---
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  family: Edmunds
  given: Scott
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date: '2016-02-15T00:00:00+00:00'
date_updated: '2025-12-06T10:34:26+00:00'
guid: http://blogs.biomedcentral.com/gigablog/?p=1671
identifier: https://doi.org/10.59350/jvb07-zra31
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keywords:
- Health
- Disease Outbreaks
- Guest Post
- Infectious Disease
- Open Data
lang: en
license: https://creativecommons.org/licenses/by/4.0/legalcode
rid: byaye-h6y70
rights: https://creativecommons.org/licenses/by/4.0/legalcode
summary: '<strong> The current global panic about Zika is a "data gap" issue: a vacuum
  of information due to gaps in understanding of its spread and pathogenesis, and
  gaps in sharing the research data and specimens that will enable the global research
  community to keep one step ahead of the disease spread. </strong>'
title: 'Guest Blog: Mind the Zika Data Gap.'
url: https://wayback.archive-it.org/22098/2025-05-01T17:13:42Z/http://gigasciencejournal.com/blog/guest-blog-mind-zika-data-gap
version: v1
---

**The current global panic about Zika is a [\"data
gap](https://www.washingtonpost.com/world/the_americas/brazil-considers-reforming-biosecurity-law-amid-criticism/2016/02/05/ba2108ba-cc80-11e5-b9ab-26591104bb19_story.html)\"
issue: a vacuum of information due to gaps in understanding of its
spread and pathogenesis, and gaps in sharing the research data and
specimens that will enable the global research community to keep one
step ahead of the disease spread. [As with
Ebola](http://www.nature.com/news/data-sharing-make-outbreak-research-open-access-1.16966),
there has been frustration at many key players not sharing these
materials, but a number of the major health bodies, funders and
publishers (including our co-publishers at SpringerNature) have [signed
a consensus
statement](http://blog.wellcome.ac.uk/2016/02/10/sharing-data-during-zika-and-other-global-health-emergencies/)
on timely and transparent pre-publication sharing of data and results.
Journal signatories make a commitment that all content concerning the
Zika virus free to access, and data and preprints deposited ahead of
submission of any paper will not pre-empt its publication in these
journals, although there has [already been
complaints](http://www.nature.com/news/zika-microcephaly-paper-sparks-data-sharing-confusion-1.19367)
regarding appropriate credit not being provided. We at *GigaScience*
already have stringent open and transparent data, review and publication
policies in place, and would encourage submission of Data Notes and
Technical Notes (methodological and software papers) to enable due
credit to producers of data and tools. As with our dissemination of the
data from the [deadly German 2011 *E. coli*
outbreak](http://blogs.biomedcentral.com/gigablog/2011/08/03/notes-from-an-e-coli-tweenome-lessons-learned-from-our-first-data-doi/),
curation and dissemination will be rapid, and we will also offer waivers
of our article and data processing charges for Zika studies to encourage
this. Please contact us if you have presubmission enquiries or
questions. If you are in Hong Kong please come along to the [Zika
Hackathon](https://opendatahk.com/2016/02/hong-kong-versus-zika-come-fight-the-data-gap-at-zikahackathon/)
that some of the *GigaScience* team are helping organize on the 16^th^
February at
[MakerBay](http://www.makerbay.org/events-classes/2016/2/16/zika-hackathon-hong-kong).**

**[![](http://gigasciencejournal.com/blog/wp-content/uploads/2015/01/author.jpg){.alignright
.size-full .wp-image-1422 loading="lazy" decoding="async"
srcset="http://gigasciencejournal.com/blog/wp-content/uploads/2015/01/author.jpg 150w, http://gigasciencejournal.com/blog/wp-content/uploads/2015/01/author-100x100.jpg 100w"
sizes="(max-width: 150px) 100vw, 150px" width="150"
height="150"}](http://gigasciencejournal.com/blog/wp-content/uploads/2015/01/author.jpg)Trying
to fill some of these gaps, and following
[similar](http://blogs.biomedcentral.com/gigablog/2014/10/27/guest-blog-the-2014-ebola-epidemic-approaches-and-resources-to-slow-the-spread-of-infection/){target="_blank"
rel="noopener"}
[blogs](http://blogs.biomedcentral.com/gigablog/2015/01/15/guest-blog-the-ebola-epidemic-revisited-where-are-we-in-2015/){target="_blank"
rel="noopener"} on the Ebola epidemic,** **we present another data
oriented guest post from [Michael
Dean](https://ccr.cancer.gov/michael-dean) from the Center of Cancer
Research at the NIH who has pooled together various available data to
present a non-specialist view of the Zika crisis.** ***\[Note: the
material presented here is from Michael Dean\'s own perspective and does
not represent the viewpoint of the NIH, or NCI.\]***

