Zika in the Media – We Need More Research

Today I have a special post up at the Altmetric blog about some of the most popular research papers in the media this month, with a focus on Zika-related research in the news.

Zika virus (ZIKV) is a flavivirus related to yellow fever, dengue and West Nile. On February 1, 2016, the World Health Organization (WHO) declared a public health emergency due to a concerning rise in symptoms and disorders potentially associated with Zika, including microcephaly (a condition in which children are born with abnormally small heads). In May 2015, the Pan American Health Organization issued an alert after confirming Zika infections in Brazil.

But when it comes to covering research about Zika, has the media been focusing on the most important aspects of understanding this virus and the impact of the current outbreak? To try to answer this question, I talked to Dr. Rebecca Christofferson, an assistant professor who studies infectious disease transmission including transmission of Zika virus at Louisiana State University. We exchanged the following Q&A over e-mail.

Dr. RC Christofferson looking for mosquitoes in a graveyard with her graduate student
Interact with her on Twitter @RC_Epi

"... the scientific community is scrambling to be able to investigate this virus and the outbreak..."

Me: You recently wrote a mini-review article on Zika, and you've also written a few posts on your blog about how the current Zika outbreak has been dealt with by the media. In your opinion, what is the major disconnect between the outlook on Zika within the scientific community and the outlook on it in the public media sphere?

Christofferson: The headlines from the media, and sometimes the content of the articles themselves, make it seem like the scientific field has reached an evidence-based consensus on Zika virus. This is not the case.  The disconnect is that the scientific community is scrambling to be able to investigate this virus and the outbreak (often relying on funding mechanisms that often take months) and results are coming slowly (with the exception of case reports). The media, however, presents these breadcrumbs, sometimes out of proportion, so it can seem like we are learning much more, much faster than we are.

(By the way, this is not only a public press problem. I’ve seen scientific published papers with headlines that suggest we’ve solved the problem.)

Me: As a researcher who works with Zika, has your outlook on your work changed over the course of the current outbreak?

Christofferson: It’s been a double-edged sword. On the one hand, it’s very gratifying that one of these neglected diseases that I work on is getting so much attention. I’m very proud of the work my laboratory is doing and I’m hopeful that it will be well received in the near future.

However, it can also be frustrating because there are viruses that have caused significant morbidity and mortality in developing nations that still aren’t being given the same level of attention. When Zika wanes, there will still be dengue and there will still be threats of other pathogens. The bigger conversation I wish the media would drive is support for interdisciplinary surveillance networks to forewarn of the next emergent pathogen.

Me: What Zika research (papers) have you seen get big media play in the last few months, if any? As a researcher, is/are there other research (papers) that you think the media should instead be focusing more attention on?

Christofferson: Until this outbreak, there wasn’t much out there about Zika compared to other similar pathogens. One thing that has surprised me is the seeming lack of retrospective literature study. For example, it was frustrating that sexual transmission was touted as a new phenomenon when there were two compelling studies out there that supported this (Musso 2015, Foy 2011).

Most of what is coming out from this outbreak so far are case reports and observational studies that, while important and informative, cannot tease apart the other potentially confounding factors associated with this outbreak. While very much needed, the basic research that can answer many of these questions takes time to do. So the basic research is still in the pipelines, but I hope the media tunes in to see what I and other laboratories can discern in the near future.

"... we know very little about this virus, so basic virological studies need to be conducted..."

Me: What, in your opinion, should be the biggest research-oriented priority when it comes to characterizing Zika or investigating the current outbreak?

Christofferson: The phenomenon surrounding pregnant women and the risk to unborn children, of course, should be investigated. The evidence is circumstantial at this point, but there needs to be a controlled, scientific study to either definitively associate Zika with microcephaly or to identify what other factor(s) might be increasing the risk of this deformation.

But again, we know very little about this virus, so basic virological studies need to be conducted to fill these holes in our knowledge-base such as potential reservoirs in South and Central America (what other animals can get the virus and keep it in circulation), the vector host range (what mosquitoes carry the virus), and quantification of the contribution of sexual transmission to the whole transmission cycle.

"... there needs to be a controlled, scientific study to either definitively associate Zika with microcephaly or to identify what other factor(s) might be increasing the risk of this deformation... "

Me: Anything else you'd like to add about the current Zika outbreak, from a media coverage or research angle?

Christofferson: I don’t believe we really know the intensity of transmission of Zika. In these areas, there are other diseases that clinically look a lot like Zika – dengue and chikungunya. Some of the diagnostic tests used to differentiate dengue and Zika cannot distinguish well between these two related viruses. From a treatment standpoint, this doesn’t matter. You can’t cure viruses and so you treat the symptoms, which are very similar for these viruses. But from a follow-up standpoint, it’s important.

Zika is known to be found in semen of some infected men. If you’re diagnosed with dengue where this isn’t a risk and you aren’t told to protect your partner, transmission can occur in the days or weeks following your misdiagnosed Zika infection. On the other hand, in these endemic areas, if you get a second dengue infection, you are at risk for developing hemorrhagic fever, which is potentially fatal. But if you are misdiagnosed with Zika, you (and potentially your physicians) may not know that your risk is enhanced because that first dengue infection was misdiagnosed.

From a media standpoint, support for public funding of science is important. A good portion of the knowledge we have of these neglected tropical diseases comes from academic researchers who are crazy enough to study them. In addition, it is vital that we begin to survey for these emerging pathogens before they become the next big thing. There are many programs out there that are positioned to do this in an efficient manner through collaborations among academia, the government, and the military. The common theme is prioritizing funding for these programs and garnering public support for such.