Two weeks after an article on the Zika outbreak appeared in the August issue of Clinical Laboratory News (CLN), the Centers for Disease Control and Prevention (CDC) announced the first cases of U.S. infections, while the U.S. Food and Drug Administration (FDA) approved the first clinical trial for a Zika vaccine.
Both occurrences represent the speed at which global pathogens spread, as well as the preparedness of the medical community to address the threat. These are key messages in writer Sarah C.P. Williams’ August CLN article, “Predicting the Next Outbreak.”
While Williams’ article highlights the causes and repercussions of the Zika outbreak, as well as the rapid response of the CDC and the FDA to the threat, it also emphasizes the threat of other pathogens.
In an interview with Williams, Suerie Moon, MPH, PhD, research director and co-chair of the Forum on Global Governance for Health at the Harvard Global Health Institute in Cambridge, said, “The number of outbreaks that occur and are reported to the World Health Organization (WHO) each year is amazing. It’s in the range of 200 to 300 per year.”
The ability of scientists to understand these new pathogens at the genetic level, as well as develop rapid assays to test for the viruses, as they did with Zika, is always improving, Williams wrote. However, better tools and more funding are needed.
“If you really want to be able to respond to a disease like Zika in a timely, educated way, you would have been studying it 10 years ago,” said Paul Roepe, PhD, a professor in the department of chemistry at Georgetown University and co-director of the Georgetown Center for Infectious Disease in Washington, D.C.
One challenge in attacking emerging pathogens that lead to pandemics is that they tend to be viruses, not bacteria, Roepe told Williams. That makes them much harder to attack, he explained, because not only are they more like sacs of nucleic acids than cells, they also mutate quicker and more often than bacteria. Because scientists understand less about the biology of these rapidly evolving viruses, as well as how they interact with their hosts, it’s harder to design drugs to combat them.
Another challenge, Williams found, is getting diagnostic tests for rapidly disseminating infections from the point of regulatory approval to clinical use. “On the scientific side, there can be lots of progress; new methodologies, new approaches to diagnosis,” Jane Hata, PhD, director of the clinical microbiology laboratory at Mayo Clinic Florida in Jacksonville, told CLN. “But then the problem is getting those tests FDA-approved and commercialized.”
For instance, the FDA didn’t grant emergency use authorization (EUA) for the Quest Diagnostics Zika Virus RNA Qualitative Real-Time RT-PCR test (Zika RT-PCR test) until late April. Since then, however, the agency has granted several EUAs for Zika test kits that clinical laboratories can use.
The challenge for laboratories is to be ready constantly to test for these pathogens, said Hata. “I always recommend that labs think about specific scenarios,” she told CLN. “What would you do, and how exactly would you do it, if a patient came in one afternoon and needed Zika or Ebola testing?”