London School of Hygiene and Tropical Medicine, United Kingdom.
Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Center, Aurora.
J Infect Dis. 2018 Mar 13;217(7):1060-1068. doi: 10.1093/infdis/jix678.
Epidemics of dengue, Zika, and other arboviral diseases are increasing in frequency and severity. Current efforts to rapidly identify and manage these epidemics are limited by the short diagnostic window in acute infection, the extensive serologic cross-reactivity among flaviviruses, and the lack of point-of-care diagnostic tools to detect these viral species in primary care settings. The Partnership for Dengue Control organized a workshop to review the current landscape of Flavivirus diagnostic tools, identified current gaps, and developed strategies to accelerate the adoption of promising novel technologies into national programs. The rate-limiting step to bringing new diagnostic tools to the market is access to reference materials and well-characterized clinical samples to facilitate performance evaluation. We suggest the creation of an international laboratory-response consortium for flaviviruses with a decentralized biobank of well-characterized samples to facilitate assay validation. Access to proficiency panels are needed to ensure quality control, in additional to in-country capacity building.
登革热、寨卡和其他虫媒病毒病的流行频率和严重程度正在增加。目前,快速识别和管理这些流行疾病的努力受到急性感染时诊断窗口期短、黄病毒之间广泛的血清学交叉反应以及缺乏在初级保健环境中检测这些病毒的即时诊断工具的限制。登革热控制伙伴关系组织了一次研讨会,以审查黄病毒诊断工具的现状,确定当前的差距,并制定策略,加速有前途的新技术在国家规划中的采用。将新的诊断工具推向市场的限速步骤是获得参考材料和经过良好特征描述的临床样本,以促进性能评估。我们建议建立一个具有去中心化生物库的国际黄病毒实验室反应联盟,以促进分析验证。需要获得能力验证计划以确保质量控制,以及在国内进行能力建设。