\*\*From Ebola to Zika\
\*\*Just as the countries of West Africa were achieving elimination of
the Ebola pandemic, the Americas were experiencing the rise of a
pandemic of Zika virus. Zika (ZIKV) is a flavivirus related to viruses
causing dengue (DENV), [chikungunya]{.st} (CHIKV) and yellow fever (YFV)
and West Nile disease (WNV). ZIKV was discovered by A.J. Haddow in the
Zika forest of Uganda in
1947.^[1](http://www.ncbi.nlm.nih.gov/pubmed/12995440){target="_blank"
rel="noopener"}^ ZIKV is known to cause fever, rash, headache, and
recently neurological symptoms. Campos et al. reported on 7 confirmed
cases of ZIKV infection in samples collected on March 26, 2015 in Bahia,
Brazil.^[2](http://wwwnc.cdc.gov/eid/article/21/10/15-0847_article){target="_blank"
rel="noopener"}^ The isolates were most related to Asian strains that
have been circulating in the Polynesian Islands since 2013.^3-5^ By
November, 2015 ZIKV transmission was reported across 18 of the 27
Brazilian states, and in October confirmed in Venezuela. To date
within-country transmission [has been
reported](http://www.cdc.gov/zika/geo/index.html) in 26 American nations
(Table 1, Figure 1).

|                                           |                     |
|-------------------------------------------|---------------------|
| Barbados                                  | Guyana              |
| Bolivia                                   | Haiti               |
| Brazil                                    | Honduras            |
| Colombia                                  | Jamaica             |
| Commonwealth of Puerto Rico, US territory | Martinique          |
| Costa Rica                                | Mexico              |
| Curacao                                   | Nicaragua           |
| Dominican Republic                        | Panama              |
| Ecuador                                   | Paraguay            |
| El Salvador                               | Saint Martin        |
| French Guiana                             | Suriname            |
| Guadeloupe                                | U.S. Virgin Islands |
| Guatemala                                 | Venezuela           |

**Table 1. Countries in the Americas with confirmed in-country
(autochthonous) transmission.**

[![figure1-zika](http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/figure1-zika.png){.aligncenter
.size-full .wp-image-1673 loading="lazy" decoding="async"
srcset="http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/figure1-zika.png 975w, http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/figure1-zika-300x179.png 300w, http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/figure1-zika-768x459.png 768w"
sizes="(max-width: 975px) 100vw, 975px" width="975"
height="583"}](http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/figure1-zika.png)**Figure 1.
Reported active transmission of ZIKV
(http://www.cdc.gov/zika/geo/index.html)**.

\*\*ZIKV and Microcephaly\
\*\*Troubling reports from midwives of an increased incidence of
microcephaly in newborns began emerging in Brazil in late 2015, and in
November the [Ministry of Health
reported](http://paraiba.pb.gov.br/saude-discute-notificacao-de-casos-de-microcefalia-na-paraiba-nesta-sexta-feira){target="_blank"
rel="noopener"} a 20-fold incidence in microcephaly in states of Brazil
with high infection rates. Brazil called a state of emergency in public
health and required the reporting of all cases. By January 2016, 4074
confirmed or under investigation cases have been reported and 88% of
cases are in the Northeast region of the country, where the ZIKV
infection is the highest (Table 2, Figure 2). ZIKV infection results are
only confirmed for 41 of these children to date, 40 in the Northeast
region.

[![](http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/Screen-Shot-2016-02-15-at-15.41.42.png){.aligncenter
.size-full .wp-image-1676 loading="lazy" decoding="async"
srcset="http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/Screen-Shot-2016-02-15-at-15.41.42.png 1038w, http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/Screen-Shot-2016-02-15-at-15.41.42-300x253.png 300w, http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/Screen-Shot-2016-02-15-at-15.41.42-768x647.png 768w, http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/Screen-Shot-2016-02-15-at-15.41.42-1024x862.png 1024w"
sizes="(max-width: 1038px) 100vw, 1038px" width="1038"
height="874"}](http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/Screen-Shot-2016-02-15-at-15.41.42.png)**Table
2. Cases of microcephaly and/or malformation suggestive of congenital
infection in Brazil.**

