Zika in Singapore: insights from One Health and social medicine

Lysaght, Tamra; Lee, Tsung Ling; Watson, Sangeetha; Lederman, Zohar; Bailey, Michele; Tambyah, Paul Anantharajah

doi:10.11622/smedj.2016161

Cited by 14 publications

(10 citation statements)

References 10 publications

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“…We very much agree with the message conveyed by Lange and Cegolon (1) in their letter, written in response to our editorial, (2) about the significance and potential impact of global climate change on emerging and re-emerging zoonotic infectious diseases. One Health emphasises optimal health for not only humans and nonhuman animals, but also the environment.…”

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confidence: 73%

Authors’ reply: Comment on: Zika in Singapore: insights from One Health and social medicine

Lysaght¹,

Lederman²,

Pa³

2017

smedj

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L e t t e r t o t h e E d i t o r 114Dear Sir, We very much agree with the message conveyed by Lange and Cegolon (1) in their letter, written in response to our editorial,about the significance and potential impact of global climate change on emerging and re-emerging zoonotic infectious diseases. One Health emphasises optimal health for not only humans and nonhuman animals, but also the environment.(3) Rising global temperatures will have profound effects on the ecological health of environments that humans share with nonhuman animals and plants.(4) Variations in temperature, rainfall and humidity are expected to affect the transmission and infection rates of pathogens that are already present in the region, including vector-borne diseases such as Zika, dengue and West Nile virus infection.(5) The most vulnerable groups are marginalised communities with limited healthcare resources, and relatively endangered plant and animal populations that are unable to adapt quickly enough to rapidly changing environmental conditions. Ironically, the human populations that have contributed the least to the emission of carbons may end up disproportionately shouldering the greatest burdens of climate change and, most likely, the emergence of new pathogens and infectious diseases. One Health and social medicine offer frameworks that can address these issues of global justice and encourage policies and interventions that benefit the most vulnerable, human and nonhuman, as the climate changes.Yours sincerely,

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Section: Dear Sirsupporting

confidence: 73%

Authors’ reply: Comment on: Zika in Singapore: insights from One Health and social medicine

Lysaght¹,

Lederman²,

Pa³

2017

smedj

Self Cite

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“…This led the World Health Organization (WHO) to declare a global health emergency in February 2016 . ZIKV has now spread throughout nearly all of Latin America and the Caribbean, with additional outbreaks in Africa (Cape Verde) in 2015 and Puerto Rico, the continental United States (Florida), and Asia (Singapore) in 2016 . From 2007 to September 2016, a total of 72 countries and territories have reported evidence of ZIKV transmission; 20 have reported microcephaly and other central nervous system malformations potentially associated with ZIKV, while 18 have reported an increase in incidence in Guillain‐Barré syndrome .…”

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Amustaline (S‐303) treatment inactivates high levels of Zika virus in red blood cell components

et al. 2017

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BACKGROUND:The potential for Zika virus (ZIKV) transfusion-transmission (TT) has been demonstrated in French Polynesia and Brazil. Pathogen inactivation (PI) of blood products is a proactive strategy to inactivate TT pathogens including arboviruses. Inactivation of West Nile, dengue, Zika, and chikungunya viruses was previously demonstrated by photochemical treatment with amotosalen and ultraviolet A (UVA) illumination. In this study, we evaluated ZIKV inactivation in red blood cell (RBC) components by a chemical approach that uses amustaline (S-303) and glutathione (GSH). STUDY DESIGN AND METHODS: RBC componentswere spiked with a high titer of ZIKV. Viral titers (infectivity) and ZIKV RNA loads (reverse transcriptionpolymerase chain reaction) were measured in spiked RBCs before and after S-303 and GSH treatment and confirmed using repetitive passages in cell culture. A mock-treated arm validated the approach by demonstrating stability of the virus (infectivity and RNA load) during the process. RESULTS:The mean ZIKV infectivity titer and RNA load in RBCs were 5.99 6 0.2 log 50% tissue culture infectious dose (TCID 50 )/mL and 7.75 6 0.16 log genomic equivalents/mL before inactivation. No infectivity was detected immediately after S-303 and GSH treatment and after five serial passages in cell culture. CONCLUSION:Complete ZIKV inactivation of more than 5.99 log TCID 50 /mL in RBCs was achieved using S-303 and GSH at levels higher than those found in asymptomatic ZIKV-infected blood donors. Therefore, the S-303 and GSH PI system is promising for mitigating the risk of ZIKV TT. US areas with active ZIKV circulation, the main recommendations included donor deferral, blood collection suspension, and importation of blood components from nonactive transmission areas and either implementation of ZIKV nucleic acid testing (NAT) or pathogen inactivation (PI). PI is a proactive strategy designed to reduce or eliminate infectivity of bacteria, viruses, and parasites in blood. 35 Several processes have been developed for the inactivation of pathogens in fresh-frozen plasma and platelet (PLT) concentrates. 35In FP, the INTERCEPT Blood System for PLTs (Cerus Corporation), a CE mark-approved technology, was implemented in 2010 and has since been used routinely. During the FP ZIKV outbreak, plasma units were imported from metropolitan France. 22 However, during the outbreak, no PI technology was commercially available for red blood cell (RBC) treatment.The INTERCEPT Blood System for RBCs uses a chemical treatment with the small molecule amustaline (S-303) that forms covalent crosslinks and adducts with nucleic acids resulting in the inactivation of pathogens. S-303 is a reactive modular compound that is designed to react quickly and then decompose by hydrolysis to the nonreactive compound S-300 (Fig. 1). It is formulated in the presence of the natural tripeptide glutathione (GSH) to quench unreacted side reactions. S-303 has been shown to inactivate a variety of enveloped and nonenveloped viruses, Gram-positive and -negative b...

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“…(1) The authors also mentioned the importance of ecology and environmental interactions for emerging diseases. Today, researchers consider ecological impacts, such as those resulting from global warming or climate change, to be one of the major factors influencing the spread, emergence and changing pattern distributions of old and new diseases, with the role of determinants such as social factors, immigration and local animal populations (as reservoirs) likely to be magnified by environmental change.…”

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confidence: 99%