Zika is now a full-blown epidemic and according to the World Health Organization, we are likely to see millions of cases of infection in South America, Central America, Mexico and southern and eastern United States. Monitoring replikin count through regular sampling of infected persons will be useful in understanding the dynamics of this outbreak and predicting its course. However, there are lessons to be learned that can be used for outbreaks that have yet to occur.
In July 2015 samples of Ebola virus were found to have replikin counts had increased twofold from the October 14 averages. Between July and August of 2015 there was a small cluster of new cases that were contained by public health measures. By November Liberia also reported a small cluster of cases and marked the first time the virus has reemerged since the nation was declared free of Ebola in May 2015. As of April 1st of this year Liberia became the second country to confirm a new case with the infection and subsequent death of a 30 year old woman.
Ebola can stay active in survivors for many months after they recover. It has been detected in immune protected tissues, primarily the eyes and testes. These reservoirs of active virus are believed to be the source of ongoing flare-up of the disease. However, it remains to be seen if this is conclusive in ever new case. Given the correlation between replikin spikes and outbreaks the question is will there be a new large-scale outbreak of Ebola in West Africa.
Biosurveillance and Replikin Count
The usefulness of replikins in predicting outbreaks is clear. A time frame can be established within which one might expect to see an outbreak of a particular virus. The question is where and how it might proceed. A myriad of other factors can affect how or even if an outbreak will proceed. These are actively monitored by public health authorities and more recently by intelligence agencies. One novel method is being used by the Department of Homeland Security’s NBIC (National Biosurveillance Integration Center). The center doesn’t deploy in-house assets into the field to conduct surveillance but rather takes advantage of information that is produced by various other organizations, both public and private. Via web scraping and natural language processing technology is ingests over 24,000 open sources and with a taxonomy of over 8,000 words and phrases it looks for indicators of a possible outbreak or bio-terrorist event in progress.
As powerful as this might be one might question if replikins is part of that taxonomy. Adding it is something that would be recommended given what is known about replikins and outbreaks. In addition to open source methods a more organized and methodical approach of the use of replikin counts in sampling and surveillance of new and emerging viruses would be an important compliment to existing open source efforts.
Currently Replikins Ltd. samples known pathogens largely as part of its effort to develop patentable synthetic vaccines that use a replikin blocking mechanism for immunization. They have neither the resources or the motivation to implement a wider and more systematic global surveillance program. Although this would not be the only tool in the toolbox of such an effort, to the best of my knowledge, no such effort yet exists.
In 1994 Laurie Garret, author of The Coming Plague: Newly Emerging Diseases in a World Out of Balance, framed the challenge we face regarding emerging diseases as one that will be determined by coordinated biosurveillance on a global scale. She summarized it in stark terms.
“The lesson is that a health problem in any part of the world can rapidly become a health problem to many or all. A worldwide early-warning system is needed to detect quickly the eruption of new diseases and the unusual spread of old diseases. Without such a system, operating on a truly global level, we are essentially defenseless, relying on blind luck to protect us.”
More than 20 years later her observation of the current state of biosurveillance remains unchanged.