3. Zika: the enemy at the door

“We have many gaps when it comes to understanding the Zika virus. We don’t have antiviral drugs or a vaccine, and information about the risk factors of transmission from mother to fetus is limited”, says Antoni Soriano, a pediatrician specialized in infectious diseases at Vall d´Hebron Hospital in Barcelona. “For pediatricians, it was a kind of déjà vu, reminding us of the beginnings of the rubella virus or even the AIDS virus.”

Soriano is currently monitoring around 60 children, the eldest of whom is only 13 months old (all are imported cases, where the infection occurred abroad). In addition to the risk of microcephaly, “we know hardly anything about the possible long-term effects”, he says. The pediatrician forms part of the ZIKAction consortium, a multidisciplinary European project which aims to establish a network to improve research on the virus and the response capacity in the event of an outbreak.

Another European project to fight the virus is ZIKAVAX, which focuses on developing a vaccine. “The objective is to achieve 80% effectiveness”, says Odile Leroy, executive director at the European Vaccine Institute, and project coordinator. In total “there are 50 projects from 27 different institutions across the world”, she says, 10 of which are already in the clinical trial stage.

Meanwhile, there is the threat of outbreaks of the virus replicating and spreading. The regions at risk of being ‘colonized’ by the virus are those where mosquitoes capable of transmitting it are present. Some of these are areas on the Mediterranean coast, where a few years ago the Aedes albopictus, the ‘tiger mosquito’, settled.

“The first time we detected the mosquito in Catalonia was in 2004, in Sant Cugat”, said Mireia Jané, subdirector of the Department of Surveillance and Response to Public Health Emergencies of the Public Health Agency of Catalonia. Since then, concern has led to new initiatives such as Mosquito Alert, a collaborative citizen science platform which, according to the project director Frederic Bartumeus, “aims to close the circle between science and public health.” The warning by citizens of the presence of the mosquito allows “control and surveillance measures to be increased and is, in itself, a research platform.”

On an official level, a surveillance plan has been in place since 2014 to fight diseases transmitted by these mosquitoes. The plan initially included dengue, chikungunya and the Western Nile virus, with the Zika virus being added later. Since then, 237 cases of dengue, 203 of chikungunya and up to 156 cases of Zika have been confirmed, all of them imported from other countries. That is, no transmission has occurred in Catalonia, nor has the virus been found present in mosquitoes.

But there is a risk that this could happen. Therefore, the surveillance plan involves numerous actors and measures - political, health, scientific and communication.