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Translational Medicine of Zika

Zika virus is a flavivirus. The name came from the Zika forest in Uganda where the virus was first isolated. The most recent outbreak of Zika infection began in Brazil and spread rapidly across other parts of South America as well as in Central America, the Caribbean, and the Pacific Islands. Zika virus is mainly transmitted through mosquito bites and it can also be transmitted sexually and through blood transfusion. 

Zika infection during pregnancy has been causally associated with fetal microcephaly, intrauterine growth retardation, Guillain-Barré Syndrome , and spectrum of central nervous system abnormalities humans1,2. The incubation period of Zika virus disease is thought to be few days. The symptoms of Zika infection include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild in nature, last for 2-7 days and are similar to other arbovirus infections such as dengue. 

A diagnosis of Zika virus infection can only be confirmed through laboratory tests on blood or other body fluids, such as urine, saliva or semen. Few commercially available in vitro diagnostic devices have undergone regulatory evaluation. Currently there are no available treatments or vaccine for Zika infection. A a safe and effective Zika virus vaccine can be developed building on the same technologies that have been successfully used to develop human flavivirus vaccines (Yellow Fever, Tick-Borne Encephalitis, Japanese Encephalitis, Dengue). This goal may be rapidly attained because of scientific advancement in the field3. The value of developing medicinal agents for the treatment of Zika infection is questionable because of the lack of understanding of the infection, clinical progression and pathogenesis, and the need to conduct clinical efficacy trials in pregnant women. A more potentially beneficial pathway is the development of prophylactic therapies. Repurposing approved drugs where safe use in pregnant women has been established appears to be the most efficient pathway to develop prophylactic Zika therapy.

 References

  1. N Engl J Med. 2016 Dec 15;375(24):2321-2334.
  2. N Engl J Med. 2016 Mar 10;374(10):951-8.
  3. Nature. 2016 Aug 4;536(7614):48-53.
Disclaimer: The content of this report does not reflect the views or policies of the US Food and Drug Administration (FDA) or its staff. No official support or endorsement by the FDA is intended or should be inferred.
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