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A group of Salvadoran mothers participate in the "Kangaroo Mother" program at the National Maternity Hospital in San Salvador. REUTERS/Luis Galdamez (2011)

ZikaPLAN (Preparedness Latin America Network) at LSHTM

A multinational and multidisciplinary consortium implementing critical research on the existing Zika virus outbreak whilst preparing a sustainable response capacity for future emerging epidemics in Latin America.

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About

Bringing together the expertise of 25 leading research and public health organisations from Latin America, North America, Africa, Asia, and Europe, ZikaPLAN sets out to address the knowledge gaps in Zika and build a rapid research response to emerging infectious disease outbreaks.

Who we are

The ZikaPLAN consortium is being led by Professor Annelies Wilder-Smith from Umeå University in Sweden. The London School of Hygiene and Tropical Medicine’s contribution is being led by Professor James Logan.

About
About ZikaPLAN

Bringing together the expertise of 25 leading research and public health organisations from Latin America, North America, Africa, Asia, and Europe, ZikaPLAN sets out to address the knowledge gaps in Zika and build a rapid research response to emerging infectious disease outbreaks. The London School of Hygiene and Tropical Medicine is a major contributor to ZikaPLAN and is responsible for leading research on Congenital Zika Syndrome (CZS) and neurological complications; developing a platform for diagnosis innovation and evaluation; investigating vaccines in antibody-dependent enhancements (ADE); establishing mathematical models to inform public health policies; and developing wearable protective  technologies against mosquitoes.

MERG: Unravelling Congenital Zika Syndrome

The objective of this working group is to determine the attack rate and full clinical spectrum of Congenital Zika Syndrome (CZS) by building on the work of the Microcephaly Epidemic Research Group (MERG).

The main research areas of MERG: Unravelling Congenital Zika Syndrome:

  • Congenital Zika Syndrome (CZS) implications for pregnant women aims to determine the risk of miscarriage, still birth, microcephaly and other manifestations in neonates of pregnant women with Zika Virus by gestational age. The full spectrum of CZS at birth will be defined and an improved case definition of CZS for surveillance purposes and birth defect registries will be developed.
  • Congenital Zika Syndrome (CZS) implications for neonates will characterise the clinical spectrum of CZS for neonates and validate simple tools for assessing deficiencies in other low resourcing-setting.
  • Social and economic impact of Congenital Zika Syndrome (CZS) will estimate the social impact and economic cost of having a child with CZS on the women’s and the family’s life and impact of public services.

Participating Organisations

Group leader: Prof. Laura Rodrigues, London School of Hygiene & Tropical Medicine

  • Umeå University
  • Queen Mary University of London
  • Ulster University Associação Técnica–Científica de Estudo Colaborativo Latino Americano de Malformações Congênitas
  • Fundação Oswaldo Fiocruz
  • Universidade de Pernambuco
Platform for Diagnostics Innovation and Evaluation

This working group aims to develop and validate tools for the diagnosis, surveillance and research on Zika virus (ZIKV). By setting up a biobank of specimens and a network of laboratory and clinical sites, pre-approved for clinical trial protocols, novel ZIKV diagnostic tests in accordance with WHO Target Product Profiles and epidemiologic research will be established and the validation of their performance and operational characteristics of diagnostic tests accelerated. The group also sets out to develop a Point of Care Test(POST) for NS1/IgM for Zika, establish and disseminate a Manual and Standard Operating Procedures on sample collection, and characterization and conduct landscape analyses of Zika diagnostic assays that are in development or commercially available.

Participating Organisations

Group leader: Prof. Rosanna Peeling, London School of Hygiene and Tropical Medicine

  • Fundación Universidad del Norte
  • Fondation Mérieux
  • The University of North Carolina at Chapel Hill
  • Institute of Tropical Medicine in Antwerp
  • Instituto Medicina Tropical Pedro Kouri
  • Institut Pasteur de Dakar
  • International Vaccine Institute
INVADE: Investigating Vaccines in Antibody Dependant Enhancement

The working group will identify the major T-cell epitopes and cross reactive B-cell epitopes on Zika virus (ZIKV) and assess the role of flavivirus antibodies in protective and pathogenic immunity following ZIKV through antibody dependant enhancements (ADE). The group is determined to find out whether a pre-existing immunity to other co-circulating flaviviruses or flavivirus vaccines is playing a protective or detrimental role in ZIKV immunity. Over 2000 T cell epitopes and epitopes targeted by type-specific and neutralising antibodies will be identified providing critical information for the development of vaccines, serological diagnostic assays. This will additionally aid in understanding potential mechanisms of immune pathogenesis reasonable for severe neurological and foetal defects.