\*\*[![](http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/zikabrazil.png){.aligncenter
.size-full .wp-image-1677 loading="lazy" decoding="async"
srcset="http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/zikabrazil.png 975w, http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/zikabrazil-300x225.png 300w, http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/zikabrazil-768x577.png 768w"
sizes="(max-width: 975px) 100vw, 975px" width="975"
height="732"}](http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/zikabrazil.png)Figure
2. Map of Brazil with confirmed and under-investigation cases of
microcephaly/100,000. Difference in rate between NE Brazil and the rest
of the country X^2^=5980, P\~0. Source: data adapted from
http://portalsaude.saude.gov.br/index.php/cidadao/principal/agencia-saude/22145-ministerio-da-saude-investiga-3-852-casos-suspeitos-de-microcefalia-no-pais\
\*\*

Ultrasound data from two ZIKV positive microcephaly cases from Brazil
has been
published.^[6](http://onlinelibrary.wiley.com/doi/10.1002/uog.15831/abstract){target="_blank"
rel="noopener"}^ The blood of these women was not positive for Zika, but
their amniotic fluid was, documenting perinatal transmission, and
illustrating future challenges in studying the infection. These two
cases were examined at 29 and 30 weeks of gestation and were 2.6 and 3.1
SD below normal head circumference. The second displayed marked brain
developmental abnormalities as well as small size. A report on 35
infants with microcephaly born in ZIKV prevalent areas showed 25(75%)
had severe microcephaly, defined as \>3 standard deviations (SD) below
age and gender adjusted head
circumference.^[7](http://www.cdc.gov/mmwr/volumes/65/wr/mm6503e2.htm){target="_blank"
rel="noopener"}^

Columbia has reported approximately 20,000 ZIKV infected persons, of
these 2,116 are pregnant women whose health and pregnancies are being
closely followed. GBS cases in ZIKV+ patients have been documented in El
Salvador, and the Pan American Health Organization (PAHO) has mobilized
resources to educate populations, eliminate mosquito breeding grounds,
and collect additional data. On February 1 the WHO declared a Public
Health Emergency of International Concern (PHEIC), only the 3^rd^ time
this step has ever been taken.

ZIKV, nor any other flavivirus, has been previously linked to
microcephaly, but ZIKV has been associated with Guillain-Barré syndrome
(GBS), an auto-immune like disorder, that can be severe or fatal.
However [a recent WHO
statement](http://ecdc.europa.eu/en/publications/Publications/zika-microcephaly-Brazil-rapid-risk-assessment-Nov-2015.pdf)
mentions an unpublished cluster of microcephaly in Polynesia in 2014,
and the French Polynesian health authorities described at least 17 cases
of central nervous system malformations in fetuses and infants during
2014--2015, potentially linked to Zika. [Other reports (including this
podcast](http://www.radio1.pf/le-zika-est-plus-dangereux-quon-ne-le-pensait/)
with interviews (in French) with Dr. Henry-Pierre Mallet, head of the
Health Surveillance Office Branch) list this as 18 cases of birth
defects \'probably related to Zika\', ten pregnancies were aborted, two
babies died and the six living children are either in a vegetative state
or have brain stem deformities. WHO cited a similar report but I am
unable to find a direct link to the Ministry of Health of French
Polynesia, to confirm this data.

A 25-year old European woman who was living in Brazil in a Zika endemic
region became ill with fever, rash and pain at 13 weeks of a pregnancy.
She had a normal ultrasound at 14 and 20 weeks, but abnormal findings at
29 and 32 weeks, including microcephaly and brain calcifications. The
pregnancy was terminated and an autopsy of the fetus with documented
severe brain abnormalities and cell death with abundant viral particles
in the brain. ZIKV could be amplified only in the brain and a
full-length virus sequence showed closest relationship to Brazilian ZIKV
isolates.^[8](http://www.nejm.org/doi/full/10.1056/NEJMoa1600651){target="_blank"
rel="noopener"}^ While this is a single case, [it suggests that ZIKV is
neurotropic](https://www.newscientist.com/article/2077091-whole-zika-genome-recovered-from-brain-of-baby-with-microcephaly/).
There is no commercial diagnostic test for ZIKV or vaccine.

\*\*Using data to gaze into the crystal ball\
\*\*As with my blogs on Ebola (see
[this](http://blogs.biomedcentral.com/gigablog/2014/10/27/guest-blog-the-2014-ebola-epidemic-approaches-and-resources-to-slow-the-spread-of-infection)
and
[this](http://blogs.biomedcentral.com/gigablog/2015/01/15/guest-blog-the-ebola-epidemic-revisited-where-are-we-in-2015))
I will try to use the data at hand to model the possible future outcomes
of the pandemic.

