Zika epidemic uncovers Brazil’s hidden birth-defect problem

Alex Cuadros – Washington Post, 03/01/2016

As researchers race to establish a link between the Zika virus and a birth defect known as microcephaly, one of their biggest obstacles is the lack of reliable health data in Brazil, where the epidemic broke out there last year.

Since October, Brazil’s Health Ministry has received reports of about 5,600 suspected cases of microcephaly, in which babies are born with unusually small heads. Many cases have been thrown out, and many more are still being investigated, but given that the country previously reported 150 such cases per year, the number would still seem to indicate a massive jump.

Many doctors, though, say that the jump is largely illusory — based on massive underreporting of microcephaly and other birth defects in Brazil. What’s more, this poor record-keeping reflects much larger public health problems here: poor prenatal care and woefully inadequate services for children with disabilities. Until the Zika epidemic, these issues were mostly swept under the rug.

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CDC arrives in Brazil to investigate Zika outbreak

Rob Stein – NPR, 02/22/2016

A team of U.S. government disease detectives Monday launched an eagerly anticipated research project in Brazil designed to determine whether the Zika virus is really causing a surge of serious birth defects.

A 16-member team of epidemiologists from the Centers for Disease Control and Prevention began training dozens of Brazilian counterparts in Joao Pessoa, Brazil, in preparation to begin work on Tuesday. The researchers will gather data on hundreds of Brazilian women and their children.

“Having the data at this point in time are very critically important for understanding the impact Zika might be having in the future and as it spreads in the region,” says J. Erin Staples, a CDC medical officer leading the CDC team in Brazil.

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WHO: $56 needed million to fight Zika outbreak in coming months

Brady Dennis – The Washington Post, 02/17/2016

The World Health Organization says it will take $56 million to kickstart a coordinated international response to the Zika virus outbreak racing through much of the Americas, and the WHO plans to tap a newly created emergency contingency fund to pay for the initial efforts.

In a lengthy action plan published Tuesday,  the organization said a hefty chunk of the money will go toward disease surveillance, which will include tracking new Zika cases and the suspected birth defects and rare autoimmune syndrome that scientists suspect are linked to the mosquito-borne virus. More funding will be used to help provide counseling to pregnant women, as well as to help communities with mosquito-control programs. Still more funds will go toward research to speed the development of new vaccines, treatments and diagnostic tests, as well as to study whether and how Zika is causing serious conditions such as microcephaly.

More than half the money will be spread among a collection of international partners, including non-governmental organizations and research institutions such as Unicef, AmeriCares, Save the Children, the International Medical Corps and the University of Texas Medical Branch. The remaining funds will be disbursed within the WHO and its regional offices in the Americas — known as the Pan American Health Organization — to help carry out the plan through June. Earlier this month, the organization declared the Zika outbreak and the accompanying spike in congenital brain abnormalities in newborns to be a public health emergency of international concern.

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Zika epidemic prompts pharma rush to develop vaccine

Clive Cookson – Financial Times, 02/13/2016

The global pharmaceutical and bioscience industry has responded swiftly to the Zika epidemic, with 15 companies involved in vaccine development and 20 in making diagnostic tests for the mosquito-borne virus, which is associated with birth defects.

In update briefings in Geneva and Washington on Friday, senior officials from the World Health Organisation and the US National Institutes of Health contrasted the industry’s response to Zika with its slow reaction to previous epidemics, particularly Ebola.

“We had been working on an Ebola vaccine for 10 years and had no interest from industry,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “We made a West Nile vaccine several years ago but couldn’t find a pharmaceutical partner.

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Study in Brazil links Zika virus to eye damage in babies

Catherine Saint Louis – The New York Times, 02/09/16

Infants infected with the Zika virus may be born not only with unusually small heads, but also with eye abnormalities that threaten vision, researchers reported on Tuesday in the journal JAMA Ophthalmology.

