Thursday, May 05, 2016

Brazilian MOH: Weekly Microcephaly Report - May 4th


The Brazilian MOH Microcephaly report is out, albeit about 24 hours later than usual, and this week we see the number of new cases placed under investigation has increased by 115 after hitting a low of only 78 in the last report.
Both numbers are a fraction of the numbers we were seeing added only a couple of months ago. While the cause of this drop is unknown, a few possible factors include:
  • In March Brazil 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 during that time period as well

Meanwhile, upon further investigation, another 172 have been discarded as not meeting the criteria for microcephaly, while 73 were confirmed. The total remaining under investigation sits at 3,580.
While microcephaly is the most visibly apparent 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.  

Meaning it may be months or even years before we know whether any of these `discarded' cases will go on to display other congenital defects

Registration Date: 05/04/2016 16:05:18 the amended 05/04/2016 16:05:18 the
The new epidemiological bulletin of the Ministry of Health disclosed on Wednesday (4), points out that, until 30 April, were confirmed 1,271 cases of microcefaliae other nervous system disorders, suggestive of congenital infection in all país. No total of 7,343 suspected cases have been reported since the start of the investigation in October 2015, and 2,492 were discarded. Other 3,580 are under investigation. The report meets weekly information submitted by state health departments.
Of the confirmed cases, 203 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. In Brazil, the 1,271 confirmed cases occurred in 470 municipalities located in 25 states of the federation.
Microcephaly was confirmed in the states of Alagoas, Bahia, Ceará, Maranhão, Paraíba, Pernambuco, Piauí, Rio Grande do Norte, Sergipe, Espírito Santo, Minas Gerais, Rio de Janeiro, Amapá, Amazonas, Pará, Rondônia, Roraima, Tocantins, Distrito Federal, Goiás, Mato Grosso, Mato Grosso do Sul, Parana, Rio Grande do Sul, and Sao Paulo which recorded eight cases of the disease to the Health Ministry, one with laboratory confirmation for Zika.
In the same period, there were 267 microcephaly suspicious deaths and / or alteration of the central nervous system after birth or during pregnancy (miscarriage or stillbirth) in the country. Of these, 57 were confirmed to microcephaly and / or alteration of the central nervous system. Other 178 are still under investigation and 32 were discarded.
Already 2,492 cases were discarded because of normal examinations or submit microcefalias and / or changes in the central nervous system by an infectious causes. It should be noted that the Ministry of Health is investigating all cases of microcephaly and other disorders of the central nervous system, informed 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 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 shirts and use repellents allowed to pregnant women.