Thursday, June 30, 2016

Brazil's MOH To Re-Evaluate Criteria For Zika Congenital Syndrome


In light of the study, published yesterday in the The Lancet (see The Lancet: Two Congenital Zika Virus Studies), finding that Zika Congenital Syndrome may exist without overt microcephaly, the Brazilian MOH has announced plans to re-evaluate their surveillance criteria.

As a side note, we usually get Brazil's weekly Microcephaly  report on Tuesday or Wednesday, but this week's has yet to be posted.

Registration Date: 29/06/2016 19:06:45 the amended 06/29/2016 19:06:45 the 

Largest study ever conducted on the Zika indicates that signs and symptoms of neurological disorders are included as criteria for trigam babies, regardless of the presence of microcephaly

The microcephaly and rash history during pregnancy are insufficient criteria to identify the consequences of infection Zika virus in newborns. The finding is part of a study commissioned by the Ministry of Health, published on Wednesday (29) by the British journal, The Lancet. The study results suggest that the signs and symptoms of neurological disorders are included as criteria for screening of babies, regardless of the presence or absence of microcephaly.

The study was done in partnership with the Federal University of Pelotas (UFPel), the Brazilian Society of Medical Genetics, the Latin American Center for Perinatology of the Pan American Health Organization (PAHO / WHO) and Harvard University, US. 1,501 live births were analyzed, which had already been investigated by state and local health departments, which is the largest study ever done on the subject in the world. Before, the largest study had analyzed 104 children.

Research shows that for every five children with congenital infection Zika virus - confirmed or probable - a non had microcephaly, indicating that 80% of children were taken through investigation using the criteria of microcephaly and rash. "We are adapting our protocols to those found to expand research and improve our surveillance system. At this time, Brazil and the world have accumulated more knowledge about the disease and can, with this learning, improve the monitoring of the consequences of congenital infection Zika virus, "said the general coordinator of Surveillance and Response to Emergencies in Public Health, the Ministry of Health, Wanderson Oliveira.

At the beginning of the epidemic investigation in November 2015, the Ministry of Health adopted a more sensitive case definition to identify the microcephaly, with the criterion of 33 cm head circumference for newborns of both sexes. This definition was subsequently changed to 32 cm. The adoption of these more sensitive definitions identified that 20% of children with a condition of clinical importance not had microcephaly. So this is an important aspect being considered to adjust the microcephaly surveillance model for Congenital changes.
"Using this cutoff point more sensitive at the beginning of the investigation allowed us to identify those children who had not microcephaly, but who had other disorders of the central nervous system, possibly related to infection by Zika virus," he stressed.

The article was based on information from the Event Log in Public Health (RESP) and Live Birth Information System (SINASC) of the Ministry of Health, with the support of all states. Based on this finding, the Ministry of Health is now studying the adequacy of current surveillance protocol and Response to Occurrence of microcephaly and / or central nervous system changes. It is noteworthy that the investigation of other causes is already held by the Ministry of Health in conjunction with states and municipalities, through hearing tests and vision.

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