The study described damage to the retina or optic nerve in 10 of 29 newborns examined at Roberto Santos General Hospital in Salvador, Brazil. All the infants were presumed to have been infected with the Zika virus and had small heads, a condition called microcephaly. Other causes of the defect, like infection with rubella or toxoplasmosis, were ruled out.

Seven out of the 10 newborns had defects in both eyes, while three infants had damage in a single eye. The most common problems were black speckled lesions in the back of the eye, large areas of tissue damage in the retina itself, or damage in the layer of blood vessels and tissue below the retina.

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Zika Virus: Survey Shows Many Latin Americans Lack Faith in Handling of Crisis

Jessica Glenza – The Guardian, 02/09/2016

Many Latin Americans doubt that public health officials in their countries can contain the Zika virus, but nevertheless said they find it reasonable to follow official advice and delay having children, a new study has shown.

The virus, which has spread rapidly through the Americas, has been linked to a rise in microcephaly in Brazil, a debilitating birth defect where children are born with abnormally small heads. Last week the World Health Organisation declared the wave of birth defects a public health emergency of international concern, but, other than that it is carried by mosquitoes, there is little scientific knowledge about Zika.

The study, provided exclusively to the Guardian by the data analysis firm RIWI Corporation, found that not only did some Latin Americans lack confidence in their governments’ response to the virus, but many were unsure how it is spread.

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Brazilian Studies Aim to Unravel Zika’s Link to Birth Defect

Julie Steenhuysen – Reuters, 02/09/2016

At Roberto Santos General Hospital in Salvador, Brazil, Dr. Antonio Almeida and a team of specialists are closely following two groups of women: Those who deliver babies with abnormally small heads and those who deliver apparently normal babies.

The hospital is one of three in this city on Brazil’s eastern coast where investigators are studying the most urgent question of the Zika outbreak: Is the virus causing a spike in birth defects, and, if so, how great is the risk?

The answer will help shape the response to the rapid spread of Zika throughout the Americas. Concerns over the potential link to microcephaly have prompted a U.S. alert advising pregnant women against travel to 31 countries and territories with outbreaks.

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Brazil minister says no plans to cancel Rio Games

Stephen Wade – Associated Press, 02/05/2016

RIO DE JANEIRO (AP) — Brazilian organizers have reiterated they have no intention of canceling the Rio de Janeiro Olympics because of the outbreak of the Zika virus, with Sports Minister George Hilton saying the topic “is not in discussion.”

Hilton issued a statement Thursday saying he “lamented material and opinions in the press” speculating that South America’s first Olympics might be called off.

“The Brazilian government is fully committed to ensure that the 2016 Rio games take place in an atmosphere of security and tranquility,” Hilton wrote.

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After criticism, Brazil transferring Zika samples to US

Raphael Satter, Maria Cheng – ABC News, 02/05/2016

Brazilian officials say they’re sending a set of samples related to the Zika outbreak to the United States, a move which follows complaints that the country was hoarding disease data and biological material.

The announcement came hours after The Associated Press revealed that international health officials were frustrated at Brazil’s refusal to share enough viral samples and other information to answer the most worrying question about the outbreak: Whether the disease is truly causing a spike in babies born with abnormally small heads.

U.S. and U.N. officials told AP that Brazil probably shared fewer than 20 samples when experts say hundreds or thousands of samples are needed to track the virus’ evolution and develop accurate diagnostics and effective drugs and vaccines. Many countries’ national laboratories are relying on older strains from outbreaks in the Pacific and Africa, the AP found.

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Questioning an approach to Zika control: delaying pregnancy

Donald G. McNeil Jr. – New York Times, 02/05/2016

Health officials in several countries stricken by the Zika virus have given their female citizens an unprecedented warning: “Don’t get pregnant.”

The advice has been greeted in many quarters with a mixture of shock and derision. Medical historians said they had never heard the like. Advocates for women mocked it as unrealistic, disconnected from the difficult lives of women in a part of the world where contraception can be hard to obtain and abortion is often illegal.

Yet a growing number of infectious disease experts say that delaying pregnancy could work — and may be the most effective way to break the back of this global epidemic.

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