Zika, story of a (disturbing) failure (Didier Raoult, Le Point, February 11, 2016)

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Didier Raoult:
https://en.wikipedia.org/wiki/Didier_Raoult

Zika, story of a (disturbing) failure

The epidemic could have been anticipated. But health authorities were not listening to whistleblowers.

The Point
11 Feb 2016
By Didier Raoult

The Zika virus is a tragic example of the importance of detection and responsiveness in terms of epidemics. Transmitted by mosquitoes, it has long been known in Africa. But very little work had been devoted to it. The interest began in 2008, when an epidemic broke out in Micronesia. However, until 2013, only 27 publications were devoted to the subject, although it was discovered in meantime, in Singapore, that the famous tiger mosquito was the vector. It also transmits dengue and chikungunya. Therefore, what followed was predictable. Same reservoir, man, and same vector. In 2013, the disease has invaded Tahiti, where one of my former students, Didier Musso (. See interview on Lepoint en), has for the first time, reported the risk of sexual and blood transmission - the disease can be asymptomatic - and describes the serious and potentially fatal neurological it can cause - GuillainBarr? syndrome. Finally, he warned in The Lancet on the risk of globalization. The disease has reached New Caledonia and the Americas - Brazil, Guyana, West Indies - with a gigantic scale. In parallel appeared an "epidemic" of microcephalic children births.

The risk of sexual transmission is proven and its future role unpredictable. What to do now? Conduct an urgent study to see how long the virus persists in semen. Generalizing the serological tests to identify susceptible individuals, decontaminate the blood by the method validated by Musso, and test effective antibiotics on this type of virus. As a priority, ivermectin and teicoplanin, two old molecules never tested on viruses because they were deemed to act only on bacteria. Until ivermectin prove its effectiveness on chikungunya and teicoplanin on ebola ...

In the future, whistleblowers, when they are published in the best scientific journals, will have to be listened to in ministries and integrated into a strategy of fight which leans on the researchers capable of showing innovation. Health monitoring must detect abnormal new phenomena and show responsiveness. Which was not the case neither of WHO or national health authorities.

France was the first of major scientific countries informed through the investigation of a researcher based in Tahiti. And general mobilization was triggered by America after the invasion of Brazil by the virus. ...

http://www.lepoint.fr/invites-du-po...-inquietant-ratage-14-02-2016-2017792_445.php

 

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Excerpts from publications with collaboration of Didier Musso concerning the outbreak of Zika in French Polynesia:

Rapid spread of emerging Zika virus in the Pacific area

D. Musso1, E. J. Nilles2 andV.-M. Cao-Lormeau1
Article first published online: 4 AUG 2014

DOI: 10.1111/1469-0691.12707

? 2014 The Authors Clinical Microbiology and Infection ? 2014 European Society of Clinical Microbiology and Infectious Diseases
...
Following the FP outbreak in late 2013, there were subsequent outbreaks in New Caledonia, the Cook Islands, and Easter Island [10] (Fig. 1). Because of the typically mild clinical symptoms, limited ZIKV diagnostic capacity, and overlapping clinical features of ZIKV, dengue, and chikungunya, which are also circulating in the Pacific, we believe that ongoing and undetected ZIKV transmission in other Pacific island countries, and potentially beyond, is highly probable. The observation that severe clinical complications may occur highlights the need to strengthen surveillance for this emerging virus, and, in the event of a ZIKV outbreak, establish rigorous clinical monitoring to detect GBS or other unusual clinical manifestations.

http://onlinelibrary.wiley.com/doi/10.1111/1469-0691.12707/full

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Euro Surveill. 2014 Apr 10;19(14). pii: 20761.

Potential for Zika virus transmission through blood transfusion demonstrated during an outbreak in French Polynesia, November 2013 to February 2014.

Musso D1, Nhan T, Robin E, Roche C, Bierlaire D, Zisou K, Shan Yan A, Cao-Lormeau VM, Broult J.
Author information
Erratum in
Euro Surveill. 2014;19(15)ii/20771.

Abstract

Since October 2013, French Polynesia has experienced the largest documented outbreak of Zika virus (ZIKAV) infection. To prevent transmission of ZIKAV by blood transfusion, specific nucleic acid testing of blood donors was implemented. From November 2013 to February 2014: 42 (3%) of 1,505 blood donors, although asymptomatic at the time of blood donation, were found positive for ZIKAV by PCR. Our results serve to alert blood safety authorities about the risk of post-transfusion Zika fever.

http://www.ncbi.nlm.nih.gov/pubmed/...nch+Polynesia,+November+2013+to+February+2014

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Eurosurveillance, Volume 19, Issue 9, 06 March 2014

Rapid communications

ZIKA VIRUS INFECTION COMPLICATED BY GUILLAIN-BARR? SYNDROME ? CASE REPORT, FRENCH POLYNESIA, DECEMBER 2013

E Oehler ()1, L Watrin2, P Larre2, I Leparc-Goffart3, S Last?re4, F Valour1, L Baudouin5, H P Mallet6, D Musso7, F Ghawche2

...
Zika fever, considered as an emerging disease of arboviral origin, because of its expanding geographic area, is known as a benign infection usually presenting as an influenza-like illness with cutaneous rash. So far, Zika virus infection has never led to hospitalisation. We describe the first case of Guillain?Barr? syndrome (GBS) occurring immediately after a Zika virus infection, during the current Zika and type 1 and 3 dengue fever co-epidemics in French Polynesia.
...
As suggested by DENV and ZIKA serological tests in our patient, the simultaneous epidemics of type 1 and 3 dengue fever may also be a predisposing factor for developing GBS during Zika fever, as DENV infection had also been associated with GBS [19,20]. Our patient, like part of others who also presented a GBS, harboured serological markers of resolute dengue and recent ZIKA infections. This raises the hypothesis of a sequential arboviral immune stimulation responsible for such unusual clustering of GBS cases during concurrent circulation of ZIKA and two dengue serotypes. The risk of developing GBS would be consequently underlain by a specific sequence of DENV and ZIKA infections.

