Friday, July 08, 2016

Brazil Weekly Microcephaly Report - July 7th


Running a bit later this week than usual, the Brazilian MOH has released their latest weekly Microcephaly report card and it shows the number of suspected cases under investigation has increased by 136 over the past 7 days, while the total number of confirmed microcephaly cases has risen by 18.  

Upon further investigation, another 49 have been discarded as not meeting the criteria for microcephaly, increasing the number still under investigation to 3130.

Once again we see the number of completed investigations (n=68 either confirmed or discarded) has dipped over the past week, possibly due to looking for congenital defects beyond just Microcephaly. 

In the past we've seen weeks where in excess of 200 cases have been categorized. 

Recent reports suggest fetal exposure to Zika results in more than just microcephaly (see The Lancet: Two Congenital Zika Virus Studies), and last week the Brazilian MOH announced plans to Re-Evaluate Criteria For Zika Congenital Syndrome.

Which means that some percentage of the 3500+ previously reviewed and `discarded' cases may still be affected by serious, but less obvious, neurological problems.

This week's (translated) report from the Brazilian MOH follows:

Ministry of Health confirmed 1,656 cases of microcephaly

The weekly report gathers information submitted by state health departments until July 2. Other 3,130 cases remain under investigation

The Ministry of Health released, on Thursday (07), microcephaly new data. Until July 2, it was confirmed 1,656 cases of microcephaly and other nervous system disorders, suggestive of congenital infection throughout the country.
Other 3,130 suspected cases of microcephaly across the country remain under investigation by the Ministry of Health and the states. Since the beginning of the investigation, in October last year, 8,301 cases were reported to the Ministry of Health. Of these, 3,515 were discarded because of exams normal, or because they have microcephaly or malformations confirmed because noninfectious. Were also discarded by do not meet the case definition. 
Of the total confirmed cases, 255 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 1,656 confirmed cases in Brazil occurred in 588 municipalities located in all Brazilian states and the Federal District. The mortality rate in the same period, there were 334 suspected deaths of microcephaly and / or alteration of the central nervous system after childbirth or during pregnancy (miscarriage or stillbirth) in the country. This represents 4% of the total reported cases. Of these, 92 were confirmed to microcephaly and / or alteration of the central nervous system. Other 184 are still under investigation and 58 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, as well as 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, the elimination of breeding, and protect themselves from mosquito exposure, keeping doors and windows closed or screened, wear pants and long sleeved shirts and use repellents allowed to pregnant women.

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