February 12, 2016

By Sharon Deem, DVM, PhD, DACZM
Director, Saint Louis Zoo Institute for Conservation Medicine

Every few months, invasive viruses from distant lands attack the Americas—dengue, avian flu, chikungunya and now, mosquito-borne Zika virus. In Brazil alone, this virus is linked to over 4,000 cases of microcephaly—a rare birth defect that causes brain damage and an abnormally small head.

Zika was first identified in Uganda and was named after a forest there 70 years ago. However, the current epidemic with associated congenital malformations and rapid spread throughout the Americas, has sent scientists into uncharted territory. Today, they are scrambling to sequence the genome. Like much other virus work, understanding the virus' code is imperative for diagnostic testing, vaccination and therapeutic development.

Concerned about these frequent zoonotic disease outbreaks, the Saint Louis Zoo in 2011 founded the Institute for Conservation Medicine (ICM) to conduct research and work with a range of partners to help keep animals and humans healthy.

There are many lessons to be learned from the recent tragic outbreak of Zika. Like many other devastating diseases, Zika comes to the Americas because of rapid urbanization and the trash it brings, plus global trade and travel.

The most important mosquito vector of dengue, chikungunya and Zika virus is Aedes aegypti. Weighing less than a grain of rice, this mosquito lives only a few weeks and strays no more than 100 yards from where it hatches. And, unfortunately it loves humans and our waste!

When and how did Zika make it to Brazil? These are two of the top questions we are all asking. We suspect Zika was brought to the Americas by a traveler infected with his/her full suite of microbes coming from Africa or Oceania (where Zika is endemic) to attend the World Cup in 2014.

We may also do well to ask why we continue to be caught off guard by these types of emerging infectious disease (EID) outbreaks—and even more importantly, what is our plan for preventing the next EID? Any strategy must begin with improving animal, ecological and human health. Maintaining healthy habitats, reducing human-animal conflicts, keeping long-term surveillance in public health and eliminating breeding grounds for vectors (e.g., mosquitoes) may provide some keys for curtailing EIDs such as Zika.

There is hope! Bright young people are realizing the need to study these diseases in a holistic conservation medicine/One Health approach that works along the environment-animal-human health continuum. During the past year, the Zoo has hosted a brilliant young scientist—Dr. Lilian Catenacci. A veterinarian, Lilian came to the Zoo's ICM to learn more about conservation medicine while finalizing her data analyses, writing and publications to further her Ph.D. research in viral epidemiology.

Lilian is no stranger to the natural world. She spent her childhood growing up in a Brazilian state park surrounded by wildlife, and after college, lived in a Brazilian forest for three years to study the endangered golden-headed lion tamarin. With her zoology master's degree in hand, she became a professor teaching clinical and wildlife management at the Federal Brazilian University.

Since March 2015, when Lilian came to the Saint Louis Zoo, she has shadowed veterinarians and animal care professionals, attended classes and worked in the Parker Lab (led by Dr. Patricia Parker) at the University of Missouri-St. Louis (UMSL). During her stint with the Zoo and UMSL, Lilian has worked with other research projects in the Galápagos Islands, attended a conference on One Health and presented at international conferences.

Next month, Lilian returns to Brazil to complete her Ph.D. at Evandro Chagas Institute and to test for the presence of Zika in 1,000+ samples collected from free-living primates and sloths, mosquitoes and humans—all collected in the state of Bahia where Zika and microcephaly first appeared in Brazil.

Through these samples collected at "ground zero," Lilian may find the key to unlocking the answers to the how, what, where, when and why of this devastating zoonotic disease. These answers will be instrumental as we develop preventive measures and therapeutic plans to address the current epidemic. Like all conservation medicine projects, this was a collaborative process; Lilian worked with partners across many institutions and disciplines.

Lilian has big plans for her country. She wants to bring greater awareness of conservation medicine by educating a range of Brazilian audiences about the need to protect species, live in balance with the environment and other measures that help prevent zoonotic diseases, including Zika.

As she leaves St. Louis, we wish her luck and hope that this great young scientist, collaborating with others, will provide answers to help solve today's critical health challenges for her nation—and the world.

Health Department Services
Evandro Chagas Institute-SAARB (PA, Brazil)
State Health Public Laboratories-LACEN (BA, Brazil)
Secretarias municipais de saude de Ilheus e Una (BA, Brazil)
6 Diretoria Regional de saude (BA, Brazil)

Environmental Institutions
Centre for Research and Conservation of the Royal Zoological Society of Antwerp (Antwerp, Belgium)
Federal Environmental Services-ICMbio (BA, Brazil)
Bicho do Mato Instituto de Pesquisa (MG, Brazil)
NGO Instituto de Estudos Socioambientais do Sul da Bahia (BA, Brazil)
Center for Conservation and Sustainable Development of the Missouri Botanical Garden (MO, USA)

Education Institutions
Federal University of Piaui State-UFPI (PI, Brazil)
State University of Santa Cruz-UESC (BA, Brazil)
University of Missouri-Saint Louis-UMSL (MO, USA)