Wednesday, April 27, 2016

Brazilian MOH: Weekly Microcephaly Report - April 26th


Brazil has posted their weekly Microcephaly investigation update, and once again we see the number of new cases added over the past week has declined, dropping down into the double digits for the first time since the alarm was raised last fall.

While the cause of this drop is unknown, a few possible factors include:
  • Brazil recently adopted a more stringent definition for microcephaly 
  • Much of Brazil was still in their winter dry season (Aug-Dec) - with presumably fewer mosquitoes - when this week's birth cohort were in their 1st & early 2nd trimester
  • Brazil's mosquito control efforts and mosquito protection awareness efforts were starting to ramp up at that time as well

Overall, only 78 new suspected cases were added last week, a quarter of what we were seeing only a couple of months ago. Meanwhile another 91 have been discarded as not meeting the criteria for microcephaly, while 30 were confirmed.

The total remaining under investigation sits at 3,710. 

While microcephaly is the most visibly striking congenital defect, we've been warned by CDC, NIH, and WHO that maternal Zika infection may produce other, less obvious neurological deficits in developing fetuses. 

It may be some time before we know whether any of these `discarded' cases will go on to display other congenital defects
Registration Date: 26/04/2016 17:04:33 the amended 26/04/2016 17:04:31 the

Of the 7,228 cases reported so far to the Ministry of Health, 3,710 are still under investigation and 2,320 were discarded

Until April 23, it was confirmed 1,198 cases of microcephaly and other nervous system disorders, suggestive of congenital infection, throughout the country. In all, 7,228 suspected cases have been reported since the start of the investigation in October 2015, and 2,320 were discarded. Other 3,710 are under investigation. 

The information is the new epidemiological bulletin of the Ministry of Health, released on Tuesday (26), containing the information passed on by state health departments.
Of the total confirmed cases, 194 had laboratory confirmation to the 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.

The 1,198 confirmed cases occurred in 435 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. Already 2,320 cases were discarded because of normal examinations or submit microcefalias and / or changes in the central nervous system causes no infectious.

In the same period, there were 251 suspected deaths of microcephaly and / or alteration of the central nervous system after birth or during pregnancy (miscarriage or stillbirth). Of these, 54 were confirmed to microcephaly and / or alteration of the central nervous system. Other 167 are still under investigation and 30 were discarded.

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, many infectious agents, in addition to 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 the mosquito Aedes aegypti , with the elimination of breeding sites , and protect themselves from mosquito exposure, keeping doors and closed or screened windows, wear pants and long-sleeved shirt and use repellents allowed for pregnant women.

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