Wednesday, March 09, 2016

Brazil MOH: Epi Week 9 Microcephaly report

# 11,121

The Brazilian MOH's weekly report card on their microcephalic surveillance has been released, and it indicates that 249 new suspected cases have been added since last week's report.

Meanwhile another 238 cases have been investigated, and of those 104 (43%) were found to meet the criteria for Microcephaly, while 134 were discarded.  

This is a slightly higher positive rate than we've seen in recent weeks (avg 38%).  As of this report, there are 745 confirmed microcephaly cases, and 4,231 cases still under investigation.

We've two (translated) MOH reports. 

First, some excerpts from today's Microcephaly Report Card, and then the announcement from the Brazilian MOH that they are adopting the WHO standard for diagnosing Microcephaly going forward.
Registration Date: 09/03/2016 18:03:00 the amended 09/03/2016 18:03:00 the
It has been confirmed 745 suspected cases of microcephaly and other nervous system disorders, suggestive of congenital infection. Other 1,182 cases were discarded

The Ministry of Health is investigating 4,231 suspected cases of microcephaly and other nervous system disorders, suggestive of congenital infection. Cases already analyzed, 745 were confirmed and 1,182 discarded. Since the beginning of the investigation have been reported 6,158 suspected cases of microcephaly. Data from epidemiological report from the Ministry of Health are sent weekly by the state departments of Health and were closed on Saturday, March 05.

The 745 confirmed cases occurred in 282 municipalities located in 18 Brazilian states: Alagoas, Bahia, Ceará, Maranhão, Paraíba, Pernambuco, Piauí, Rio Grande do Norte, Sergipe, Espírito Santo, Minas Gerais, Rio de Janeiro, Pará, Rondônia , Goiás, Mato Grosso, Mato Grosso do Sul and Rio Grande do Sul. the 1,182 cases were classified discarded because they had normal exams, or submit microcefalias and / or changes in the central nervous system by an infectious causes.

The 6,158 cases reported since the beginning of the investigation, are distributed in 1,179 municipalities, from all regions of the country. Most were registered in the Northeast (4,827 cases, which corresponds to 80%), and the state of Pernambuco is the federation of the unit with the highest number of cases are still being investigated (1214). Next are Bahia (609), Paraíba (447), Rio de Janeiro (289), Rio Grande do Norte (278) and Ceará (252).

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.

Until March 5, there were 157 suspected deaths of microcephaly and / or alteration of the central nervous system after birth or during pregnancy (miscarriage or stillbirth). Of these, 37 were confirmed to microcephaly and / or alteration of the central nervous system. Another 102 are still under investigation and 18 were discarded.

Of the total confirmed cases of microcephaly, 88 tested positive for Zika. In these cases, specific laboratory test was used to 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.
To date, signaled to the Ministry of Health to indigenous circulation of Zika virus 22 Brazilian states: Goiás, Minas Gerais, Federal District, Mato Grosso do Sul, Roraima, Amazonas, Pará, Rondônia, Mato Grosso, Tocantins, Maranhão, Piauí, Ceara, Rio Grande do Norte, Paraiba, Pernambuco, Alagoas, Bahia, Espirito Santo, Rio de Janeiro, São Paulo and Paraná. 
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Parameter cephalium perimeter for boys and girls will be different. Premature babies also have a specific definition

The Ministry of Health will adopt from this Wednesday (09), new parameters for measuring head circumference and identify suspected cases of babies with microcephaly. For boy, the measure will be equal to or less than 31.9 cm and, for girls, equal to or less than 31.5 cm. The change is in line with the recommendation recently announced by the World Health Organization (WHO), and aims to standardize the references to all countries, valid for babies born at 37 or more weeks of gestation.

"Again, we show that Brazil is in line with the recommendations of the World Health Organization and the conclusions of the medical and scientific societies around the world. We are walking together and on track to discover and define increasingly specific form all directions around the microcephaly and Zika virus, "said Health Minister Marcelo Castro.

The new standard is being adopted by the Ministry of Health in accordance with state and municipal departments of Health and received a favorable assessment of the technical committee of medical scientific societies and experts in the fields of pediatrics, infectious diseases and medical genetics. Gauging the perimeter should be made preferably after the first 24 hours of birth, or until the first week of birth.

The measure is part of the adjustments being carried out before the new scientific findings, taking into account the continuous learning with discoveries about microcephaly and its relation to Zika virus.

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