Participating Organisations

Group leader: Prof. Andrew Falconar, Fundación Universidad del Norte

  • London School of Hygiene & Tropical Medicine
  • La Jolla Institute for Allergy and Immunology
  • The University of North Carolina at Chapel Hill
Mathematical modelling to inform public health policies

This working group is developing mathematical models which will inform public health policies on how best to mitigate the Zika outbreak in Latin America (based on the MERG: Unravelling Congenital Zika Syndrome working group findings). The mathematical model set out to be achieved by the group on transmission dynamics will additionally anticipate and prepare for the impact of Zika on health care systems in the region. The study will model various aspects of the Zika epidemic, including Disability-Adjusted Life Year (DALY) of Congenital Zika Syndrome (CZS); the extent of neurological complications and their impact on health care utilisation; the role of non-vector transmission in Zika virus dynamics; vector parameters based on viral fitness; vector control strategies, such as using Wolbachia-infected and genetically modified mosquitos; optimal control bundles to mitigate future outbreaks, in particular in Latin American cities; and the burden of disease by age group and location to inform vaccine developers. These results will be translated into policy-beliefs and health policy recommendations.

Participating Organisations

Group leader: Prof. Eduardo Massad, Universidade de São Paulo

  • Umeå University
  • London School of Hygiene & Tropical Medicine
  • University of Oxford
WEAR: Wearable Aedes Repellent Technologies

This working group will produce novel wash-in detergent formulations and long-lasting plastic technologies containing repellents for the treatment of clothing and other wearable repellent technologies for the protection of pregnant women against Aedes mosquito bites. New wash resistant technologies will be investigated, including silica-shell, polymer fibres and microencapsulated formulations to determine whether repellent active ingredients can be retained in fabrics for multiple washes. This working group will also include focus group studies in Colombia and modelling study to determine what level of protection is required to reduce Zika transmission in pregnant women.

Participating Organisation

Group leader: Professor James Logan, London School of Hygiene & Tropical Medicine

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Events
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Publications

Research on the current Zika virus outbreak is moving fast. To keep up-to-date with the latest on Congenital Zika Syndrome (CZS) and how its escalation is affecting families, local healthcare structures and public health policies, vaccines in antibody dependant enhancement, and innovative personal protective technologies against mosquitoes, please read through our most recent resources and publications.

Publications ZikaPLAN
The Zika Virus Epidemic in Brazil: From Discovery to Future Implications
Rachel Lowe, Christovam Barcellos, Patrícia Brasil, Oswaldo G. Cruz, Nildimar Alves Honório, Hannah Kuper and Marilia Sá Carvalho
Int. J. Environ. Res. Public Health 2018
Characteristics of Dysphagia in Infants with Microcephaly Caused by Congenital Zika Virus Infection, Brazil, 2015
Mariana C. Leal, Vanessa van der Linden, Thiago P. Bezerra, Luciana de Valois, Adriana C.G. Borges, Margarida M.C. Antunes, Kátia G. Brandt, Catharina X. Moura, Laura C. Rodrigues, and Coeli R. Ximenes
Aug-17| EID Journal, Online. L.C.R. is partially funded by European Union’s Horizon 2020 research and innovation program under Zika- PLAN grant agreement No. 734584
Infectious causes of microcephaly: epidemiology, pathogenesis, diagnosis, and management
Dr Delan Devakumar| Microcephaly is an important sign of neurological malformation and a predictor of future disability. In this Review, we summarise important aspects of major congenital infections that can cause microcephaly, and describe the epidemiology, transmission, clinical features, pathogenesis, management, and long-term consequences of these infections. Whilst Zika virus has brought the attention of the world to the problem of microcephaly, prevention of all infectious causes of microcephaly and appropriately managing its consequences remain important global public health priorities.
Aug-17| The Lancet, Online| http://dx.doi.org/10.1016/S1473-3099(17)30398-5
Symptomatic dengue infection during pregnancy and the risk of stillbirth in Brazil, 2006–12: a matched case-control study
Enny S Paixão, Maria da Conceição N Costa, Maria Glória Teixeira, Katie Harron, Marcia Furquim de Almeida, Mauricio L Barreto, Laura C Rodrigues| Background Maternal infections during pregnancy can increase the risk of fetal death. Dengue infection is common, but little is known about its role in fetal mortality. We aimed to investigate the association between symptomatic dengue infection during pregnancy and fetal death.
Lancet Infect Dis 2017; 17: 957–64
Aedes aegypti Control Through Modernized, Integrated Vector Management
The first theoretical assessment of combining novel Aedes aegypti control technologies. Excellent synergies are described whereby the Zika vector populations are effectively suppressed and replaced by virus-resistant insects| Laith Yakob, Sebastian Funk, Anton Camacho, Oliver Brady, and W. John Edmunds
30-Jan-17| PLOS Currents: Outbreaks
Comparative Analysis of Dengue and Zika Outbreaks Reveals Differences by Setting and Virus
Fitting models to data from dengue and zika outbreaks in Micronesia showed that transmission is similar for both viruses. Dengue models that have been developed for decades can and should be exploited in the current context of the Zika pandemic| Sebastian Funk , Adam J. Kucharski, Anton Camacho, Rosalind M. Eggo, Laith Yakob, Lawrence M. Murray, W. John Edmunds
06-Dec-16| PLOS Currents: Outbreaks
How do biting disease vectors behaviourally respond to host availability?
A novel formula that accounts for vectors’ diverse feeding behaviour is presented and nested into a vector-borne disease transmission model. This coupled structure offers a flexible framework that can be applied to any vector-borne disease to assess the epidemiological importance of the availability of multiple blood host species| Laith Yakob
17-Aug-16| BioMed Central
Zika’s Long Haul: Tackling the Causes of Human Vulnerability to Mosquito-Borne Viruses
Laura C. Rodrigues
Jun-17| American Journal of Public Health
Low risk of a sexually-transmitted Zika virus outbreak
The first assessment of the threat posed by Zika virus in the absence of vectors i.e. when its spread relies primarily on sexual transmission. Recommendations are made for the appropriate timescale of testing semen for viable virus| Laith Yakob, Adam J. Kucharski, Stephane Hue, W. John Edmunds
Oct-16| Elsevier
Who we are
Who we are ZikaPLAN

