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Northeastern researchers examine the Zika pandemic

by Thea Singer

The Zika virus con­tinues its inex­orable spread. April 6 updates from the World Health Orga­ni­za­tion and the Cen­ters for Dis­ease Con­trol and Pre­ven­tion pro­vide the latest numbers:

A total of 62 coun­tries and ter­ri­to­ries have doc­u­mented cases of the Zika virus, reported WHO, with 1,069 cases of micro­cephaly and other birth defects sus­pected to be asso­ci­ated with the dis­ease. Zooming in on U.S. sta­tis­tics, the CDC reported 346 travel-​​associated cases here, seven of which had been sex­u­ally transmitted.

North­eastern researchers are working to be part of the solu­tion. The agency updates coin­cided on Wednesday with an inter­dis­ci­pli­nary panel dis­cus­sion called “The Global Response to the Zika Pan­demic.” The dis­cus­sion fea­tured three dis­tinct per­spec­tives on the crisis: Those of Alessandro Vespig­nani, Stern­berg Family Dis­tin­guished Uni­ver­sity Pro­fessor of Physics, Com­puter Sci­ence, and Health Sci­ences; Richard Wamai, assis­tant pro­fessor in the Depart­ment of African Amer­ican Studies; and law pro­fessor Brook K. Baker, who spe­cial­izes in intel­lec­tual prop­erty and access to med­i­cines. Robert L. Hall, asso­ciate pro­fessor in the Depart­ment of African Amer­ican Studies, mod­er­ated the event, which was spon­sored by the Col­lege of Social Sci­ences and Humanities.

The issues cov­ered ran the gamut, from the ori­gins and geo­graph­ical dis­tri­b­u­tion of the virus to mis­per­cep­tions about the dis­ease, from the asso­ci­a­tion of micro­cephaly with Zika to poli­cies that affect treat­ment options to the com­plex­i­ties of using net­work theory in tracking the disease’s spread.

Here are some key take­aways from the event:

Richard Wamai: On the asso­ci­a­tion between Zika virus and microcephaly

04/06/16 - BOSTON, MA. -  Scenes during the Zika virus discussion held in 909 Renaissance Park at Northeastern University on April 6, 2016. Panelists included, Brook K. Baker, JD Professor of Law, Alternative Dispute Resolution, School of Law, Alessandro Vespignani, PhD Sternberg Family Distinguished University Professor, Department of Physics, College of Science, and Richard Wamai, PhD, Assistant Professor, Department of African American Studies, College of Social Sciences and Humanities. Photo by Matthew Modoono/Northeastern University

Richard Wamai, assis­tant pro­fessor in the Depart­ment of African Amer­ican Studies

This still remains a big ques­tion,” said Wamai. WHO reported that between Oct. 22, 2015, and mid-​​March 2016, 6,480 cases of sus­pected micro­cephaly were reported in Brazil— “ground zero” for Zika and the birth defect, he noted. Some 2,000 of those cases were checked with brain scans, and 863, or 39 per­cent, of them were con­firmed. Those num­bers stand in stark con­trast to the average number of cases reported each year in Brazil between 2001 and 2014: just 163.

Of course, the uptick in the number of cases is causing the sus­pi­cion,” said Wamai, who then looked into the typ­ical number of micro­cephaly cases in pop­u­la­tions around the world. In the U.S. and Europe, for example, he found it was only about three out of 10,000. The offi­cial word from WHO on the sub­ject, he noted, reflects the close asso­ci­a­tion between Zika and the birth defect: “Zika virus has not been proven to be the cause of increased inci­dence of micro­cephaly in Brazil, but there is sci­en­tific con­sensus on the sus­pi­cion,” said Wamai, quoting director-​​general Mar­garet Chan.

There are many other causes for micro­cephaly, including syphilis, tox­o­plas­mosis, rubella, and herpes sim­plex. “Those should also be inves­ti­gated for their pos­sible link to micro­cephaly,” Wamai said. More­over, Brazil does not track the number of birth defects annually—a first step for estab­lishing a base­line to com­pare cur­rent and future num­bers against.

