The Centre for Emerging Zoonotic and Parasitic Diseases (CEZPD) was established by the amalgamation of six former NICD sections: Special Bacterial Pathogens Reference Laboratory, Special Viral Pathogens Reference Laboratory, Arbovirus Reference Laboratory, Electron Microscopy, Parasitology Reference Laboratory and Vector Control Reference Laboratory. The CEZPD operates the only suit biosafety level 4 (BSL4) facility on the African continent, which places it both strategically and critically in a position to assist in the response of highly dangerous emerging and re-emerging zoonotic pathogens.
The CEZPD has a strong track record in providing a comprehensive capacity for the differential diagnosis and research of viral haemorrhagic fevers, arthropod-borne diseases, human rabies, anthrax, plague, leptospirosis and other infectious diseases of public health importance. Furthermore, CEZPD offers specialised parasitological diagnostic tests and is involved in the surveillance of drug-resistant malaria and vector control strategies in South Africa. The CEZPD, in addition, provides training to BSc Hons, MSc and PhD students, and national and international research fellows in laboratory techniques, including training in working in BSL3 and BSL4 biocontainment facilities.
The objectives of CEZPD are:
- To be a national and international centre of excellence for emerging and re-emerging zoonotic diseases, especially those categorised as biosafety level 3 and 4 pathogens;
- To function as a resource for knowledge and expertise to the South African government, SADC countries and the African continent;
- To assist in the planning of relevant policies and programmes and to harness innovation in science and technology;
- To support control, surveillance, detection and outbreak response systems; and
- To support South Africa’s commitment to the International Health Regulations, One Health and Global Health Security Agenda.
The Special Viral Pathogens Laboratory (SVPL) conducts referral laboratory diagnosis of viral haemorrhagic fevers (VHF) and human rabies. It offers extensive an array of diagnostic tests for the investigation of Crimean-Congo haemorrhagic fever, a VHF that is endemic to South Africa. In addition, the SVPL has the capacity to interrogate suspected cases of VHF such as Ebola virus disease, Marburg virus disease, Lassa fever, related arenaviruses and yellow fever, therein supporting South Africa’s capacity for the detection of cases importing high consequence pathogens. In order to provide diagnostic services and to enable research involving VHF and other risk group 4 pathogens, the SVPL operates biosafety level 3 and 4 facilities, as well as providing a mobile laboratory capacity at sites of formidable outbreaks.
Dog-transmitted rabies is endemic in South Africa, and the SVPL provides diagnostic support for the diagnosis of human cases in the country and elsewhere by conducting tests for ante-mortem and post-mortem investigation of suspected human rabies cases.
Apart from laboratory expertise, the SVPL supports the mission of CEZPD and the NICD to provide surveillance, relevant research and training to support better health outcomes. The SVPL collaborates with various stakeholders to promote One Health, capacity for response to zoonotic disease events, and related policy development.
In recent years an increasing number of emerging and re-emerging arthropod borne (arbo) viruses have become pathogens of public health importance, largely due to the unprecedented expansion of the geographical distribution of the arthropod vectors and changes in their virulence. There are more than 500 recognised arboviruses, of which more than 130 are known human pathogens. The Arbovirus Reference Laboratory (ARL) performs reference diagnostic services for endemic and exotic mosquito-borne viral diseases, including Rift Valley fever, West Nile fever, chikungunya, dengue and Zika. Furthermore, the laboratory is involved in surveillance and other projects studying the ecology and prevalence of arboviruses in specific areas that previously served as epicentres for large outbreaks, or where exotic viruses are likely to be introduced from neighboring countries. Discovery, detection and characterisation of unknown and known arboviruses, which will result in better preparedness for possible future emergence or re-emergence, is an important part of the laboratory’s function. The laboratory also operates a recently-renovated insectary facility to study the competence of South African mosquito species to transmit endemic and exotic arboviruses.
The Special Bacterial Pathogens Reference Laboratory (SBPRL) houses a biosafety level 3 facility that deals with a variety of high-consequence bacterial pathogens and other zoonoses. The laboratory conducts specialised human diagnostics for anthrax, plague, botulism and leptospirosis, and also serves as a reference laboratory for other high-consequence pathogens such as Brucella, Francisella tularensis, and Burkholderia, and is the World Health Organization Regional Reference Laboratory for Plague in the SADC region. The SBPRL is also involved with a number of surveillance activities. The laboratory conducts plague surveillance in susceptible rodent populations in the City of Johannesburg and Nelson Mandela Metropolitan (Port of Coega, Eastern Cape Province) in order to alert public health authorities to any increased human plague risk. The laboratory is also involved with sero-surveillance studies for bacterial zoonoses (brucellosis, leptospirosis, Q fever and bartonellosis) in patients with undifferentiated fever, and brucellosis in high-risk populations (abattoir workers, (para) veterinary professionals, and farming communities).
