Our understanding of congenital infections is based on prospective studies of women infected in pregnancy. The European Union has funded three consortia to study Zika virus (ZIKV), each including a prospective study of pregnant women. Another has been funded by National Institutes of Health. This personal view sets out the study designs required to research ZIKV, and questions whether funding academics in the EU and US to work with collaborators in outbreak areas is an effective strategy. Three years after the 2015-2016 outbreaks, these collaborations have taught us little about ZIKV vertical transmission. In the time taken to approve funding, agree contracts, secure ethics approval, and equip laboratories, Zika had largely disappeared. By contrast, prospective studies based on local surveillance and standard of care (SOC) protocols have already provided valuable data. Threats to fetal and child health pose new challenges for global preparedness requiring support for the design and implementation of locally appropriate protocols. These can answer the key questions earlier and at lower cost. Local protocols can also provide a framework for recruitment of unexposed controls required to study less specific outcomes. Other priorities include accelerated development of non-invasive tests, and longer-term storage of neonatal and antenatal samples to facilitate retrospective reconstruction of cohort studies.
- Zika Virus
- vertical transmission
- prospective cohort studies
- standard of care
Ades, A. E., Thorne, C., Soriano-Arandes, A., Peckham, C., Brown, D., Lang, D., Glenn Morris, J., Christie, C., & Giaquinto, C. (2020). Researching Zika in pregnancy: lessons for global preparedness. The Lancet Infectious Diseases. https://doi.org/10.1016/S1473-3099(20)30021-9