Zika virus [to 20 February 2016]
Public Health Emergency of International Concern (PHEIC)
ZIKA – STRATEGIC RESPONSE FRAMEWORK & JOINT OPERATIONS PLAN – JANUARY-JUNE 2016
WHO – February 2016 :: 32 pages
The over-arching goal of this strategy is to investigate and respond to the cluster of microcephaly and other neurological complications that could be linked to Zika virus infection, while increasing preventive measures, communicating risks and providing care to those affected.
:: Provide up to date and accurate epidemiological information on Zika virus disease, neurological syndromes and congenital malformations.
:: Engage communities to communicate the risks associated with Zika virus disease and promote protective behaviors, reduce anxiety, address stigma, dispel rumors and cultural misperceptions.
:: Increase efforts to Control the spread of the Aedes and potentially other mosquito species as well as provide access to personal protection measures equipment and supplies.
:: Provide guidance and mitigate the potential impact on women of childbearing age and those who are pregnant, as well as families with children affected by Zika virus.
:: Investigate the reported increase in incidence of microcephaly and neurological syndromes including their possible association with Zika virus infection.
:: Fast-track the research and development (R&D) of new products (e.g. diagnostics, vaccines, therapeutics).
Zika Strategic Response Framework Announcement
Zika Outbreak: WHO’s Global Emergency Response Plan
Global prevention and control strategy
16 February 2016
WHO has launched a global Strategic Response Framework and Joint Operations Plan to guide the international response to the spread of Zika virus infection and the neonatal malformations and neurological conditions associated with it.
The strategy focuses on mobilizing and coordinating partners, experts and resources to help countries enhance surveillance of the Zika virus and disorders that could be linked to it, improve vector control, effectively communicate risks, guidance and protection measures, provide medical care to those affected and fast-track research and development of vaccines, diagnostics and therapeutics.
WHO says $56 million is required to implement the Strategic Response Framework and Joint Operations Plan, of which $25 million would fund the WHO/AMRO/PAHO response and $31 million would fund the work of key partners. In the interim, WHO has tapped a recently established emergency contingency fund to finance its initial operations.
As part of WHO’s new emergency programme, the agency’s headquarters activated an Incident Management System to oversee the global response and leverage expertise from across the organization to address the crisis.
WHO’s Regional Office for the Americas (AMRO/PAHO) has been working closely with affected countries since May 2015, when the first reports of Zika virus disease emerged from northeastern Brazil. AMRO/PAHO and partner specialists were deployed to help health ministries detect and track the virus, contain its spread, advise on clinical management of Zika and investigate the spikes in microcephaly and Guillain-Barré syndrome in areas where Zika outbreaks have occurred.
AMRO/PAHO will continue to work with partners to manage the response in the Americas.
WHO is issuing regular information and guidance on the congenital and neurological conditions associated with Zika virus disease, as well as related health, safety and travel issues.
Working with partners, WHO is also mapping efforts to develop vaccines, therapies, diagnostic tests and new vector control tactics and putting in place mechanisms to expedite data sharing, product development and clinical trials…
WHO – Press Conference: update on global response to Microcephaly (Geneva, 19 February 2016)
WHO update on global response to microcephaly, neurological disorders and Zika virus.
WHO has launched a global prevention and control strategy to guide its international response to the spread of Zika virus infection and the neonatal malformations and neurological conditions associated with it.
The strategy includes working with partners to investigate and respond to increases in microcephaly and other neurological disorders in areas where there are also Zika outbreaks, to contain the spread of Zika virus, and fast track R & D, and boost preparedness in at risk countries.
Zika has catalysed immediate action to put into place some of the practical processes that will underpin WHO’s new programme on outbreaks and emergencies.
WHO will also give an overview of the vector control measures that work to prevent Zika.
:: Dr Bruce Aylward, Executive Director, Outbreaks and Health Emergencies (ai), WHO
:: Dr Pedro Alonso, Director Global Malaria Programme, WHO
WHO activities on Zika R&D
Dr Marie-Paule Kieny, Assistant Director-General, Health Systems and Innovation
16 February 2016
Commentary [Excerpt; Editor’s text bolding]
The Ebola outbreak of 2014-15 highlighted the need for a master plan for research and development (R&D) to both prepare for health emergencies and to be able to mount a fast response in case of need. The World Health Organization’s “R&D Blueprint” aims to accelerate the availability of medical countermeasures during epidemics and limit damage as much as possible. We have now established critical paths for coordinated action and industry interest in providing platform technologies for the development of medical products.
Our relatively poor knowledge of the Zika virus presents a series of challenges for research and development. However, building on experience from the Ebola epidemic, WHO has been able to set in motion a rapid R&D response for Zika.
We have already identified a large number of manufacturers and research institutions either involved in the development of medical tools for Zika, or interested in embarking on such research.
Embarking on vaccine and diagnostic research
Numerous groups are looking at the feasibility of initiating animal or human testing, particularly for vaccines and diagnostics.