The ZikaPLAN consortium is being led by Annelies Wilder-Smith from Umeå University in Sweden. The London School of Hygiene and Tropical Medicine’s contribution is being led by James Logan and involves researchers from the Faculty of Infectious and Tropical Diseases, the Faculty of Epidemiology and Population Health and the Faculty of Public Health and Policy.

Meet the team

MERG: Unravelling Congenital Zika Syndrome

 

Laura Rodrigues - Professor

Professor Laura Rodrigues leads the MERG: Unravelling Congenital Zika Syndrome working group. Since the start of the Zika epidemic, Laura has been involved in research into microcephaly and the Congenital Zika Virus Syndrome (CZVS). She is a founding  member of the Microcephaly Epidemic Research Group (MERG) commissioned by the Brazilian Government to investigate the epidemic of microcephaly and has contributed to Brazilian and UK Government, PAHO and WHO meetings on the subject. Laura is a Professor of Infectious Disease Epidemiology in the Faculty of Epidemiology and Population Health at the London School of Hygiene and Tropical Medicine.

Laura Rodrigues

Elizabeth Brickley - Assistant Professor

Dr. Elizabeth Brickley is a member of the MERG: Unravelling Congenital Zika Syndrome working group.  Elizabeth is an infectious disease epidemiologist, specializing in pregnancy and birth cohort studies.  In addition to investigating Congenital Zika Syndrome, she serves as a key liaison for the Zika Data Share platform and the REDe Research Capacity Network.  Elizabeth is an Assistant Professor of Infectious Disease Epidemiology in the Faculty of Epidemiology and Population Health at the London School of Hygiene and Tropical Medicine and an Adjunct Assistant Professor of Epidemiology at the Geisel School of Medicine at Dartmouth College (USA).

 

Hannah Kuper - Professor

Professor Hannah Kuper is a part of the working group MERG: Unravelling Congenital Zika Syndrome. Hannah is investigating the social and economic impact of Congenital Zika Syndrome in Brazil whilst looking at mitigating its effects through the development of parent support programmes. She is the Director of the International Centre for Evidence in Disability, a research group at the School that works to expand the research and teaching activities in the field of global disability. Her main research interests are in disability in low and middle income countries. 

Kuper Hannah

Platform for Diagnostics Innovation and Evaluation

 

Rosanna Peeling - Professor

Professor Rosanna Peeling leads the Platform for Diagnostics Innovation and Evaluation working group. Rosanna is Professor and Chair of Diagnostics Research and the Director of the International Diagnostics Centre (IDC) at the London School of Hygiene and Tropical Medicine. After training as a medical microbiologist, Professor Peeling was the Research Coordinator and Head of Diagnostics Research at the Special Programme on Research and Training in Tropical Diseases (TDR), and the Chief of the Canadian National Laboratory for Sexually Transmitted Diseases.

