Wednesday, March 30, 2016

Brazilian MOH: Weekly Microcephaly Report - March 29th


The number of new suspected microcephaly cases added (n=105) by the Brazilian MOH has dropped over the last reporting week to the lowest number since alarm bells began ringing last fall.

While this would be a welcome trend, it should be noted that Brazilian state health departments were closed on March 26th due to Easter, and the weekly chart (above) is curiously dated `Distribution of reported cases of microcephaly by UF until March 19, 2016'.

Brazil also adopted a stricter definition for microcephaly three weeks ago, and this could be a factor as well.  In any event, we'll need to see a couple of more weeks of reporting before we call this drop a trend.

The total under investigation actually dropped over last week, since more cases were confirmed and/or discarded (n=107) than were added (n=105).

A translation of this week's MOH report follows:

Registration Date: 29/03/2016 17:03:19 the amended 03/29/2016 17:03:19 the
Pernambuco follows as the state with the largest number of microcephaly notifications. Cases already completed, 944 were confirmed and 1,541 discarded.

The Ministry of Health is investigating 4,291 suspected cases of microcephaly and other nervous system disorders, suggestive of congenital infection. Cases already completed, 944 were confirmed and 1,541 discarded. Since the beginning of the investigation, in October 2015, it was reported 6,776 suspected cases of microcephaly.  

Data from epidemiological report from the Ministry of Health are sent weekly by the state departments of Health and were closed on Saturday, March 26. Of the total confirmed cases of microcephaly, 130 tested positive for Zika. In these cases, specific laboratory test was used to Zika virus. However, the Ministry of Health points out that this figure does not represent adequately the total number of cases related to the virus. That is, the folder considers that there was infection Zika most of the mothers who had babies with a final diagnosis of microcephaly.  

This week, the states of Acre, Amapá, Santa Catarina and Rio Grande do Sul reported to the Ministry of Health the indigenous movement the Zika virus. Thus, all 27 Brazilian states are with Zika circulation. The 944 confirmed cases occurred in 358 municipalities located in 21 Brazilian states: Alagoas, Bahia, Ceará, Maranhão, Paraíba, Pernambuco, Piauí, Rio Grande do Norte, Sergipe, Espírito Santo, Minas Gerais, Rio de Janeiro, Amazonas, Pará , Rondônia, Distrito Federal, Goiás, Mato Grosso, Mato Grosso do Sul, Rio Grande do Sul and Parana. 
The 1,541 cases disposed were classified because they have normal exams, or submit microcefalias and / or changes in the central nervous system by an infectious causes.  

Until March 26, there were 208 deaths (fetal or neonatal) microcephaly suspects and / or amendment the central nervous system after birth or during pregnancy (miscarriage or stillbirth). Of these, 47 were confirmed to microcephaly and / or alteration of the central nervous system. Other 139 are still under investigation and 22 were discarded.  

The 6,776 cases reported are distributed in 1,285 municipalities, from all regions of the country. Most were registered in the Northeast (5,315 cases, which corresponds to 78%), the State of Pernambuco the Federation Unit with the largest number of cases are still being investigated (1207). Next are Bahia (676), Paraíba (412), Rio de Janeiro (322), Rio Grande do Norte (289) and Ceará (240). It should be noted that the Ministry of Health is investigating all cases of microcephaly and other central nervous system disorders, informed by the states, and the possible relationship with the Zika virus and other congenital infections.  

Microcephaly can be caused by various infectious agents beyond Zika as Syphilis, Toxoplasmosis, Other Infectious Agents, Rubella, Cytomegalovirus and Herpes Viral. The Ministry of Health advises pregnant women to adopt measures to reduce the presence of Aedes aegypti, with elimination of breeding sites , and protect themselves from mosquito exposure, keeping doors and closed or screened windows, wear pants and long sleeved shirts and use repellents allowed to pregnant women. 

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