Ron Rosenberg, ScD Division of Vector-Borne Diseases...
Transcript of Ron Rosenberg, ScD Division of Vector-Borne Diseases...
![Page 1: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/1.jpg)
February 16, 2016
Ron Rosenberg, ScD
Division of Vector-Borne Diseases
National Center for Emerging & Zoonotic Infectious Diseases
![Page 2: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/2.jpg)
![Page 3: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/3.jpg)
The Yap Epidemic Duffy et al, 2009, N Engl J Med 360:2536
• April - July, 2007 • Macropapular rash, conjunctivitis, fever, arthralgia • dengue IgM negative
• Lab diagnosis protocol • Positive: PCR+ or IgM+, PRNT90 >20 & dengue PRNT90 >4 • Probable: IgM+, PRNT90 >20 & dengue PRNT90 <4
• Sought care (n=185): • 49 confirmed, 59 probable, 72 suspect Zika
• Household survey (n=557): • 74% IgM+, 19% ill
• Aedes hensilli: 36% of containers
![Page 4: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/4.jpg)
Zika Virus - Basics
Genus Flavivirus (Family Flaviviridae)
26 vector-borne human pathogens, 1 non-arbovirus
tick & mosquito vectors
neuroinvasive or hemorrhagic
Discovery
Rockefeller Foundation dedicated to arbovirus discovery
1947 (sentinel macaque), 1948 (mosquito), 1954 (human)
Sequence: Kuno & Chang, January, 2007 (Arch. Virol. 152:687)
![Page 5: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/5.jpg)
1947 Discovery
The Spread of Zika Virus Discovery
![Page 6: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/6.jpg)
1947 Discovery
The Spread of Zika Virus Discovery
1954 1st Human
![Page 7: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/7.jpg)
1947 Discovery
The Spread of Zika Virus Discovery
1954 1st Human
1954-2007 Asia
![Page 8: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/8.jpg)
1947 Discovery
The Spread of Zika Virus Discovery
1954 1st Human
1954-2007 Asia
2007-2014 Pacific
![Page 9: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/9.jpg)
1947 Discovery
The Spread of Zika Virus Discovery
1954 1st Human
1954-2007 Asia
2007-2014 Pacific
2015 Americas
![Page 10: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/10.jpg)
South Pacific Outbreaks
• 2013 – French Polynesia
• Estimated 28,000 (11% population) – clinically similar to Yap, but…
• First suspect association Guillan-Barré syndrome
• 2015 retrospective case review: increase in microcephaly
• 2014 – New Caledonia, Cook Islands, Solomons, Easter Island
• Asian genotype – Yap, Cambodia
![Page 11: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/11.jpg)
![Page 12: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/12.jpg)
Kraemer MUG, et alii, eLife 2015;4:e08347
Actual & Potential Geographic Distribution of Aedes aegypti
![Page 13: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/13.jpg)
Some Things We Need or Need to Know
• Infection course • Length of viremia, asymptomatic infectivity, antibody profile
• Birth defects, GBS • Incidence • Risk factors (co-morbidities) • Has mutation increased risk?
• Risk of non-vectored transmission • Transfusion, transplantation • Sexual
• Diagnostics • Serology – poor specificity in dengue endemic areas • RNA in urine?
• Ecology • Animal reservoirs • Vector species
• and 200 other obscure or “non-pathogenic” arboviruses….
![Page 14: Ron Rosenberg, ScD Division of Vector-Borne Diseases ...iom.nationalacademies.org/~/media/Files/Activity Files/PublicHealth... · February 16, 2016 Ron Rosenberg, ScD Division of](https://reader031.fdocuments.net/reader031/viewer/2022022409/5c0c0b2d09d3f295058b6e92/html5/thumbnails/14.jpg)
For more information, contact CDC 1-800-CDC-INFO (232-4636) TTY: 1-888-232-6348 www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.