Therefore in endemic areas, clinician should be aware of the risk of diffuse demyelinating disorder in case of ZIKA infection.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20720
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Eurosurveillance, Volume 19, Issue 13, 03 April 2014

Rapid communications

EVIDENCE OF PERINATAL TRANSMISSION OF ZIKA VIRUS, FRENCH POLYNESIA, DECEMBER 2013 AND FEBRUARY 2014

M Besnard1, S Last?re1, A Teissier2, V M Cao-Lormeau2, D Musso ()2
+ Author affiliations

Centre hospitalier de Polyn?sie fran?aise, H?pital du Taaone, Tahiti, French Polynesia
Institut Louis Malard?, Tahiti, French Polynesia

A Zika virus (ZIKAV) outbreak started in October 2013 in French Polynesia, South Pacific. We describe here the clinical and laboratory features of two mothers and their newborns who had ZIKAV infection as confirmed by ZIKAV RT-PCR performed on serum collected within four days post-delivery in date. The infants? infection most probably occurred by transplacental transmission or during delivery. Attention should be paid to ZIKAV-infected pregnant women and their newborns, as data on the impact on them are limited.

Conclusions

Given the severe neonatal diseases reported with other arbovirus infections, such as chikungunya [16] and dengue [10,12], we recommend close monitoring of perinatal ZIKAV infections. Due to the high ZIKAV RNA load detected in breast milk, and even though no replicative ZIKAV particles were detected, ZIKAV transmission by breastfeeding must be considered.

Zika fever has been reported in tourists returning from French Polynesia to Japan in 2013?14 [21]. An outbreak of ZIKAV infection was also declared in February 2014 in New Caledonia, in the South Pacific [22]. Patients living in or returning from ZIKAV-endemic or epidemic areas presenting with a ?dengue-like? syndrome but testing negative for DENV should be tested for ZIKAV, with attention paid to infected pregnant women and their newborns, as data on the impact of the infection on them are limited.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20751

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J Clin Virol. 2015 Jul;68:53-5. doi: 10.1016/j.jcv.2015.04.021. Epub 2015 Apr 29.

Detection of Zika virus in saliva.

Musso D1, Roche C2, Nhan TX3, Robin E4, Teissier A5, Cao-Lormeau VM6.
Author information
Abstract

BACKGROUND:
During the largest Zika virus (ZIKV) outbreak ever reported that occurred from October 2013 to March 2014 in French Polynesia, we observed that several patients presenting the symptoms of acute phase Zika fever were tested negative in blood by ZIKV real-time PCR (RT-PCR).
...
RESULTS:

ZIKV was more frequently detected in saliva compared to blood. For the 182 patients with both samples collected, tests were positive for 35 (19.2%) in saliva while negative in blood and tests were positive for 16 (8.8%) in blood while negative in saliva; the difference in mean days after symptoms onset and the percentage of the main symptoms of Zika fever for patients only positive in saliva or in blood was not significant.

CONCLUSION:

The use of saliva sample increased the rate of molecular detection of ZIKV at the acute phase of the disease but did not enlarge the window of detection of ZIKV RNA. Saliva was of particular interest when blood was difficult to collect (children and neonates especially).

Copyright ? 2015 Elsevier B.V. All rights reserved.
KEYWORDS:
Arbovirus; French Polynesia; PCR; Saliva; ZIKV; Zika

http://www.ncbi.nlm.nih.gov/pubmed/26071336

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Volume 21, Number 2?February 2015

Dispatch

Potential Sexual Transmission of Zika Virus


Didier Musso Comments to Author , Claudine Roche, Emilie Robin, Tuxuan Nhan, Anita Teissier, and Van-Mai Cao-Lormeau
Author affiliations: Institut Louis Malard?, Papeete, Tahiti, French Polynesia
...
Our findings support the hypothesis that ZIKV can be transmitted by sexual intercourse. Furthermore, the observation that ZIKV RNA was detectable in urine after viremia clearance in blood suggests that, as found for DENV and WNV infections, urine samples can yield evidence ofZIKV for late diagnosis, but more investigation is needed.

Dr. Musso is a medical doctor and director of the Diagnosis Medical Laboratory and the Unit of Emerging Infectious Diseases of the Institut Louis Malard?, Papeete, Tahiti, French Polynesia. His research programs target endemic infectious diseases, especially arbovirus infections, leptospirosis, tuberculosis, and lymphatic filariasis.

http://wwwnc.cdc.gov/eid/article/21/2/14-1363_article
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Volume 386, No. 9990, p243?244, 18 July 2015

Zika virus: following the path of dengue and chikungunya?

Didier Musso email, Van Mai Cao-Lormeau, Duane J Gubler
...
The adaptation of ZIKV to an urban or peri-urban cycle, involving Aedes aegypti and other mosquitoes of the Stegomyia subgenus as vectors and humans as amplification hosts, should be of great concern to public health officials. With more than half of the world's human population living in areas infested with these mosquitoes, the potential for major urban epidemics of ZIKV, DENV, CHIKV, yellow fever, epidemic polyarthritis, and other as yet unknown mosquito-borne viruses that might emerge, is overwhelming, and underscores the desperate need to develop more effective mosquito control as well as vaccines and drugs.

The future of ZIKV is unpredictable, but the worldwide spread of DENV and CHIKV?closely tied to the trends of urbanisation and globalisation, suggests that ZIKV has the potential to follow in their path.


http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)61273-9/fulltext?rss=yes