Rosanna Peeling

Debi Boeras – Consultant

Dr. Debi Boeras is a consultant on the Platform for Diagnostics Innovation and Evaluation working group for ZikaPLAN whilst a diagnostics consultant with the International Diagnostics Centre at the London School of Hygiene and Tropical Medicine (LSHTM). She is working to improve the quality of testing in resource-limited settings. Debi previously worked at the International Laboratory Branch at the U.S. Centers for Disease Control and Prevention (CDC) to strengthen molecular diagnostics in collaboration with Ministries of Health (MOH). She led both laboratory and field evaluations of new technologies and continues these efforts alongside partners to ensure the introduction of accessible quality diagnostics will impact patient care.

Debi Boeras

INVADE: Investigating Vaccines in Antibody Dependant Enhancement

 

Michael Gaunt – Assistant Professor

Dr Michael Gaunt performed a PhD at Oxford University in flaviviruses and was the first person to sequence the E-protein of Zika virus. He moved to the London School of Hygiene and Tropical Medicine to undertake a fellowship in molecular approaches towards understanding vector and pathogen interactions. Michael is currently working on Zika virus and its potential to cause antibody dependent enhancement (ADE) in human populations. The work is performed in collaboration with Andrew Falconar who is based in Colombia and La Joya Institute, San Diego.

 

Mathematical modelling to inform public health policies

 

Laith Yakob - Assistant Professor

Dr Laith Yakob leads on the working group for Mathematical Modelling to Inform Public Health Policies at the London School of Hygiene and Tropical Medicine. Following the report of the initial Zika diagnosis in Brazil, he applied in May 2015 for funding to ramp up arbovirus surveillance in the region. Dr Yakob and his group are developing models to inform optimal control strategy that takes advantage of modern methods of Aedes aegypti management. Laith is Assistant Professor at the London School of Hygiene & Tropical Medicine. His background is in infectious disease epidemiology and he specialises in quantitative methods for disease control strategy.

 

Kathleen O’Reilly - Research Fellow

Dr Kathleen O’Reilly is an epidemiologist specialising in the use of statistical and mathematical models to inform control and eradication strategies. Kathleen is currently constructing life history models for humans and mosquito species and applying these models to answer questions about Zika transmission. These models will be used to test different control strategies according to setting. Kathleen is also part of the ZikAlliance consortia and regularly collaborates with colleagues from across different disciplines.

Kathleen O'Reilly

WEAR: Wearable Aedes Repellent Technologies

 

James Logan - Professor

Professor James Logan is the Principal Investigator for ZikaPLAN at the London School of Hygiene and Tropical Medicine and leads on the WEAR: Wearable Aedes Repellent Technologies working group. James is the UK's leading expert on insect repellents and methods of personal protection against arthropod vectors. Whilst being a Professor of Medical Entomology in the Faculty of Infectious and Tropical Diseases he holds the positions of the Head of Department for the Department of Disease Control and the Director of the Arthropod Control Product Test Centre (arctec).

James Logan

Thomas Ant - Research Fellow

Dr Thomas Ant is investigating the development and implementation of personal protective technologies for the prevention of arbovirus transmission for ZikaPLAN’s WEAR: Wearable Aedes Repellent Technologies working group. Before joining the London School of Hygiene and Tropical Medicine, Tom held a research position at the Centre for Virus Research at the University of Glasgow. His primary research interests lie in mosquito vector biology and ecology, and the interactions between vector and pathogen.

Coordination

 

Grace Power – Project Manager

Grace Power is the Project Manager for ZikaPLAN at the London School of Hygiene and Tropical Medicine. Her academic background lies in Anthropology and the Life Sciences for Subjects Allied to Medicine. She has held a variety of roles in programme delivery, education, fundraising and communications across international development NGOs. Grace currently leads on all aspects of grant management, coordination and communications for the London School of Hygiene and Tropical Medicine’s contribution to ZikaPLAN and contributes to social research on Zika risk factors and perceptions for Work Package 10.

Hannah Miyanji – Assistant Project Coordinator

Hannah Miyanji supports the ZikaPLAN team at the London School of Hygiene and Tropical Medicine as the Assistant Project Coordinator. She comes from a third sector background and studied History at undergraduate level.

