Knowledge Exchange by ISID

The International Society of Antimicrobial Chemotherapy (ISAC) and the International Society for Infectious Diseases (ISID) hosted a special joint World AIDS Day webinar that focused on cutting‑edge developments in HIV infection, from scientific breakthroughs to global implementation challenges. The session brought together world leaders in HIV research and global health to discuss major advances in cure strategies, next‑generation prevention tools, and the future of HIV control.

Dengue is a viral infection spread to humans by mosquitoes. It is more common in tropical and subtropical climates but continues to increase globally in different areas. Currently, around half of the world's population is at risk.

Although there is currently no definitive treatment for dengue, supportive options are available only for patients with the infection. Managing dengue presents significant clinical challenges, including timely diagnosis, fluid management, and severe complications. Addressing these challenges requires improved diagnostic tools, optimized clinical protocols, and strengthened public health interventions. Recently, some progress was achieved as the first Dengue vaccines were licensed; some additional options are in the pipeline, and as Live attenuated vaccines remain a very efficacious and widely utilized tool for combating viral infections, new strategies incorporating this technology continue to advance. Orthoflavivirus genome recoding is an innovative live attenuated vaccine technology designed to provide broad-spectrum protection against mosquito-borne orthoflaviviruses from the Aedes and Culex clades. 

This session will cover the challenges in the clinical management of dengue and a specific vaccine technology strategy. 

Chikungunya virus is a mosquito-transmitted alphavirus that causes acute fever and acute and chronic musculoskeletal pain in humans. Chikungunya virus is transmitted by mosquitoes, most commonly Aedes (Stegomyia) aegypti and Aedes (Stegomyia) albopictus. These mosquitoes bite primarily during daylight hours. With the absence of definitive treatment and widespread vaccination, the main method to reduce transmission of CHIKV is through control of the mosquito vectors. This requires mobilization of communities, particularly to destroy breeding sites of the mosquitoes. There is a need to better understand the epidemiology of chikungunya for better prevention and control measures to be implemented. Due to the challenges in reporting and diagnosis, the number of people affected by chikungunya is underestimated. It is important for health care workers to have a high index of suspicion to request for the right diagnostic tests since chikungunya, dengue and zika have similar symptoms.

Chikungunya is a mosquito-borne viral disease caused by the chikungunya virus (CHIKV), an RNA virus in the alphavirus genus of the family Togaviridae. In August 2007, an outbreak of autochthonous chikungunya virus infections was declared in Italy for the first time in Europe. For international travelers, people traveling to areas of active CHIKV transmission should apply basic precautions, including the prevention of mosquito bites by the use of insect repellents, wearing long sleeves and trousers, and ensuring rooms are fitted with nets to prevent mosquitoes from entering their rooms and houses. Prevention of infection by avoiding mosquito bites is the best protection. According to the World Health Organization, patients suspected of having CHIKV infection should avoid getting mosquito bites during the first week of illness to prevent further transmission to mosquitoes, who may, in turn, infect other people. This measure is crucial for preventing the spread of chikungunya to areas with little or no transmission.

TB is a re-emerging disease. According to the WHO, about a quarter of the global population is estimated to be infected with Mycobacteria tuberculosis. About 5-10% of those infected develop symptomatic TB which they can spread to others. In 2022, TB was the second leading infectious cause of death after COVID-19. TB is preventable and curable. TB can be prevented by use of the vaccine BCG. BCG is usually given at birth as part of routine immunization for children in most low resource settings. Antibiotics are available for the treatment of TB, however the development of Multidrug Resistant TB may necessitate use of second line antibiotics in the treatment of TB. Prevention, early diagnosis and treatment of at-risk groups like those co-infected with HIV is necessary for effective control and management of TB.

Chikungunya is a mosquito-transmitted alphavirus. Since its emergence in Africa in 1953, the global distribution has rapidly expanded, and the disease has spread to most continents. In the past 20 years, chikungunya has reemerged in the Indian Ocean region and emerged in new areas, including Europe, the Middle East, and the Pacific. The spread to new areas is possible due to the travel of infected persons and mosquitoes in these new areas that can spread the disease. The spread is more in tropical and sub-tropical countries. Dengue and Zika have similar symptoms to chikungunya, making chikungunya easy to misdiagnose in countries where these infections occur. Due to the challenges in reporting and diagnosis, the number of people affected by chikungunya is reported to be underestimated.

Chikungunya virus (CHIKV) has been identified as a priority pathogen and as an emerging infectious disease requiring special action by the World Health Organization (WHO). Its reemergence is rapid and geographically extensive, it has caused large outbreaks with high attack rates in Africa, Asia, Europe, Americas, and islands in the Indian and Pacific Oceans. 
Although Chikungunya fever is a self-limiting disease and the associated fatality rate is low, chikungunya-related death has been reported in certain populations, specially in people with pre-existing conditions.

Since there is no specific treatment, there is a medical need for prophylaxis against CHIKV infection. Some promising preclinical and clinical vaccine candidates have been developed during recent years, involving a wide range of technology platforms including: inactivated Viruses and Subunit Vaccines, Live-Attenuated Viruses, Virus-Like Particles, Viral Vector Vaccines and Nucleic Acid-Based Vaccines. Advancing developments in current candidates in the pipeline as well as further R&D work required is crucial as it is understanding the epidemiological gaps and modeling needs to perform further efficacy trials; in this webinar some of these aspects will be presented and questions welcomed from the audience.