EXPERTS ADVISORY

The Centers for Disease Control and Prevention, which reports a dozen cases of Zika virus in the U.S., has issued a travel advisory for pregnant women, asking them to avoid countries that are currently seeing high rates of infection.

The University of Michigan has experts who can discuss the virus:

Marisa Eisenberg, assistant professor of epidemiology at the School of Public Health, is an expert in modeling infectious diseases, particularly cholera and waterborne disease in Haiti, Thailand and Africa. She has also studied other infectious diseases, such as dengue, chikungunya and Ebola.

She is part of a group of scientists from around the country who are involved with the Modeling Infectious Disease Agents Study, an NIH-funded program that focuses on infectious disease transmission modeling. Their work has informed recent Ebola projections about infection rates and deaths.

“Forecasting and model-building to project the dynamics of Zika spread will be challenging, however many modeling groups do have previous experience with other diseases transmitted in the same mosquitoes, such as dengue and chikungunya,” she said. “It will be important to build on surveillance and response efforts to both reduce risk to the population and forecast disease spread.”

Contact: 734-763-2991, marisae@umich.edu

Janet Smith, research professor at the Life Sciences Institute, and her colleagues at the LSI’s Center for Structural Biology, for years have worked on understanding how flaviviruses—like dengue fever, West Nile and Zika—replicate and spread infection.

Their research was the first to solve the physical structure of a difficult to isolate protein, called NS1, in West Nile and dengue. NS1 is produced inside infected cells, where it plays a key role in replication and spread of the virus. The 3-D images they created show which parts of the protein help the virus replicate and which parts may interact with the immune system, and thus provide important information toward designing a vaccine or therapeutic drug.

“The tools and techniques of structural biology have given us important new insights about how flaviviruses replicate and spread,” she said. “Continuing to build a deep understanding of the fundamental biology of these mosquito-borne diseases is a critical element in the fight against them.”

Contact: 734-647-9837, idemsky@umich.edu

Joseph Eisenberg, professor of epidemiology at the School of Public Health, is an expert on infectious disease epidemiology and has 20 years of experience in microbial risk assessment work focused on water quality. He is part of a group of scientists from around the country who are involved with the Modeling Infectious Disease Agents Study, an NIH-funded program that focuses on infectious disease transmission modeling with a particular focus on waterborne pathogens. Their work has informed recent Ebola projections about infection rates and deaths.

“ZIka is likely to continue to spread as this is a new emerging pathogen and there is, therefore, little population immunity,” he said. “With upcoming international events in Brazil, such as carnival and the Olympics, global spread is likely and should be tracked. Given its principal mode of transmission is through the same mosquito vector as dengue and Chikungunya, any surveillance network already set up for these pathogens can be easily extended to Zika.”

Contact: (734) 764-5435, jnse@umich.edu

Aubree Gordon, assistant professor of epidemiology at the School of Public Health, works on infectious disease epidemiology and global health, particularly the epidemiologic features and transmission of influenza and Dengue Fever in Nicaragua. Her research also includes study of Zika virus, and she is conducting testing with her pediatric cohort and making plans to launch a pregnancy study as well.

“We are on a steep learning curve about the virus. What we do know is that it’s transmitted by the same mosquito as Dengue Fever and Chikungunya. Government and public health officials across the Americas are working together to try to expand our knowledge and reduce the risk to the population.”

Contact: 734-763-3580, gordonal@umich.edu

Emily Toth Martin, assistant professor of epidemiology at the School of Public Health, is an infectious disease epidemiologist with a focus on virus epidemiology and the use of vaccines and therapies to prevent and treat infection. Her research includes optimizing the use of diagnostics for viral diseases.

“It is important to remember that we think Zika virus is predominantly spread by mosquitoes, not by contact with an infected person,” she said. “Recent cases in the United States were infected after travel to affected countries.”

Contact: 734-647-4723, etmartin@umich.edu

Dr. Arnold Monto, the Thomas Francis Jr. Collegiate Professor of Epidemiology, is an internationally known expert who can discuss transmission, prevention, mitigation and social response to outbreaks and pandemic planning. This includes transmission modes.

“This is a very unusual situation because it is a virus which causes very mild disease in other population groups, but if it infects a pregnant woman during her gestation, it can cause major damage to the unborn child,” he said. “It’s a particular challenge because the virus is apparently widespread.”

Contact: 734-764-5453, asmonto@umich.edu

Dr. Marjorie Treadwell, director of the U-M Fetal Diagnosis Center, is a maternal and fetal medicine expert who can speak about the Zika virus and particularly the concerns for pregnant women.

“Although the Zika virus rarely causes significant illness in adults, the effects could be severe and irreversible for the fetus of a pregnant woman who is infected,” she said. “Unfortunately, there are still many unknowns. We don’t know how likely it is for a fetus to be affected by the virus if the mother has it. We don’t know if women are more likely to get an infection just because they are pregnant. At the present time, there is no treatment available and the recommendations focus on prevention.

“It’s important to emphasize that the only known way a person can be infected by this virus is through a mosquito bite. Pregnant women who have not traveled to countries where the Zika virus has been reported are not at risk.”

Contact: Call Beata Mostafavi at 734-764-2220. Read her blog: http://uofmhealthblogs.org/general/what-is-the-zika-virus/26906/

Mark Wilson, professor of epidemiology at the School of Public Health, is an ecologist and epidemiologist, with broad research interests in infectious diseases, including the analysis of transmission dynamics and the environmental and social determinants of risk. Studies have addressed various arthropod vector-transmitted and “emerging” diseases including Lyme disease, malaria, leishmaniasis and dengue fever. He can discuss disease transmission, global patterns of disease and relationship to human activity.

“One challenge with mosquito-transmitted Zika virus is that even though all previously unexposed humans are susceptible, not all new infections produce symptoms. Thus, people who are infected yet asymptomatic might travel to areas where competent vectors (Aedes species mosquitoes) are present and unknowing introduce Zika to the local population,” he said. “Where these mosquitoes are abundant, outbreaks can quickly occur as transmission is intensified. Anticipating where and when Zika might appear, as well as improving surveillance and rapid response, increases the need for public health infrastructure and capacity in those settings.”

Contact: 734-936-0152, wilsonml@umich.edu

Alexandra Stern is a professor of American Culture and holds appointments in the departments of History, Women’s Studies, and Obstetrics and Gynecology. Her research focuses on the history of eugenics, genetics, society, and justice in the U.S. and Latin America.

“The emergence of the Zika virus and its association with microcephaly in newborns has the potential to shift conversations and laws related to abortion and contraception in Latin America,” she said. “Two of the key questions are: Who will be part of that conversation, and what priorities will frame it?

“Women’s health advocates across the region have been working toward the decriminalization of abortion by foregrounding that reproductive rights are human rights. If an emphasis on human rights is a core guiding principle, then meaningful change is possible. However, if the emphasis is on abortion as a preventive measure in response to an anomalous infectious health crisis then this outcome is much less likely.”

Contact: 734-936-5902, amstern@umich.edu

More information:

• Zika Virus: Information and Resources from the School of Public Health