With every report of a new area being struck by Zika and babies being born with devastating birth defects, the need to contain the spread of the Zika virus becomes more urgent.
A key part of the solution involves making Zika testing readily accessible, highly accurate and affordable, and this can best be achieved by testing at the point of care. Rapid point-of-care tests provide real-time results that can be delivered to patients wherever they are, so that those who are infected can be quickly linked to care. Currently, the only available Zika tests are lab-based, and by the time results are available, healthcare workers may no longer be able to locate the tested patients and educate them about the risk of Zika – especially as it relates to childbearing.
Despite calls for improved Zika testing by global stakeholders such as the World Health Organization (WHO), progress in Zika screening is lagging. Here are four issues that need to be addressed to make point-of-care Zika testing possible:
- Multiple Approaches to Testing – Viruses like Zika can be screened by detecting the protective antibodies produced in response to infection (indirect testing), and by testing for the virus itself (direct testing). Molecular testing (a direct testing method which detects viral genetic material) is often more accurate, but is best suited for screening recent infections – and finding people who may have been recently infected can be difficult since they may not exhibit any symptoms.
For further discussion on the diagnostic challenges, see a blog post on Alere’s website by Dr. Luis Gonzalez, Director of Medical and Scientific Affairs for Alere Latin America, and Dr. Amilar Tanuri of the Genetics Department of the Unversidade Federal do Rio de Janeiro.
- Access to Blood Samples – Companies seeking to develop Zika tests need hundreds of samples of infected blood to validate their tests. However, in most countries where Zika is circulating, not only is the availability of confirmed blood samples limited, but medical institutions do not allow them to leave the country – creating roadblocks for diagnostic companies in other countries.
- Testing Guidelines – In the U.S., government funding for testing programs are tied to the official guidelines issued by the U.S. Centers for Disease Control and Prevention (CDC). As of today, the CDC’s Zika testing guidelines are primarily focused on pregnant women, making it difficult and expensive for other at-risk populations, such as women trying to become pregnant and their male sexual partners, to get tested.
- Economics and Infrastructure – Many of the countries hardest hit by Zika are struggling with economic problems, and their governments will almost certainly be unable to finance screening programs when a point-of-care Zika test is available. International assistance will be needed, through agencies such as the Pan-American Health Organization, UNICEF and USAID, to help national governments fund Zika testing.
Unless these issues are addressed, new cases of Zika could increase exponentially. However, when stakeholders work together, results can be dramatic, as with efforts to contain malaria that have reduced global deaths by more than half in the last decade. Alere plans to partner with government and global health stakeholders on this new collaborative effort to make the availability of a point-of-care Zika test a reality in the near future.