Coordinating Research on Emerging Arboviral Threats Encompassing the Neotropics (CREATE-NEO)

ABSTRACT The Coordinating Research on Emerging Arboviral Threats Encompassing the Neotropics (CREATE-NEO) network provides a nimble and flexible network of surveillance sites in Central and South America coupled to cutting-edge modeling approaches to anticipate and counter emerging zoonoses and arboviruses. CREATE- NEO forewarns local, regional, and global public health agencies of zoonoses and arboviruses that pose particularly high risk of spillover, emergence into transmission among humans, and/or international spread. The parent grant 1U01 AI151807 supports CREATE-NEO operations during typical conditions of emerging zoonoses and arbovirus activity. Since, 2020 we have built local capacity to detect, predict and respond to such emergence events at their point of origin, thereby maximizing the potential to avert full-blown emergence. Critical activities included: (i) genomic surveillance with deep sequencing and comprehensive phylogenetic analyses of dengue virus in Sao Jose do Rio Preto (SJdRP), Brazil; (ii) vector and non-human primate surveillance in Brazil and Panama; and (iii) characterization of human cases of Zika, dengue and Ilheus virus infections associated with cerebrovascular and encephalitic events. With the onset of the COVID-19 pandemic, we expanded our activities to include: (iv) characterization of human cases of SARS-CoV-2 and dengue virus coinfection; (v) surveillance of NHPs for potential spillback of SARS-CoV-2; (vi) supporting genomic surveillance of SARS-CoV-2 variants in SJdRP and Panama; and (vii) supporting clinical surveillance of arbovirus circulation in Panama and Brazil. Thus, the emergence and rapid spread of SARs-CoV-2 offers an example of our capacity to quickly redirect resources to address any emerging zoonotic or vector-borne diseases. This U01 supplement will continue and expand these emergency activities in support of NIH-funded and other international research on SARS-CoV-2 through the following supplemental activities related to the parent grant's original aims. We will expand our genomic surveillance capabilities of SARS-CoV-2 variants in SJdRP and Panama. We will characterize both between-host and within-host diversity through deep sequencing using Illumina technologies and perform comprehensive phylogenetic studies using complete genomic sequences of SARS-COV-2 to infer patterns of virus spread and to inform hypotheses regarding variation in transmissibility and clinical outcomes (Aim 2e).