Zika virus transmission dynamics and mitigation strategies

SANDERS B.; MIRETTI M.; ESPINEL M.; GONZALES ROSAS C.

Sao Paulo

Workshop; GLOPID-R: Zika Virus Research Workshop; 2016

GLOPID-R

Assessing Zika virus transmission dynamics and mitigation strategies. A multidisciplinary approach.Abstract: Since its detection in Brazil in May 2015, Zika virus has spread rapidly throughout the range occupied by Aedes aegypti mosquitoes in Latin America and the Caribbean (LAC). The association of Zika virus infection with microcephaly and other neurological disorders led the WHO to declare a Public Health Emergency of International Concern in Feb 2016. Significant knowledge gaps remain in understanding factors that affect Zika virus spread at the interface of humans, mosquitoes, and their environments (ecological transmission dynamics) and the effectiveness and cost-effectiveness of interventions.Our objective is to characterize the ecological transmission dynamics of ZIKV and design integrated ZIKV intervention strategies.We have developed multidisciplinary and international collaborations to conduct field studies in Argentina, Colombia and Ecuador to characterize the ecological transmission dynamics of Zika virus and predict areas at risk in each country and across the LAC region. We will design and assess integrated Zika virus intervention strategies using computer simulation based on the data collected in the field studies and other data (from collaborators and the literature).Zika virus presents a unique and urgent challenge that compels a multidisciplinary response. Our research will address critical research priorities identified by PAHO/WHO, including assessing mosquito control measures; providing decision-makers with a tool to rapidly determine optimal intervention strategies.Specific objectivesOur objective is to characterize the ecological transmission dynamics of ZIKV and design integrated ZIKV intervention strategies. We have two specific aims:1. To characterize ZIKV vector populations, viral genetic diversity and ecological transmission dynamics in three different eco-epidemiological settings, and predict areas at risk for ZIKV transmission across the LAC region, andZikaV Research Workshop_ Sao PauloProjects summaries 62. To identify a range of integrated ZIKV intervention strategies (e.g., mosquito control, vaccine) and assess their predicted comparative effectiveness, economic impact and cost-effectiveness using a computer simulation model.Summary of the methodological approachAim 1: Field studiesWe will conduct field studies in LAC countries where ZIKV emerged early in the epidemic (Colombia) or is recently emerging (Ecuador, Argentina), to characterize ZIKV vector populations and ecological transmission dynamics, and apply spatial and statistical models to predict areas at risk for ZIKV transmission across the LAC region. We will use data on entomological indices from field studies, including human-biting rates and estimated infection indices, to inform the simulation model, providing valid estimates of the likely variations in vector density and ZIKV transmission rates in different ecological settings.Aim 2: Computer simulation modelWe will design and assess integrated ZIKV intervention strategies using a data-driven computer simulation model consisting of three major components: (1) mosquito life-cycle, (2) ZIKV transmission, and (3) ZIKV natural disease history, predicting downstream health outcomes and Quality-adjusted life years (QALYs).We will apply the model to Argentina, Colombia, and Ecuador, and typical eco-epidemiological settings across LAC regions. We will integrate health economic data (cost of ZIKV intervention strategies, ZIKV illness) and outcomes across all model components to enable comparative effectiveness and cost-effectiveness analysis of ZIKV interventions.Expected resultsOur proposed multidisciplinary study integrates vector studies with state-of-the-art computer simulation modelling to substantially contribute to our understanding of ZIKV vectors, transmission and mitigation. By developing predictive models that are trained using prospective field-derived and remote sensing datasets, we are incorporating the complexities of ZIKV at the interface between humans, vectors and their various environments, a major omission of existing work. This novel integrated approach will enable us to fill the significant knowledge gaps in the current literature and accelerate the analysis of ?what-if? scenarios to rapidly identify the most effective and cost-effective ZIKV mitigation strategies, yielding invaluable evidence supporting public health decision-making in LAC.Timeline: Start date: 11-2016 ? End Date: 10-2019; Duration: 36 monthsCoordinator: Beate Sander ? beate.sander@oahpp.caPublic Health Ontario, 480 University Ave, Suite 300, Toronto, ON Canada, M5G 1V2Annex: PartnershipsPrincipal Investigators:Partner 1: Public Health Ontario and University of TorontoPrincipal Investigator: Beate SanderZikaV Research Workshop_ Sao PauloProjects summaries 7Partner 2: Instituto de Biología Subtropical (IBS) UNaM?CONICET; Universidad Nacional de Misiones, ArgentinaPrincipal Investigator: Marcos MirettiPartner 3: Universidad de los Andes, ColombiaPrincipal Investigator: Camila González RosasPartner 4: Universidad Yachay Tech, EcuadorPrincipal Investigator: Mauricio EspinelPartner 5: University of Ottawa, CanadaPrincipal Investigator: Manisha KulkarniPartner 6: York University, CanadaPrincipal Investigator: Jianhong WuCo-Investigators:Partner 7: National Institute for Research in Public Health of Ecuador (INSPI), EcuadorCo-Investigator: Varsovia CevallosPartner 8: UNaM?CONICET, Posadas, Misiones, ArgentinaCo-Investigator: Julian FerrerasPartner 9: Public Health Ontario, University of Toronto, CanadaCo-Investigator: Jonathan GubbayPartner 10: Heidelberg University Hospital, GermanyCo-Investigator: Thomas JaenischPartner 11: Universidad San Francisco de Quito, EcuadorCo-Investigator: Carlos Jiménez MosqueraPartner 12: St. Michael?s Hospital, University of Toronto, CanadaCo-Investigator: Kamran KhanPartner 13: McMaster University, CanadaCo-Investigator: Mark LoebPartner 14: University of Sao Paulo, BrazilCo-Investigator: Eduardo MassadPartner 15: Hospital for Sick Children and University of Toronto, CanadaCo-Investigator: Shaun MorrisPartner 16: Mt. Sinai Hospital and University of Toronto, CanadaCo-Investigator: Kellie MurphyPartner 17: London School of Hygiene and Tropical Medicine, UKCo-Investigator: Mark RowlandZikaV Research Workshop_ Sao PauloProjects summaries 8Partner 18: University of Sinú, ColombiaCo-Investigator: Catalina Tovar AceroPartner 19: University of Waterloo, CanadaCo-Investigator: William WongPartner 20: Posadas City Council, ArgentinaCo-Investigator: Horacio Zelaya