Containing Zika while we wait for a vaccineBMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j379 (Published 30 January 2017) Cite this as: BMJ 2017;356:j379
All rapid responses
Zika could reemerge as many parts of the world enter warmer months. Problematically, we still have no effective control strategy: spraying mosquitoes has not worked  in most places and a vaccine will not be ready until at least 2018.
When we proposed this interim solution, no rapid test was available for Zika. However, that recently changed. The Gene-RADAR, a RNA test that provides results in an hour, was authorized for emergency use  by the U.S. Food and Drug Administration. While the Gene-RADAR is currently authorized only for laboratory use during emergencies, it does not appear to require the specialized technicians or infrastructure needed for routine PCR and has a faster turnaround time. At the same time, a truly point-of-care test that also targets viral RNA has been developed using a platform that runs on a smartphone. Another CRISPR-based technology, SHERLOCK, was also recently reported. Though not yet ready for clinical use, the technology would enable even small amounts of Zika RNA to be detected, facilitating early diagnosis.
While the World Health Organization has issued a target product profile for Zika diagnostics based on generic performance specs, it lacks a “concept of operations” to guide the actual minimum necessary requirements for rapidly screening residents on a greater scale than was done last year in parts of Miami. If, with a fraction of the $100 million allocated for vaccine trials2 or $55 million Florida is looking to add to its health budget to fight Zika, these tests were refined and operationalized, they could be the key to halting Zika's resurgence.
1 McNeil Jr DG. How the response to Zika failed millions. New York Times. 2017 Jan 16. https://www.nytimes.com/2017/01/16/health/zika-virus-response.html
2 Sun LH. Zika vaccine test moves to next stage with more than 2,000 volunteers U.S., abroad. Washington Post. 2017 Mar 31. https://www.washingtonpost.com/news/to-your-health/wp/2017/03/31/zika-va...
3 Dhillon RS, Srikrishna D, Jha AK. Containing Zika while we await for a vaccine. BMJ 2017;356:j379. doi: https://doi.org/10.1136/bmj.j379
4 Nanobiosym Diagnostics Inc. FDA grants Nanobiosym Diagnostics emergency use authorization for Gene-RADAR Zika virus test. PR Newswire. 2017 Apr 11. http://www.prnewswire.com/news-releases/fda-grants-nanobiosym-diagnostic...
5 Priye A, Bird SW, Light YK, Ball CS, Negrete OA, Meagher RJ. A smartphone-based diagnostic platform for rapid detection of Zika, chikungunya, and dengue viruses. Scientific Reports 2017;7:44778. https://doi.org/10.1038/srep44778
6 Gootenberg JS, Abudayyeh OO, Lee JW et al. Nucleic acid detection with CRISPR-Cas13a/C2c2. Science 2017;356:438-442. https://doi.org/10.1126/science.aam9321
7 Chang D. Governor’s budget proposes more scientests, research to fight Zika virus. Miami Herald. 2017 Jan 31. http://www.miamiherald.com/news/health-care/article129810939.html
Competing interests: No competing interests