. What is happening yet in Brasil? Number of newborns with microcephaly is largely over the usual rate which underlines that something is going wrong and might be related to Zika virus. Here is the Public health Emergency of international concern (PHEIC).

So far, no vaccine, no chemo-prophylaxis and no treatment are available.

Challenges are to prevent the occurrence of the microcephaly, to contain the spread of the Zika outbreak worldwide by taking mitigation measures to prevent growth of Aedeas aegypti in one hand versus controling the “reservoir” of Zika virus, mainly population bitten by infected mosquito, keeping in mind:

No Mosquito = No Bite = No Disease (Zika,Dengue,Chikungunya or Yellow Fever)

 Do not expect having a new vaccine available soon; experts say we are far away from getting The One dedicated for Zika virus. So, fighting mosquitoes and containing reservoir as low as possible remains the most practicable and achievable strategy at the time being.

Saying that, to study if Zika virus might have mutated since 1947 in a way it becomes more harmful for CNS, especially during pregnancy; to study also the possible resistance of insecticides when fighting Aedes aegypti. Last, not least, to study the impact on new emergent vector borne diseases of genetically modified organism (GMO). WHO took into account this questions and is encouraging countries to mobilize funding and research in order to bring answers asap.

How can the Healthcare industry benefit from Social Media?

Social media and healthcare

Source: Social Media Impact 2014

I’ve discussed in the Ad Spread the use of social media for the luxury retail industry as well as for museums. Today’s topic: the healthcare industry.

Companies in the B2C sector use social media for Big Data in order to get insights on their consumers to identify new needs and explore new market opportunities. This can also be done for the healthcare sector – which the industry is slowing acknowledging and implementing.

Many users use the Internet and Social Media to find out about symptoms they may have or side effects related to medication they are taking. In 2012, the Health Research Institute (HRI) conducted a study which found that one-third of consumers were using social media for health-related matters. It also indicated that these consumers were usually choosing to research information on “community” sites over industry specialized sites. RISK: they may have access to false information.

“Social media terms such as liking, following, tagging, can provide the clues that could lead to higher quality care, more loyal customers, efficiency, and even revenue growth” (HRI, 2012). Social media could therefore help Health Organizations and departments to identify this and communicate the right information as well as suggest possible prevention procedures through keyword search, hashtags and creating a page/profile on various social networks where users can ask, engage and be informed on current health matters. Another option is to ask Health Specialists participate in external forums to reduce the risk of misleading information and generate awareness about industry approved websites.

There are current talks between the Food and Drug Administration (FDA) and Google about how the search engine could help the agency identify unknown side effects of medications (Bloomberg, 2015). This project could go a long way in terms of minimizing and tracking health risks, and reaching out to patients with possible side effects.

One thing health organizations must be weary of is providing too much information. Indeed, doctors should not be providing medical assistance to patients through social media and they would be liable for wrongful practice.

All in all, social media can benefit the healthcare industry in the following ways:

– Averting Crises: implementing a “social media watch” and creating alerts on particular search terms could help avoid a major crisis

– Prevention: communicating proper procedures and guidelines to avoid a virus / disease contamination as well as reliable websites that industry-approved

-Educate users: provide information on the latest medical news regarding diseases, new cures, and prevention methods

Sources:

Tozzi, John, and Dina Bass. ‘Your Google Searches Could Help The FDA Find Drug Side Effects’. Bloomberg.com. N.p., 2015. Web. 26 July 2015.

Social Media “Likes” Healthcare From Marketing To Social Business. PWC, 2012. Web. 26 July 2015. Health Research Institute.