The Parasitology Reference Laboratory (PRL) provides a specialised parasitology reference service for routine diagnostic medical laboratories. The laboratory offers specialised parasitological diagnostic and confirmatory tests. Certain important parasitic pathogens are targets of its surveillance, research and teaching activities. With the current drive towards malaria elimination in South Africa and its neighbours, the PRL focuses on malaria, specifically surveillance of drug-resistant malaria. Improving malaria case management by raising the standard of malaria diagnosis, both in routine laboratories (microscopy) and at point-of-care (rapid diagnostic tests) is another way the PRL supports the national strategy for elimination, through training, outreach and quality assessment of diagnostic laboratories. The estimation of the burden of diarrhoea-associated parasites in children less than five years of age is the aim of another surveillance project carried out at sentinel sites in South Africa. Research and development of new identification techniques for human parasites include current or recent projects on opportunistic diseases such as Pneumocystis pneumonia, cryptosporidiosis, microsporidiosis, toxoplasmosis, and free-living amoeba infections. Other areas of interest are soil-transmitted helminths and schistosomiasis (bilharzia)
Malaria is the major vector-borne disease in Africa, killing close to one million people annually, most of them children under five years old. In South Africa, malaria transmission is confined to the low-lying north-eastern border regions of the country. The Vector Control Reference Laboratory (VCRL) focuses on those Anopheles mosquito species responsible for malaria transmission and houses a unique collection of live mosquito colonies of the four most important vector species in Africa namely; Anopheles gambiae, An. coluzzii, An. arabiensis and An. funestus, as well as the minor vector An. merus and the non-vector An. quadriannulatus. Insecticide susceptible and resistant strains of these species provide the VCRL with a unique resource for research into insecticide resistance. These resources and substantial in-house expertise place the VCRL in a unique position to provide operational support to the National and Provincial malaria control programmes, to offer collaborations with international institutions investigating similar problems and to play a role in influencing policy decisions on vector control strategies in the southern African region. In addition, the VCRL houses the largest museum collection of African arthropods of medical importance in Africa, the third-largest such collection in the world. The University of the Witwatersrand has recognised the high level of expertise in the VCRL and it now forms part of the Wits Research Institute for Malaria.
Although positioned within the CEZPD, the Electron Microscopy (EM) laboratory functions as a core facility for the NICD, also providing transmission electron microscopy services further afield. Diagnostically, EM provides rapid viral screening of clinical specimens and cultured isolates, and is crucial for microsporidial identification. As an applied technique for researchers, EM is used for the phenotypic characterisation of viral constructs and diverse pathogens (viral, bacterial, parasitic and fungal), ultrastructural details of pathogenesis, microbiocide descriptions/applications, and morphological investigations into the vectors of communicable diseases.
The world is changing. Climate change and increased pollution is not only a direct problem for public health but a major problem for vector-borne diseases. Mosquitoes, like most insects, are sensitive to temperature. Crucially, the immature stages live in water and are sensitive to the increasing levels of water pollution. These animals, however, are still successful largely due to their capacity to adapt. One of these major adaptations is insecticide resistance. This phenotype is underpinned by a complex genotype and physiology which has a number of pleiotropic consequences.
The Vector Control Reference Laboratory in the Centre for Emerging Zoonotic and Parasitic Diseases has an active research programme investigating all aspects of insecticide resistance. This includes investigating novel chemical interventions, the interplay between insecticide resistance and pollution as well as understanding the interplay between insecticide resistance and vector competence. This student-driven research aims to leverage basic biological knowledge for improving vector control.
LEADERSHIP AND TEAM
Prof Janusz T Paweska is the Head of the Centre for Emerging Zoonotic and Parasitic Diseases and the Head of Special Viral Pathogens Division.
He is an internationally recognised specialist in the field of emerging and re-emerging zoonotic pathogens. He manages the only suit biosafety level 4 facility in Africa. He is also the Head of the World Health Organization Collaborating Center for Reference and Research on Viral Haemorrhagic Fevers and Arboviruses, the regional director of the Global Virus Network and the Deputy Director of the Southern Center for Infectious Diseases Surveillance. He holds joint appointments as a Reader/Associate Professor in the Faculty of Health Sciences at the Witwatersrand University and as an Extraordinary Professor in the Faculty of Health Sciences at the University of Pretoria. Prof Paweska has been a part of international outbreak responses caused by highly dangerous pathogens. During a fatal nosocomial outbreak in Johannesburg, 2008, he led the discovery of a new Old World arenavirus, and named it Lujo virus. In 2014 to 2016 he led the operation of the NICD’s Ebola diagnostic mobile laboratory in Sierra Leone, established as a part of international Ebola outbreak response in West Africa.