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Are We Prepared For The Next Viral Disease Threat?

Robert GalloFred Shaw went to St. Martin and all he got was a painful virus called chikungunya.

On an island stop during his Caribbean cruise vacation, Mr. Shaw was infected with the mosquito-borne virus that causes a severe fever and an arthritis-like condition in people, similar to dengue fever.  After infection, the virus still may cause long periods of fatigue and incapacitating joint pain.

Writing on Facebook, Mr. Shaw said, “The fever, leg rash and swelling were bad enough, but then followed by months of headache, joint pain and malaise, I finally have gotten over it (I think).”

Chikungunya virus was first described during an outbreak in Tanzania in 1952 and was subsequently discovered in other parts of Africa and Asia. The name ‘chikungunya’ is derived from a local phrase that means ‘that which bends up’ and describes the stooped appearance of sufferers with joint pain.

In late 2013, chikungunya was found for the first time in modern history on islands in the Caribbean. Based on our research and the evidence we have observed, it is likely that the virus is on its way to the U.S.

Vector-borne viruses—which are transmitted to people by an animal or insect—threaten half the world’s population and are responsible for millions of human infections annually. Various mosquitoes and ticks transmit a subgroup of these viruses that are called arboviruses.

There are over 100 known arboviruses that infect humans and can cause neuroinvasive diseases like encephalitis, febrile illnesses and hemorrhagic fevers.  Except for yellow fever, tick-born encephalitis and Japanese encephalitis, there are no commercially available vaccines for most arboviral disease.

As the world becomes flatter and the globe opens to new opportunities for international trade and travel, viruses that used to be confined to “over there” are increasingly coming “over here,” and they are arriving sooner rather than later.

With rains – and mosquitoes – due to surge in the Caribbean in coming months, it won’t be long before mosquitoes in many parts of the country that are capable of spreading chikungunya, particularly in the Southeast, may become infected.

According to the Centers for Disease Control and Prevention (CDC), 72% to 97% of infected people experience symptoms—far higher proportions than is true of West Nile virus and dengue.

The World Health Organization (WHO) has designated April 7 as World Health Day, and the focus this year is on vector-borne diseases.

Unfortunately, few places where these diseases spread have the laboratory capabilities to carry out efficient testing for vector-borne diseases. Latin American countries in general are not prepared with sufficient diagnostic facilities and reagents, and the inability to test for chikungunya locally has, for example, delayed and perhaps prevented timely confirmation of suspected cases in the Caribbean and possibly other parts of the Americas.

The imbalance in global preparedness to deal with an emerging global public health crisis highlights the need for an international, collaborative effort among leading scientists to find solutions to the growing problem of vector-borne viruses before they reach pandemic levels.

The Global Virus Network (GVN), a global authority and resource for the identification, investigation, and control of viral diseases posing threats to mankind, has established the GVN Chikungunya Task Force to find solutions to the growing problem of the chikungunya virus.

The task force is reviewing the state of the science and potential research opportunities, identifying potential funding sources to support new research, and training the next generation of researchers to deal with this growing threat. The task force includes experts from countries that have addressed chikungunya in the past, including Thailand, Italy and France, so that lessons learned can be shared, along with expertise and resources.

Collaboration is needed to understand the viral diseases we know of today, and prepare for the ones that are coming.

Since HIV/AIDS first appeared in the 1980s, catching the medical and scientific communities unaware, it has been clear that mankind will best be served if the world’s leading virologists are organized and better equipped to deal with new and existing viral threats.  Being unprepared is simply not an option.

Here in the U.S., and around the world, we must be ready for the likely spread of chikungunya and other vector-borne diseases.  This means better and more widespread diagnostic capabilities, and a commitment to research and funding to control their spread and to develop effective vaccines to eradicate them.

This article may have been the first occasion where you’ve seen the word “chikungunya.”  But it most assuredly won’t be the last.

Scott Weaver, M.S., Ph.D.  is co-chair of the Global Virus Network Chikungunya Task Force and professor for the Departments of Pathology and Microbiology & Immunology at the University of Texas Medical Branch.

Robert C. Gallo, M.D. is co-founder and scientific director of the Global Virus Network and director of the Institute of Human Virology at the University of Maryland School of Medicine.

Sharon Hrynkow, Ph.D.  is president of the Global Virus Network.

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