Wednesday, June 15, 2016

Brazil Weekly Microcephaly Report - June 15th


Brazil has released their weekly Microcephaly report card and it shows the number of suspected cases under investigation has increased by 106 over the past 7 days, while the total number of confirmed microcephaly cases has risen by 30.  

Upon further investigation, another 46 have been discarded as not meeting the criteria for microcephaly, leaving the number still under investigation at 3047.

While this is the lowest weekly increase in confirmed microcephaly cases we've seen since this crisis began, it is also the lowest number of  investigated-and-discarded cases as well.

Last week, while adding roughly the same number of new cases (n=107), they made determinations on 252 cases.  This week, only 76.  

As for what might be behind this sudden slowdown in the processing of cases, I've seen nothing mentioned by the MOH.

While microcephaly is the most visibly apparent congenital defect linked to Zika, we've been warned by CDC, NIH, and WHO for months that maternal Zika infection is apt to lead to a variety of less obvious neurological deficits in developing fetuses.

An outcome which is discussed in a recent Lancet report entitled `Zika: neurological and ocular findings in infant without microcephaly'.

All of which means it may be months or even years before we know the full extent of fetal injury due to Zika, or how many of these `discarded' cases are destined to experience other Zika related sequelae.

This (translated) report from the Brazilian MOH.

Registration Date: 06/15/2016 12:06:01 the amended 15/06/2016 12:06:42 the
Since the beginning of the investigation, in October 2015, 7,936 suspected cases were reported to the Ministry of Health. Of these, 3,308 have been discarded and 3,047 remain in research

The Ministry of Health confirmed 1,581 cases of microcephaly and other nervous system disorders, suggestive of congenital infection throughout the country. The data is in epidemiological bulletin released on Wednesday (15). The report gathers information sent weekly by state health departments related to week 23 of this year, which runs through June 11.

The new report recorded 3,308 cases discarded because of normal tests, or because they have microcephaly and malformations or confirmed because no infectious or do not meet the case definition. Other 3,047 remain under investigation. Overall, since the beginning of the investigation, in October 2015, it was reported 7,936 suspected cases of microcephaly in Brazil.

Of the total confirmed cases, 226 were confirmed by specific laboratory criteria for Zika virus. The Ministry of Health, however, points out that this figure does not represent adequately the total number of cases related to the virus. The folder considers that there was infection Zika most of the mothers who had babies with a final diagnosis of microcephaly. 

The 1,581 confirmed cases in Brazil occurred in 562 municipalities located in 25 Brazilian states and the Federal District. There is no confirmation register only in the state of Acre.

In relation to deaths in the same period, there were 317 suspected deaths of microcephaly and / or alteration of the central nervous system after birth or during pregnancy (miscarriage or stillbirth) in the country. Of these, 73 were confirmed to microcephaly and / or alteration of the central nervous system. Other 198 are still under investigation and 46 were discarded.

The Ministry of Health says it 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 may be caused by, various infectious agents beyond Zika as Syphilis, Toxoplasmosis, Other Infectious Agents, Rubella, Cytomegalovirus and Herpes Viral.

The folder guides pregnant women adopt measures to reduce the presence of 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 shirts and use allowed repellents for pregnant women.

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