Advances in Diagnosis, Surveillance, and Monitoring of Zika Virus: An Update

Abstract

Zika virus (ZIKV) is associated with numerous human health-related disorders, including fetal microcephaly, neurological signs, and autoimmune disorders such as Guillain-Barré syndrome (GBS). Perceiving the ZIKA associated losses, in 2016, the World Health Organization (WHO) declared it as a global public health emergency. In consequence, an upsurge in the research on ZIKV was seen around the globe, with significant attainments over developing several effective diagnostics, drugs, therapies, and vaccines countering this life-threatening virus at an early step. State-of-art tools developed led the researchers to explore virus at the molecular level, and in-depth epidemiological investigations to understand the reason for increased pathogenicity and different clinical manifestations. These days, ZIKV infection is diagnosed based on clinical manifestations, along with serological and molecular detection tools. As, isolation of ZIKV is a tedious task; molecular assays such as reverse transcription-polymerase chain reaction (RT-PCR), real-time qRT-PCR, loop-mediated isothermal amplification (LAMP), lateral flow assays (LFAs), biosensors, nucleic acid sequence-based amplification (NASBA) tests, strand invasion-based amplification tests and immune assays like enzyme-linked immunosorbent assay (ELISA) are in-use to ascertain the ZIKV infection or Zika fever. Herein, this review highlights the recent advances in the diagnosis, surveillance, and monitoring of ZIKV. These new insights gained from the recent advances can aid in the rapid and definitive detection of this virus and/or Zika fever. The summarized information will aid the strategies to design and adopt effective prevention and control strategies to counter this viral pathogen of great public health concern.

Current Trends in Diagnostics of Viral Infections of Unknown Etiology

“…Target PCR is an effective and simple alternative to metagenomics, working well for both individual genes and small viral genomes [127]. PCR-based amplification is often used for whole viral genome sequencing of samples with low viral load [54], e.g., during the investigation of the measles outbreak during the Olympics in 2010 [128] and epidemics of Ebola [56] and Zika diseases [129]. Sequencing of long (2.5-3.0 kb) amplified fragments has clarified the variability of a Norovirus genome and its spreading among patients in a few hospitals in Vietnam [130,131].…”

Emerging infectious disease laboratory and diagnostic preparedness to accelerate vaccine development

“…62 EID public health and countermeasure programs have unique challenges for diagnostic and vaccine clinical assay development purposes. 2,39,41,[63][64][65][66][67][68][69][70][71] There may be an incomplete understanding of the biology or epidemiology of a new pathogen, which can delay or confound the selection of a relevant vaccine target and the subsequent assay development to be used to evaluate the candidates. The field may suffer from a lack of available reagent sources or with inconsistency in quantity and quality of those available, especially early in the discovery and development process.…”

“…Biological assay standardization is critical. 2,10,17,71,72 At a minimum, the development of relevant biological assays with adequate sensitivity and specificity for the application should use biostatistics to establish and verify assay performance and to maintain the ability to produce stable and reproducible results over time to support diagnostic or vaccine program needs. The criteria for acceptability of any given test system will be dependent upon the nature of the pathogen, our understanding of the immunology to fight the pathogen (both of which may be poorly understood in an EID situation) and the assay platform.…”

Qu’apprend-t-on de nouveau des épidémies émergentes ?

“…En l'état, le rendu négatif de deux tests successifs au terme d'un délai raisonnable plus ou moins consensuel entre experts est considéré comme indicateur de l'épuisement de la production virale et derechef de la levée des mesures d'éviction du risque viral [54]. Pour Zika, l'infectivité du sperme est rendue d'autant plus difficile à qualifier que la culture virale, qui en représente le test de référence, est techniquement compliquée, non rentable et prise en défaut [67,68]. À ce point s'ajoute la performance aléatoire des tests de dépistage sérologique accessibles à ce jour de l'infection par le virus Zika et dont la positivité conduit à la prise en charge de la surveillance moléculaire de la production virale dans le sperme.…”