Wednesday, April 20, 2016

Brazilian MOH: Weekly Microcephaly Report - April 19th


Although the shifting of cases from `under investigation' to either `discarded' or `confirmed' status makes the numbers jump around each week, in the last reporting week 135 suspect cases were added to the investigation, bringing the total to 7,150.

Meanwhile, in the past week 175 cases were discarded for not meeting the criteria for microcephaly, while 55 were confirmed.

We've been repeatedly warned by CDC, NIH, and WHO researchers that maternal Zika infection may produce other, less apparent neurological deficits in developing fetuses, so it is unknown whether any of these `discarded' cases will go on to display other congenital defects.

More than half of the suspect cases have yet to be fully investigated, but to date about 1/3rd of investigated cases have met the criteria for microcephaly.

Of the 7,150 cases reported so far to the Ministry of Health, 3,741 are still under investigation and 2,241 were discarded

The new epidemiological bulletin of the Ministry of Health disclosed on Wednesday (20), points out that, until the 16th of April, 1,168 cases have been confirmed and 2,241 were discarded for microcephaly and other nervous system disorders, suggestive of congenital infection. In all, 7,150 suspected cases have been reported since the beginning of the investigation, in October 2015, and 3,741 remain under investigation. The data of the report are sent weekly by state health departments.
The 1,168 confirmed cases occurred in 428 municipalities located in 22 Brazilian states: Alagoas, Bahia, Ceará, Maranhão, Paraíba, Pernambuco, Piauí, Rio Grande do Norte, Sergipe, Espírito Santo, Minas Gerais, Rio de Janeiro, Amapá, Amazonas , Pará, Rondônia, Distrito Federal, Goiás, Mato Grosso, Mato Grosso do Sul, Parana and Rio Grande do Sul. the 2,241 cases disposed were classified because they have normal exams, or submit microcefalias and / or changes in the central nervous system causes no infectious.
Of the total confirmed cases of microcephaly, 192 tested positive for Zika by specific laboratory testing for the 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.
Until April 16, there were 240 suspected deaths of microcephaly and / or alteration of the central nervous system after birth or during pregnancy (miscarriage or stillbirth). Of these, 51 were confirmed to microcephaly and / or alteration of the central nervous system. Other 165 remain under investigation and 30 were discarded.
The Northeast region has 77.2% of reported cases, with 5,520 records so far. The state of Pernambuco is still the unity of the federation with more research (760), followed by Bahia (647), Paraíba (389), Rio Grande do Norte (297), Rio de Janeiro (294) and Ceará (254 ).
It should be noted that the Ministry of Health is investigating all cases of microcephaly and other disorders of the central nervous system, 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 the elimination of breeding sites, and protection against exposure to mosquitoes by keeping doors and windows closed or screened, use pants and long-sleeved shirt, addition repellents allowed to pregnant women.
COOPERATION - Last week, the Center for Disease Control and Prevention of Diseases (CDC) of the United States announced the confirmation of the relationship between Zika and the occurrence of microcephaly in infants whose mothers were infected by the virus. The study conducted a thorough review of existing evidence and concluded that Zika is the cause of microcephaly and other brain damage in fetuses identified.
To support the North American study were analyzed surveys of medical and scientific community from many countries, including Brazil, which pioneered the Zika virus study associated with microcephaly. The CDC is partner of Brazil in the investigation as part of the global effort to discoveries related to the topic.
The relationship between Zika and microcephaly had already been recognized and announced by the Brazilian government in November 2015, when the virus was identified in blood and tissues of a baby with microcephaly and also in the amniotic fluid of pregnant women two. Since then, several other evidence were found, such as reddening of the skin during the first trimester of pregnancy - which is one of the symptoms of Zika - largely women who had babies with microcephaly in the states of Bahia, Pernambuco and Paraiba.

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