A Tale of Two Flaviviruses

Virology in 2016 and 2017 saw a great deal of attention paid towards Zika Virus (ZIKV) outbreaks in the Americas. In addition, recent introduction of West Nile virus to the Americas as of 1999 sees the field of virology and infectious disease adapting to the potential for these infections in a wide variety of patient populations. Work very recently published by Robinson, Enriquez, and Ho synthesized a body of work surrounding the development of WNV and ZIKV in the Americas, specifically as infection and standards of treatment apply to Solid Organ Transplantation (SOT) patient populations. Given the knowledge that WNV and ZIKV are both flaviviruses, the analysis of incidence and epidemiology involved in flavivirus infection in SOT patients is essential to the development of therapeutic techniques for these types of infections. This review is novel in that it holistically reviews cases of flavivirus infection in SOT, where donor-derived disease and increased disease severity are continuing to be fully understood in immunocompromised patient populations. In analyzing these two sources of disease within the same context as a viral family, insight was gained as to the progress that has been made in the field regarding SOT infectious disease as a whole and suggests potential next steps for development of diagnostics and treatments for flaviviruses. As clinical and scientific understanding of this virus develops, it is essential for practicing physicians to continue to develop protocols to protect SOT and immunocompromised patients, in addition to driving research into the afflictions that do not have optimal treatments. Work continues to try and develop vaccines and treatments for the diseases caused by these flaviviruses, and has resulted in many new types of Immunoglobulin based assays for the detection of viral titers in patients. This work is especially important for the immunocompromised patient and SOT communities, as limited data suggests that both WNV and ZIKV infections become exaggerated and more dangerous for these populations. Future work also continues to focus on the treatment of mosquito vectors to prevent their spread of the disease, with researchers finding new ways to either combat the disease within the mosquito or to combat the mosquito itself, much like the work of those combatting Yellow Fever in the late 1800's.

Source: Robinson ML, Enriquez K, Ho DY. A Tale of Two Flaviviruses: West Nile Virus and Zika Virus in Solid Organ Transplantation. OBM Transplantation 2019;3(1):32; doi:10.21926/obm.transplant.1901038.

~Kyle Enriquez