WHO's Zika Open began less than a week ago with the Mattos Report, and it has now become an online hot zone for rapid research. Even ten years ago this kind of response would have been impossible. The latest posting, State of knowledge on Zika virus for an adequate laboratory response, a 29-page PDF, comes from some European experts including Dr. Marion Koopmans. The abstract:
Objective: The current epidemic with Zika virus (ZIKV) has resulted in a large increase in diagnostic requests for ZIKV in the America’s but also elsewhere in travelers returning from the affected areas, especially for pregnant women with or without (past) clinical symptoms of a ZIKV infection. To support the laboratory preparedness and response for ZIKV we assessed the current state of knowledge on ZIKV diagnostics and identified present knowledge gaps for adequate ZIKV diagnostics that need to be addressed urgently.Methods: We reviewed essential ZIKV background information and current information on ZIKV diagnostics and human ZIKV diagnosis through a literature search, using “Zika”, ZIKV as search terms in PubMed. In addition we obtained information through personal communication within European preparedness networks and information provided with commercially available diagnostic tests.Findings: Essential knowledge on geographic spread, pathogen characteristics, life-cycle, infection kinetics, available tests for molecular-based and serology-based diagnosis and biosafety issues are reviewed. Specifics of tests used for human ZIKV diagnosis are discussed in the context of the current outbreak strain.Conclusion: Besides provision of essential ZIKV knowledge to the world laboratory community, knowledge gaps have been identified that need to be addressed urgently.• Rapid and extensive field validation of available molecular and serology tests in background of both affected areas and areas unaffected but welcoming returning travellers. Special focus should be given to the patient population of pregnant women.• Monitoring of genomic diversity of circulating ZIKV strains to allow verification against operational molecular tests to ensure continuous sensitivity.• Development of External Quality Assessments (EQA) for both molecular and serology testing for multiple sample types.• Insight in infection kinetics should be obtained through prospective studies, including pregnant women as well, to determine ideal sampling type or combinations thereof and sampling time. This should focus on plasma/serum, urine and saliva combinations.• The availability of reagents for diagnostic development should be facilitated.