Since one of ISARIC’s regional representatives for the Americas, Dr Fernando Bozza (FIOCRUZ and BricNET), offered an update on the Zika virus (ZIKV) outbreak in Brazil during ISARIC’s Stakeholders’ meeting in London in early December, ISARIC and partners have kept busy supporting the ZIKV response by initiating a number of actions and projects.
 
Though a link between Microcephaly and ZIKV has not been proven, the increasing numbers of confirmed ZIKV cases and an increase in Microcephaly cases in Brazil is concerning, and there is general consensus within the regional ISARIC membership and also other ISARIC members and partners that further research is needed urgently.
 
Along these lines, ISARIC investigators, the ISARIC Coordinating Centre, Nikki Shindo (WHO HQ), and PREPARE Europe colleagues have convened a working group that is making adaptions to the Case Report Forms (CRFs) and protocols that have already been developed within ISARIC and by PREPARE Europe. This has resulted CRFs that are including data collection modules for pregnant women and microcephalic newborns. The aim is to gain general agreement on what the minimum core data set should be, and that our tiered modular approach will allow for adaptability dependent on the availability of resources at the participating sites. As data collection can be labour intensive, such adaptability is key. Additionally, through these weekly calls the need for diagnostic development has been flagged as a priority and the laboratory-based members of the group are focussing on how to best take that forward together. Please follow any related developments on the Zika Infection webpage: http://www.zikainfection.org
 
We have drafted a sampling algorithm, and we are in the process of adapting the WHO-ISARIC Clinical Characterisation Protocol, which could enable an observational study with biological sampling. Getting the protocol adapted locally in the affected countries and taking it through the ethical and R&D approval processes would facilitate future responses to other pathogens.
 
Additionally, we aim to establish an openly available data management and data sharing platform to assist with rapid data collection and analysis. A fully functioning data management and sharing platform would, however, require funding. This type of infrastructure could be built upon for future outbreaks.
 
Through a rapidly initiated mapping exercise, ISARIC is connected with partners involved with a number of excellent initiatives and pre-existing networks that could adapt their activities and infrastructures to support ZIKV related epidemiological or clinical research studies. Keen to avoid duplication of work, we are encouraging data sharing across these studies and to facilitate awareness across multiple sites regarding Zika-related activities.
 
The Global Health Network, in collaboration with ISARIC and colleagues at FIOCRUZ, WHO, Institut Pasteur, ERASMUS, PREDEMICS, ANTIGONE, iDAMS, PREPARE Europe, REACTing (Aviesan), and the German Centre for Infection Research (Institute of Virology – University of Bonn Medical Centre) set up a website: http://www.zikainfection.org that is hosted on the Global Health Network. The website aims to provide clinicians and researchers in the Zika-affected areas with up to date information and a platform where they can share and develop research priorities, protocols, and data capture systems, alongside the latest epidemiology and clinical management information about ZIKV infection. The information provided on the website is made available in Portuguese, Spanish and English. This webpage is complementing WHO PAHO's Zika webpage.
 
Ultimately, we would like to see ‘PREPARE Europe type’ consortiums across the globe, that are regionally led, context specific, and addressing regional problems, research needs, and threats. Supporting the regional response to ZIKV could be one way of better preparing the region for future emerging pathogen threats.
 
We need to thank a long list of contributors who have worked through the Christmas and New Years to support our joint ZIKV efforts. We particularly owe thanks to Louise Sigfrid (PREPARE & University of Oxford), Fernando Bozza and Ernesto Marques (FIOCRUZ), Thomas Jaenisch (iDAMS), Julia Bielicki (PENTA & PREPARE), Trudie Lang, Alexis Segrt, and Francois van Loggerenberg (TGHN), and Raul Pardinaz-Solis (ISARIC CC).
 
If you would like to know more about ISARIC related ZIKV activities, please contact gail.carson@ndm.ox.ac.uk

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