Zika: Despite the scarce resources, never so much has been done with so little

Dr. Maria da Gloria Teixeira believes a quick test for the virus may be available in the second half of 2016

The current economic crisis has drawn resources from one of the most essential areas for a countrys development, which is scientific research. Despite this, the studies on Zika virus have evolved at fast paces. To the researcher Maria da Gloria Teixeira, Doctor in Public Health, never so much has been done with so little resources. The researchers are committed and working within very strict financial limits, she said

Interviewed by the Brazilian Society of Tropical Medicine (BSTM), Doctor Gloria highlights the main researches about the theme, as RNA detection in the amniotic fluid of pregnant women whose babies were diagnosed with intrauterine microcephaly. She also points which should be the main lines of work about Zika and believes a quick test for the virus may be available in the second half of 2016.

Find below the full interview:

BSTM: Which are the main ongoing researches in Brazil about Zika virus?

Dr. Maria da Glória Teixeira: Since the detection of the concentration of microcephaly cases related to zika virus (ZIKV), in October 2015, many institutions and research groups in Brazil, quickly, turned their selves to this matter, for example, the Evandro Chagas Institute; Fiocruz (Pernambuco, Paraná, Rio de Janeiro, Mato Grosso do Sul) São Paulo University (USP); Federal University of Bahia (UFBA); Federal University of Rio de Janeiro (UFRJ), among others. I have no information about the whole cast of investigations in course. From the ones I do know, I highlight: experimental studies aiming to determine which animal(s) is/are a good model(s) for zika experiments; serological tests for diagnostic (IgM and IgG); vaccines; case-control and cohort epidemiological studies among pregnant women.

BSTM: Which are the main results so far?

Dr. Maria da Glória Teixeira: The severity of the situation and the impact that caused the unexpected detection of the microcephaly outbreak propelled the researches and much has progressed even under a very limited budget, due to the bureaucratic difficulties that stall the funding for researches in Brazil, as well as the hard political-economical moment we are going through.

In a little more than seven months after the warning signals, practically, we have established the causal link between ZIKV vertical transmission and microcephaly, in a way this relation has been acknowledged by the World Health Organization (WHO), although we must keep investigating to complete the scientific evidences needed to confirm the causal link and give some consistency.

From the ongoing researches results so far, we consider most relevant the detection of ZIKV in amniotic fluid from pregnant women whose babies were diagnosed with intrauterine microcephaly, in tissues from the central nervous system and bowels of deceased fetuses and abortion material; in placenta tissue and newborns whose mothers had history of being exposed to ZIKV in Brazil. Besides this, human and mice neural in vitro cells infected with ZIKV have died. Regarding the epidemiological studies results, despite the small number of participants, we have confirmed the relation between ZIKV and malformations in a cohort of pregnant women in Rio de Janeiro.

BSTM: What is your opinion regarding financial support to the ongoing researches?

Dr. Maria da Glória Teixeira: The government has stepped forward in some initiatives towards this support, however, according to the information I have gathered until now, these supports have not yet arrived. My evaluation is that never before, so much has been done with so little resources! The researchers are committed and working within very strict financial limits.

BSTM: Is there any research line(s) to be prioritized?

Dr. Maria da Glória Teixeira: An article by Professor Maurício Barreto et al., clarifies the necessary research lines, which are: increase evidence bases – epidemiological and experimental studies; develop immunologically reliable serological tests; enhancement of vector control measures; definition of protocol for acute cases treatment (especially for pregnant women) and malformation prevention; development of a vaccine and the reorganization of the Health System in face of the outbreak.

We must be aware that we know very little about Zika and, thus, it is fundamental to study this emerging diseases natural history, from which we do not have a damage portfolio. We really dont know the real incidence of these infections, how important the hidden form is, especially, for pregnant women and babies, and; what is the risk for neurological manifestations; atypical form incidence, among many other questions. These knowledge blanks can only be filled through Longitudinal Epidemiological Clinical Studies, which require stable resource sources, so the investigations are not interrupted. It is important to notice that this knowledge is important not only to plan and enhance assistance quality for the affected populations, but also to guide the interpretation of the clinical essays results, especially regarding safety, efficiency and effectiveness of new immunogens and products.

BSTM: How long, according to the current pace of the works, it will be possible to develop an effective vaccine against the virus?

Dr. Maria da Glória Teixeira: Even if we already had a molecule tested in animals, the studies in humans (Phases I, II and III) would take at least 5 years before finished. We must remember that steps cannot be skipped, for ethical reasons and safety of the researchs subjects, according to the requirements of Resolution 466/2012 of the National Health Council (CNS) and principles of the Helsinki Declaration.

BSTM: When do you believe a quick test against Zika virus will be available in Brazil?

Dr. Maria da Glória Teixeira: According to the information I have, possible, in the second half of 2016.…