Updates
Updates List Block
An update on Zika: from epidemiology to new diagnostics and potential treatments

Duncan Catterall Seminar Room, Mortimer Market Centre, Capper Street, London, WC1E 6JD, 8.00am 

Seminar to be presented by David Hamer, Professor of Global Health and Medicine at the Boston University School of Public Health and School of Medicine 

Zika Messaging in Brazil Presented at Zika Virus and other Mosquito-borne Viruses Conference

John Kinsman, member of the ZikaPLAN Messaging project and Associate Professor in Global Health at the Epidemiology and Global Health Unit, Umeå University gave a presentation on the “Perceptions of and reactions to Zika messages in Brazil” on day two of the conference, Zika Virus and other Mosquito-borne Viruses, Science for Preparedness and Response in the Mediterranean Region, which was held in Barcelona, May 23-24.

The aim of this event, jointly organized by B·Debate and the Barcelona Institute for Global Health (ISGlobal), was to generate a forum for an interdisciplinary and international debate bringing together experts from different backgrounds to discuss the critical issues related to public health, epidemiology, entomology, virology, clinical care and diagnostics.

The objectives of the meeting included a review of current interdisciplinary knowledge and activities on mosquito-borne viral diseases research relevant to public health management with special focus on the ongoing Zika epidemic; a review of regional capacities and needs for preparedness and response against mosquito-borne viruses which can be supported by research in the Mediterranean Region; the identification of priority objectives, research activities as well as optimal channels of communication for supporting public health bodies against mosquito-borne viral diseases and the identification of existing networks and platforms which can be used or adapted as a model for research collaboration and translation from research programs to public health management.

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Case Studies
ZikaPLAN Case Studies
Kathleen O’Reilly
Kathleen O’Reilly

Kathleen O’Reilly

Kathleen O’Reilly is an epidemiologist working in collaboration with Laith Yakob and Oliver Brady through the ZikaPLAN and ZIKAlliance consortia. Whilst the project is being implemented here at LSHTM, partners are involved from across Europe, and the Americas. As part of the project Kathleen is using mathematical modelling to gain deeper insight to the potential threat of a future Zika Virus outbreak in Latin America. Comprising the use of continental-scale data on the Zika epidemic with demographic and environmental data thought to influence mosquito populations and infection risk, an analysis of the predicted future trajectory has now been finalised. Research is still underway; Kathleen and her team are optimistic that they will discover different control strategies with a strong focus on how Zika has spread across specific countries. These insights will be extremely useful and especially relevant for partners within affected communities, particularly around the control of the mosquito that spreads Zika - Aedes aegypti - which more broadly will apply to other vector-borne diseases such as dengue and chikungunya.

 


Elizabeth and the team
Elizabeth and the team at Instituto Fernandes Figueira in Rio de Janeiro led by Dr. Maria Elisabeth Lopes Moreira

Elizabeth Brickley

Dr Elizabeth Brickley is an infectious disease epidemiologist and the leader of the ‘Unravelling Congenital Zika Syndrome’ Work Package for ZikaPLAN at the London School of Hygiene and Tropical Medicine. Elizabeth collaborates with valued partners at the Instituto Fernandes Figueira in Rio de Janeiro, the Instituto de Patologia Tropical e Saúde Pública in Goiânia, and the Microcephaly Epidemic Research Group in Recife to follow-up three pregnancy and birth cohorts in Zika-affected communities in Brazil.  The teams are working to shed light on the vertical transmission of Zika virus in pregnancy and to describe the spectrum of Congenital Zika Syndrome in children.

 

 

 


Rosanna Peeling and Debi Boeras

Professor Rosanna Peeling leads Work Package 5; Platform for Diagnostics Innovation and Evaluation. Working alongside her, is Dr Debi Boeras who is a Consultant for the International Diagnostics Centre at the London School of Hygiene and Tropical Medicine. Their research has a broad scope, and is currently being implemented in Latin America, Europe, USA, and Africa. With the overall objective to develop, validate and evaluate tools for the diagnosis, surveillance and research on ZIKV, the pair have built a large team of staff and partners who are continually developing Zika diagnostic assays. Working in collaboration with UNICEF, they have successfully established a bio banking network for the first series of evaluations of new Zika diagnostics and subsequently have now set up a bio bank facilitating test development, evaluation and research studies. Professor Peeling and Dr Debi Boeras are keen to continue maintaining the ZikaPLAN bio bank, working with their evaluation sites to help accelerate market entry of new and improved Zika diagnostic assays. The team are dedicated to ensuring they have established a sustainable network of sites that work to provide access to Zika specimens, evaluate data and are sharing data.