2. Are we ready to deal with future outbreaks?

Xavier de Lamballerie, professor at Aix-Marseille University of France, outlined several areas to work on to be better prepared on a global level:

• Diagnostic tools need to be improved, especially in the poorer countries, to make them faster, safer and more readily available. “This should be an absolute priority in the research”, says de Lamballerie.
• We need to create a risk map, with coordinated, global medical surveillance.
• The natural history of the infection should be studied; although this may seem “simple and obvious, a lot of the time it is not done.”
• We need to study some social science aspects - “the perception of risk, attitudes, and behaviors”.
• Data from clinical studies should be harmonized, standardized and shared.

And, of course, advances must be made in the prevention and treatment of disease, as well as in the methods used to control the vectors. Paul Reiter, consultant at the Pasteur Institute in Paris, spoke about the latter. There are four main methods to work with: irradiate mosquitoes to sterilize and then release them, infect them with the Wolbachia bacteria −which makes reproduction difficult and prevents the development of the virus−, use transgenic mosquitoes (‘friendly’ mosquitoes) which displace the wild mosquitoes and need an antibiotic to survive, or use gene drive technology: taking advantage of the new cut-and-paste gene editing tool CRISPR to introduce sterility genes that will propagate quickly.

All these strategies carry risk and are still not as effective as we would wish. “We still need greater knowledge”, says Reiter. “But in the meantime, we must continue to do what we can, with our fingers crossed hoping that the new methods will work”. Carla A. Souza, professor at the Institute of Hygiene and Tropical Medicine in Lisbon, went a step further by asking: “Could something like that be applied in Europe?”