Systems Biology-Based Platforms to Accelerate Research of Emerging Infectious Diseases

Oh, Soo-Jin; Choi, Young-Ki; Shin, Ok Sarah

As a consequence of global warming, ZIKV/DENV-associated diseases are potential EIDs that could arise in South Korea. DENV and ZIKV are mainly transmitted by Aedes albopictus and Aedes aegypti mosquitoes, respectively. Dengue fever is a major public health concern in many parts of the tropics and subtropics, and four different serotypes are currently co-circulating in most dengue-endemic areas. 50 The pathogenesis of dengue fever is very unique in regards to antibody-dependent immune enhancement associated with DENV. Whereas primary infection usually confers durable, if not life-long, protection against re-infection by a homologous DENV serotype, secondary infection by viruses of a heterologous DENV serotype can frequently occur and result in severe pathology of the host. 51, 52 Thus, the unique complexity of DENV pathogenesis and its effect on immune enhancement pose a great challenge to the development of a safe and effective DENV vaccine. Even though South Korea is not a region where dengue is epidemic, there have been many imported DENV infection cases in South Korea, and their number is increasing due to increased traveling to Southeast Asia. 53, 54 Likewise, ZIKV is an another emerging mosquito-borne pathogen which belongs to the family Flaviviridae and is closely related to other pathogens of public health importance, including Yellow Fever virus, DENV, Japanese Encephalitis virus, and West Nile virus. The first case of human infection by ZIKV was reported in Uganda in 1952. 55 Usually, ZIKV infection results in asymptomatic clinical features, but in some cases, ZIKV infection can lead to fatal microcephaly in infants and Guillain-Barre syndrome in adults. 56 With increasing cases of ZIKV infection in America, many Asian countries, including India, the Philippines, Taiwan, and Vietnam, have reported ZIKV outbreaks, as of 2016. 57 Although South Korea is considered a non-endemic region for Aedes aegypti-transmitted diseases, the first patient infected with ZIKV was reported in South Korea in 2016. The patient had stayed in Brazil for 3 weeks, and upon arrival in South Korea, complained of various symptoms, including fever, eyeball pain, and maculopapular rash. 58 Given that Asia is endemic for ZIKV infection and the climate of South Korea is changing each year, it will be only be a mat-ter of time before mosquito-borne EIDs become endemic in South Korea. Thus, we need to prepare for protection against mosquito-borne EIDs.