PROJECT SUMMARY The recent outbreaks of arboviral infections such as Zika and Chikungunya in Latin American and Caribbean countries have uncovered the role of emergent viral infections in the increased incidence of neuroinflammatory disorders such as encephalitis, myelitis and Guillain-Barré syndrome (GBS). Here, we propose a multi-center model of university-hospital sites in Colombia to facilitate clinical, epidemiological, and virological surveillance and research of neurological disorders associated with emerging infections. The model already established as the Neurovirus Emerging in the Americas Study (NEAS), will serve as an observatory of neurological disorders associated with emerging viral infections and will facilitate the long-term goals of building and strengthening sustainable research capacity in Colombia to address the emerging threat of viral illnesses and their neurological complications. Based on our preliminary studies that helped to characterize clinical, immunological and virological features of Zika-associated GBS in Colombia (Parra et al., NEJM 2016), we hypothesize that acute neurological problems in the adult population of areas affected by emergent viral infections result from complex host-viral interactions driven by previously established circulating arboviruses (e.g., dengue, enteroviruses) as well as emergent pathogens (e.g., Zika and Chikungunya); and that variations in viral genotype as well as host immunological responses to previous viral infections drive pathogenicity and severity of neurological disease. To address this hypothesis, the specific aims of this proposal are: 1) To utilize the NEAS model to establish a sustainable approach for assessment of acute neuroinflammatory disorders such as GBS and encephalitis-myelitis and determine the role of emergent infections in the development of such complications, 2) To implement state of the art technologies to improve the diagnosis of emerging pathogens in the onset of acute neuroinflammatory disorders; and 3) To establish a training program to enhance the competence of Colombian researchers in the use of next generation molecular and immunological techniques, and computational biological approaches in metagenomics and pathogen discovery studies. We will take advantage of the past and present experience with patient recruitment and biosample collection in the NEAS cohort study population, the use of state-of-the-art immunological assays, next generation sequencing, and massive multiplexed viral peptides assay (VirScan) to achieve such aims. We believe the findings of this project will have a major public health impact and will address important questions related to viral diversity and impact on disease severity, information needed for understanding disease pathogenesis, management and vaccine development. This project will also contribute to building up capacity in Colombia by investing in clinical and translational research to better characterize neurological complications of emerging viral diseases.

NARRATIVE This project will consolidate an observatory for studying the role of emerging infections in the onset of acute neuroinflammatory disorders in Colombia. We will determine interaction of infection and neurological disease and build up resources in Colombian for neuroepidemiological and virological surveillance. RELEVANCE This project is relevant for increasing the capability of local researchers for studies of emerging viral diseases and neurological disorders.