For vaccines, the landscape is evolving swiftly, and numbers change daily. About 15 companies and research groups have been identified so far, though most have only just started work.
Two vaccine candidates seem to be at a more advanced stage: a DNA vaccine from the US and an inactivated product from India.
Still, the current absence of standardized animal models and reagents is a hindrance. And although the landscape is encouraging, it will be at least 18 months before vaccines could be tested in large-scale trials.
For diagnostics, 10 biotech companies have been identified so far that can provide nucleic acid or serological tests. Nucleic acid tests are based on a molecular technique used to detect a virus in the blood; serological tests measure the levels of antibodies as a result of exposure to a particular virus…
WHO: Zika, Microcephaly, and Guillain–Barré syndrome situation report
19 February 2016
Read the full situation report
:: Between January 2007 and 17 February 2016, a total of 41 countries and territories reported local (autochthonous) transmission of Zika virus, including those where the outbreak is now over. One country (United States of America) reported a locally acquired case without vector-borne transmission, likely to have been contracted by sexual contact, and indirect evidence of local transmission has been documented in six additional countries. Two new countries/ territories have reported local transmission in the week running up to 17 February 2016 (Aruba and Bonaire).
:: Geographical distribution of Zika virus has steadily broadened since the virus was first detected in the Americas in 2015. Zika transmission has been reported in 28 countries /territories. The discovery of Zika virus in additional countries within the geographical range of competent mosquito vectors — especially Aedes aegypti— is considered likely.
:: Six countries/territories (Brazil, French Polynesia, El Salvador, Venezuela, Colombia and Suriname) have reported an increase in the incidence of cases of microcephaly and/or Guillain-Barré syndrome (GBS) following a Zika virus outbreak. Microcephaly has so far been reported only from Brazil and French Polynesia. Puerto Rico and Martinique have also reported cases of GBS associated with Zika virus infection, but without evidence of an overall increase in the incidence of GBS.
:: Evidence that neurological disorders, including microcephaly and GBS, are linked to Zika virus infection remains circumstantial, but a growing body of clinical and epidemiological data possibly leans towards a causal role for Zika virus.
:: The global prevention and control strategy launched by WHO as a Strategic Response Framework (SRF) encompasses surveillance, response activities, and research. Following consultation with partners and taking changes in caseload into account, the SRF will be updated at the end of March 2016 to reflect epidemiological evidence coming to light and the evolving division of roles and responsibilities for tackling this emergency.
:: From 2007 to 11 February 2016, Zika virus transmission was documented in a total of 48 countries/territories (Fig. 1 and Fig. 2). This includes 36 countries which reported local transmission between 2015 and 2016, six countries with indirect evidence of viral circulation, five countries with reported terminated outbreaks and one country with a locally acquired case but without vector-borne transmission (Table 1). Two new countries/territories – Aruba and Bonaire – reported autochthonous transmission in the week running up to 17 February 2016.
WHO: Maintaining a safe and adequate blood supply during Zika virus outbreaks, interim guidance
Publication date: February 2016 :: 4 pages
Pdf: Safe-blood_supply18Feb2016.pdf pdf, 290kb
These guidelines have been developed in recognition that infection with Zika virus may present a risk to blood safety, and in consideration of the declaration on 1 February 2016 by the WHO Director-General of a Public Health Emergency of International Concern with regard to clusters of microcephaly and other neurological disorders, potentially associated with Zika virus. Currently there is limited knowledge of Zika virus biology and lack of definitive evidence of a link between infection and potential complications. These guidelines will be regularly reviewed and updated as new information becomes available.
FDA [to 20 February 2016]
February 16, 2016
FDA issues recommendations to reduce the risk for Zika virus blood transmission in the United States
As a safety measure against the emerging Zika virus outbreak, today the U.S. Food and Drug Administration issued a new guidance recommending the deferral of individuals from donating blood if they have been to areas with active Zika virus transmission, potentially have been exposed to the virus, or have had a confirmed Zika virus infection.
“The FDA has critical responsibilities in outbreak situations and has been working rapidly to take important steps to respond to the emerging Zika virus outbreak,” said Luciana Borio, M.D., the FDA’s acting chief scientist. “We are issuing this guidance for immediate implementation in order to better protect the U.S. blood supply.”
While there have been no reports to date of Zika virus entering the U.S. blood supply, the risk of blood transmission is considered likely based on the most current scientific evidence of how Zika virus and similar viruses (flaviviruses) are spread and recent reports of transfusion-associated infection outside of the U.S. Furthermore, about 4 out of 5 of those infected with Zika virus do not become symptomatic. For these reasons, the FDA is recommending that blood establishments defer blood donations from individuals in accordance with the new guidance.
In areas without active Zika virus transmission, the FDA recommends that donors at risk for Zika virus infection be deferred for four weeks. Individuals considered to be at risk include: those who have had symptoms suggestive of Zika virus infection during the past four weeks, those who have had sexual contact with a person who has traveled to, or resided in, an area with active Zika virus transmission during the prior three months, and those who have traveled to areas with active transmission of Zika virus during the past four weeks.