Alessandro Vespig­nani: On the dif­fi­culty of applying net­work mod­eling to the spread of Zika

04/06/16 - BOSTON, MA. -  Scenes during the Zika virus discussion held in 909 Renaissance Park at Northeastern University on April 6, 2016. Panelists included, Brook K. Baker, JD Professor of Law, Alternative Dispute Resolution, School of Law, Alessandro Vespignani, PhD Sternberg Family Distinguished University Professor, Department of Physics, College of Science, and Richard Wamai, PhD, Assistant Professor, Department of African American Studies, College of Social Sciences and Humanities. Photo by Matthew Modoono/Northeastern University

Alessandro Vespig­nani, Stern­berg Family Dis­tin­guished Uni­ver­sity Pro­fessor of Physics, Com­puter Sci­ence, and Health Sciences

Over the past 10 years, Vespig­nani, who is the director of Northeastern’s Net­work Sci­ence Insti­tute, has mod­eled the spread of pan­demics including the swine flu and Ebola. He is now working with a team mod­eling the spread of Zika.

At North­eastern, he and his col­leagues create large-​​scale com­pu­ta­tional tools that incor­po­rate “ultra­de­tailed” maps of pop­u­la­tions and their movement—“a syn­thetic world,” he called it on Wednesday—along with the many vari­ables that affect how a spe­cific dis­ease evolves and spreads in the world. “The idea is to antic­i­pate what will happen in the next two months, in the next six months, and so on,” he said, adding that “you have to do more than fore­cast,” say, how many cases will erupt in a par­tic­ular period of time. “You have to pro­vide sit­u­a­tional aware­ness, inter­ven­tion plan­ning,” he said. You posit scenarios—for example, “What if we kill all the mos­qui­toes? What if we develop a vaccine?”—to under­stand the trade­offs between cost and effectiveness.

Mod­eling the spread of the Zika virus is par­tic­u­larly chal­lenging, Vespig­nani said, given the many unknowns. They include the time­line of events, the number of actual cases, where the dis­ease started in each country and locale, and what frac­tion of the pop­u­la­tion has been infected by the dis­ease.
“We were com­plaining about Ebola, but with Ebola we had infor­ma­tion that was much more detailed. With Ebola there were small local outbreaks—we knew the trans­mis­sion mech­a­nism, and many, many ele­ments. And even if there was under­re­porting, the system started to pick up weekly and we had data from the field.”

With Zika there’s an addi­tional crit­ical vari­able: the mos­quito. In his pre­vious mod­eling of dis­eases, Vespig­nani said, “only humans were in the loop. When you have a vector-​​borne dis­ease, you need to know about the mos­qui­toes. And unfor­tu­nately, mos­qui­toes do not go around with a GPS and a mobile phone, so get­ting data on mos­qui­toes is not easy.”

Brook K. Baker: On policy deci­sions that affect treat­ment options

04/06/16 - BOSTON, MA. -  Scenes during the Zika virus discussion held in 909 Renaissance Park at Northeastern University on April 6, 2016. Panelists included, Brook K. Baker, JD Professor of Law, Alternative Dispute Resolution, School of Law, Alessandro Vespignani, PhD Sternberg Family Distinguished University Professor, Department of Physics, College of Science, and Richard Wamai, PhD, Assistant Professor, Department of African American Studies, College of Social Sciences and Humanities. Photo by Matthew Modoono/Northeastern University

Brook Baker, pro­fessor of law spe­cial­izing in intel­lec­tual prop­erty and access to medicines

Baker con­cen­trates on two research areas: What is the appro­priate incen­tive system for research and devel­op­ment of treat­ments for con­di­tions such as Zika and Ebola—“what we might call neglected pop­u­la­tions and neglected dis­eases”? And second, What should we do to improve afford­able access to existing treat­ments? In par­tic­ular, what role does the global intellectual-​​property system play in our not being pre­pared to pro­vide such treat­ments now?

When you look at maps of the spread of the Zika virus, Baker pointed out, you see that it and “many so-​​called neglected trop­ical dis­eases” are con­cen­trated in low-​​income warmer, trop­ical countries—or seg­ments of coun­tries with low-​​income pop­u­la­tions. “That’s impor­tant,” he said, “because at present our IP system incen­tivizes bio­med­ical research enti­ties and com­pa­nies to mainly focus research on med­ical con­di­tions for which there’s a high rate of market return—in par­tic­ular, med­ical con­di­tions affecting rich people in rich coun­tries, where either insur­ance or the gov­ern­ment pays for med­ical products.”

How might we change a system that makes deci­sions about research for med­ical care based not on need but on geog­raphy and eco­nomics? he asked.

Originally published in news@Northeastern on April 11, 2016.

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