**Viral spread.** It is clear that ZIKV can spread very rapidly
throughout tropical populations as evidenced from observations in the
Pacific islands and to date in South and Central America and the
Caribbean. With no natural immunity, or vaccine, and abundant supply of
the main vector, *Aedes aegypti*, infections are likely to continue
within the currently affected countries. Brazil estimates that 1.5
million have been infected and will reach 4 million Brazilians infected
by year end. Active transmission in Florida and the Gulf Coast states of
the US is likely, and the range of *Aedes aegypti* in the US is shown in
Figure 3. Both dengue and chikungunya currently infect part of this
range. Florida has already declared a health emergency and is mobilizing
mosquito control. If ZIKV can be significantly spread by *Aedes
albopictus,* the range could increase into parts of the Midwest and
Mid-Atlantic states. Reports of sexual transmission and virus in urine
require further confirmation, but are unlikely to increase viral spread
dramatically.

[![](http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/distribution-maps-us.jpg){.aligncenter
.size-full .wp-image-1674 loading="lazy" decoding="async"
srcset="http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/distribution-maps-us.jpg 586w, http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/distribution-maps-us-300x106.jpg 300w"
sizes="(max-width: 586px) 100vw, 586px" width="586"
height="207"}](http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/distribution-maps-us.jpg)**Figure
3. Range of the two predominant *Aedes* mosquito strains in the US
(Source: CDC).**

Table 3. displays the reported, confirmed and ZIKV positive microcephaly
cases from February 2 and 12 data. A very large fraction of the
reported, confirmed, and ZIKV positive microcephaly cases come from the
NE region of Brazil (P value essentially =0). This data strongly
supports a geographical association of the phenomenon, with Zika
strongly suspected. Interestingly, estimates of microcephaly rates are
remarkably similar in the Northeast region of Brazil and Polynesia
(60-65/million population) and this translates to very similar rates per
1000 pregnancies (4-4.2) (Table 3). The highest estimated microcephaly
rates in Brazil and 8-9 per 1000, hopefully providing an upper bound.

[![](http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/Screen-Shot-2016-02-15-at-16.05.25-300x191.png){.alignleft
.size-medium .wp-image-1679 loading="lazy" decoding="async"
srcset="http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/Screen-Shot-2016-02-15-at-16.05.25-300x191.png 300w, http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/Screen-Shot-2016-02-15-at-16.05.25-768x489.png 768w, http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/Screen-Shot-2016-02-15-at-16.05.25-1024x652.png 1024w, http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/Screen-Shot-2016-02-15-at-16.05.25.png 1046w"
sizes="(max-width: 300px) 100vw, 300px" width="300"
height="191"}](http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/Screen-Shot-2016-02-15-at-16.05.25.png)The
massive international efforts to contain the Ebola outbreaks in West
Africa were successful in containing and eventually eliminated
infections and mortality. It is certainly hoped that the risk of
developmental abnormalities in women infected with ZIKV is much lower
than suspected, and that education and public health measures will limit
the spread of the virus. This latest pandemic underscores the critical
need for global health monitoring and capabilities.

**Table 3. Microcephaly Cases in Brazil 2015-2016.**

**On top of the sources outlined here, for ongoing up-to-date discussion
see the [Zika section of
flutrackers.com](https://flutrackers.com/forum/forum/emerging-diseases-other-health-threats-alphabetical-i-thru-z/zika-virus){target="_blank"
rel="noopener"}, and all the genomics perspective and data sharing
happening via the
[virological.org](http://virological.org/c/zika){target="_blank"
rel="noopener"} portal. Please contribute and follow the work of the
[International Zika
hackathon](https://www.facebook.com/groups/zikahack/){target="_blank"
rel="noopener"}, including the [Hong Kong edition that *GigaScience* is
participating
in](https://opendatahk.com/2016/02/hong-kong-versus-zika-come-fight-the-data-gap-at-zikahackathon/){target="_blank"
rel="noopener"} on Tuesday 16th Feb.**

[![Ca3d_KIUEAA31zM.jpg_large](http://gigasciencejournal.com/blog/wp-content/uploads/2016/02/Ca3d_KIUEAA31zM.jpg_large.jpg){.aligncenter
.size-full .wp-image-1678 loading="lazy" decoding="async"
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### \*\*References \*\* {#references}

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