ZikaPLAN: Zika Preparedness Latin American Network.

The ongoing Zika virus (ZIKV) outbreak in Latin America, the Caribbean, and the Pacific Islands has underlined the need for a coordinated research network across the whole region that can respond rapidly to address the current knowledge gaps in Zika and enhance research preparedness beyond Zika. The European Union under its Horizon 2020 Research and Innovation Programme awarded three research consortia to respond to this need. Here we present the ZikaPLAN (Zika Preparedness Latin American Network) consortium. ZikaPLAN combines the strengths of 25 partners in Latin America, North America, Africa, Asia, and various centers in Europe. We will conduct clinical studies to estimate the risk and further define the full spectrum and risk factors of congenital Zika virus syndrome (including neurodevelopmental milestones in the first 3 years of life), delineate neurological complications associated with ZIKV due to direct neuroinvasion and immune-mediated responses in older children and adults, and strengthen surveillance for birth defects and Guillain-Barré Syndrome. Laboratory-based research to unravel neurotropism and investigate the role of sexual transmission, determinants of severe disease, and viral fitness will underpin the clinical studies. Social messaging and engagement with affected communities, as well as development of wearable repellent technologies against Aedes mosquitoes will enhance the impact. Burden of disease studies, data-driven vector control, and vaccine modeling as well as risk assessments on geographic spread of ZIKV will form the foundation for evidence-informed policies. While addressing the research gaps around ZIKV, we will engage in capacity building in laboratory and clinical research, collaborate with existing and new networks to share knowledge, and work with international organizations to tackle regulatory and other bottlenecks and refine research priorities. In this way, we can leverage the ZIKV response toward building a long-term emerging infectious diseases response capacity in the region to address future challenges.

Early detection of prostate cancer. What do we tell our patients?

INTRODUCTION: Early detection of prostate cancer is possible; overdetection of early disease that may never surface clinically during a lifetime is likely. On the other hand, early detection measures will detect life-threatening disease of which some maybe amenable to cure, while otherwise it would kill the patient. Proof of effectiveness of early detection is unavailable. Those who decide to be screened and those who decide not to be screened take risks that are difficult to balance against each other. How do we deal with this situation? What do we tell our patients? DISCUSSION: Ongoing randomized studies are likely to produce definitive answers on the question of whether screening will save men from prostate cancer deaths within a few years. The trials will also provide answers to the optimal way of screening and to the question of how to avoid overdiagnosis and treatment. In the meantime, however, men who are considering to undergo testing have a difficult decision to make. Our profession is obliged to provide assistance. The information provided unfortunately at this time cannot be the simple message: if you undergo testing your cancer will be detected early and be curable, so you will resolve the problem. It is necessary to stress the potential benefits and also the downside of testing. Elements of such information are provided in this article. Benefits may include the reassurance resulting from a normal test result, the early diagnosis of aggressive and still-curable cancer, and the avoidance of the consequences of advanced prostate cancer such as the occurrence of metastatic disease. The downside includes the possibility of missing prostate cancer and providing a false reassurance, the fact that screening may lead to unnecessary anxiety and medical tests when no cancer is present, and the fact that it may detect slow-growing cancer that may never cause any symptoms or shorten lifespan. All treatments have side effects to which men will be exposed, even those who do not have life-threatening cancer. In addition, there is no certainty that treatment will be successful. CONCLUSION: In the present situation, it is important to emphasize to patients that capabilities are being developed to identify those prostate cancers that may not cause any harm and to exclude them from immediate treatment. This recent development is a very important aspect for those who consider to be tested outside ongoing trials.

The use of reduced-dose Brucella abortus strain 19 vaccine in the control of bovine brucellosis.

Adult animals from a known negative and an infected herd were vaccinated with reduced-dose Brucella abortus strain 19 vaccine. Since some of these animals developed elevated post-vaccinal blood titres, it is suggested that, when adult vaccination is decided on, such herds should be bled and tested about 4 months after vaccination and thereafter at 2 month intervals. Reactions with complement fixation titres of 392 IU ml-1 or higher on the first test should be taken as positive. During the 2nd and 3rd tests, positive reactions should be taken as less than 98 IU ml-1 and 49 IU ml-1, respectively. After vaccination, an overkill of up to 5%, due to vaccination reactions could be expected. Positive cases might occur up to 9 months after vaccinating an infected herd. On farms selected for adult vaccination suitable calving facilities in isolation, largely facilitate eradication. Lochia samples for the early diagnosis of brucellosis should be collected. Adult vaccination with a reduced dose S 19 vaccine, should be practised on selected, problem herds only, where the owner is fully aware of the consequences of this procedure.