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Since early 2017, the three EU-funded consortia, ZikaPLAN, ZIKAlliance and ZIKAction, have been working together to prepare harmonized protocols and data dictionaries for the investigations of ZIKV infections in pregnancy. Investigators continue to exchange bi-weekly as part of an EU-supported Joint Statistical Analysis Plan working group, which includes Ricardo Ximenes and Elizabeth Brickley from ZikaPLAN, Neal Alexander, Thomas Jaenisch, Kerstin Rosenberger, Lorenz Uhlmann, and Moritz Pohl from ZIKAlliance, and Claire Thorne and Tony Ades from ZIKAction. During international teleconferences, the scientists share notes on how best to approach the data and discuss the development of a joint statistical analysis of the findings.
Through these open exchanges between researchers, new information is coming to the fore on a regular basis. Asking ‘What are you doing?’ and ‘How can that help in our work?’ has created a very different model for studying emerging infectious diseases. This openness is ground-breaking from a research angle and imperative from a public health perspective.
The spirit of open research is echoed on both national and international scales.
Under the leadership of the Microcephaly Epidemic Research Group (MERG) and with additional funding from the Brazilian Ministry of Health, twelve teams of scientists from Brazil, including investigators from the EU-funded consortia, are pooling data from their cohort studies of pregnant women and children affected by Zika in a large-scale individual participant data meta-analysis (IPD-MA) known as the Consórcio Coortes Brasil. Experts and health care professionals from across Brazil are joining forces to understand the full spectrum and rare outcomes of Congenital Zika Syndrome and to investigate any potential geographic variations in risk.
In addition to the Consórcio Coortes Brasil, collaborations have sprung up across the country with respect to other important research questions. In Recife, investigators from ZIKAlliance and ZikaPLAN are partnering to study ZIKV diagnostics in the context of pregnancy. In Rio de Janeiro, investigators from all three consortia are working together to track the development of children prenatally exposed to the virus.
Further collaboration under the coordination of the WHO is underway on the global stage. In October 2018, representatives from the three EU-funded consortia along with colleagues from other projects, including the NIH-funded Zika in Infants and Pregnancy (ZIP) study and the CDC funded cohorts, gathered in Geneva to discuss progress and challenges specific to ZIKV diagnostic tools. All three consortia are also planning to participate in a WHO IPD-MA (with Thomas Jaenisch of ZIKAlliance as the acting chair) of congenital ZIKV infections that will integrate data from diverse populations around the world.
Scientific partnerships with global reach are essential to epidemic preparedness.
In addition to facilitating the exchange of scientific knowledge in the present, these interdisciplinary networks of investigators are well-positioned to respond to emerging infectious disease outbreaks in the future. For example, if a rise in cases of ZIKV is identified in one location, then this information can be readily relayed out to the group of investigators to establish if it is an isolated outbreak or if an increased incidence has been observed elsewhere. Ultimately, this cultural shift towards the sharing of data and strategies lays the groundwork for rapid and coordinated responses to future public health emergencies and will be an essential tool for epidemic preparedness.