In areas with active Zika virus transmission, the FDA recommends that Whole Blood and blood components for transfusion be obtained from areas of the U.S. without active transmission. Blood establishments may continue collecting and preparing platelets and plasma if an FDA-approved, pathogen-reduction device is used. The guidance also recommends blood establishments update donor education materials with information about Zika virus signs and symptoms and ask potentially affected donors to refrain from giving blood…
PDF: Recommendations for Donor Screening, Deferral, and Product Management to Reduce the Risk of Transfusion-Transmission of Zika Virus; Guidance for Industry (PDF – 111KB)
[Bulletin of the World Health Organization]
:: New Papers available here
Update on Zika virus transmission in the Pacific islands, 2007 to February 2016 and failure of acute flaccid paralysis surveillance to signal Zika emergence in this setting
– Adam T Craig, Michelle T Butler, Roberta Pastmore, Beverley J Paterson, David N Durrheim
Posted: 19 February 2016
CDC [to 20 February 2016]
FRIDAY, FEBRUARY 19, 2016
Updated Guidelines for Healthcare Providers Caring for Infants or Children with Possible Zika Virus Infection
CDC has updated its interim guidelines for healthcare providers who care for infants and children with possible Zika virus infection.
THURSDAY, FEBRUARY 18, 2016
CDC adds 2 destinations to interim travel guidance related to Zika virus
CDC is working with other public health officials to monitor for ongoing Zika virus? transmission. Today, CDC added the following destinations to the Zika virus travel notices: Aruba and Bonaire…
MMWR February 19, 2016 / Vol. 65 / No. 6
:: Local Transmission of Zika Virus — Puerto Rico, November 23, 2015–January 28, 2016
:: Notes from the Field: Evidence of Zika Virus Infection in Brain and Placental Tissues from Two Congenitally Infected Newborns and Two Fetal Losses — Brazil, 2015
Global Virus Network
February 11, 2016
GVN Launches Zika Task Force
Global Virus Network (GVN) Launches Zika Task Force Comprised of Leading Virus Researchers from Around the Globe
GVN catalyzes international collaborations in an effort to address the urgent need to share information and research to better combat the global Zika outbreak
Baltimore, MD: The Global Virus Network (GVN), representing 35 Centers of Excellence and 5 Affiliates in 26 countries, and comprising foremost experts in every class of virus causing disease in humans, today announced the formation of the GVN Zika Task Force chaired by Scott Weaver, PhD, who is also co-chairman for the GVN Chikungunya Task Force and is director of the University of Texas Medical Branch’s Institute for Human Infections and Immunity and scientific director of the Galveston National Laboratory, a GVN Center of Excellence. The GVN Zika Task force, which is expected to grow, fills a gap identified by leading scientists to catalyze urgent international collaborative research. The announcement was made today by Robert Gallo, MD, co-founder of the GVN and chair of GVN’s Scientific Leadership Board and José Esparza, MD, PhD, president of the GVN.
“I am pleased to chair GVN’s Zika Task Force which will serve as a catalyst for driving communication and information flow between fellow GVN colleagues researching and responding to the Zika epidemic gripping much of Central and South America and the Caribbean,” said Dr. Weaver. “Our research team has been studying Zika virus for several years now, including working with countries such as Senegal to study enzootic ecology as well as Brazil and Mexico in developing sensitive diagnostics to identify those infected and follow the epidemiology of these outbreaks.” Dr. Weaver continued, “We look forward to beginning nonhuman primate model development next month and continuing vaccine research, and to coordinating efforts with others in the GVN Zika Task Force in these efforts.”…
World Bank [to 20 February 2016]
February 18, 2016
World Bank Provides $150 Million to Combat Zika Virus In Latin America and the Caribbean
Initial regional economic impact projected to be moderate but requires urgent action to halt virus spread
WASHINGTON,— In order to support countries in Latin America and the Caribbean affected by the Zika virus outbreak, the World Bank Group announced today that it has made US$150 million immediately available.
This amount is based on current country demands for financing and follows extensive engagement with governments across the region, including sending teams of technical experts to affected countries. If additional financing is needed, the World Bank Group stands ready to increase its support.
This announcement was accompanied by the release of initial projections that the short-term economic impact of the Zika virus on the region will be modest, totaling US$3.5 billion, or 0.06% of GDP in 2016. The World Bank Group noted, however, that these initial estimates are predicated on a swift, well-coordinated international response to the Zika virus. They also assume that the most significant health risks—and related behaviors to avoid transmission—are for pregnant women. This follows the World Health Organization’s February 1 declaration of the suspected link between Zika virus infection during pregnancy and microcephaly in newborns.
Even with these assumptions, however, a group of countries highly dependent on tourism—notably in the Caribbean—could suffer losses in excess of 1 percent of GDP and may require additional support from the international community to stem the economic impact of the virus. As new knowledge continues to emerge about Zika virus transmission and impact, or should public perceptions of risks from Zika rise sharply, the economic impacts will be reassessed…