The Brain Institute of Rio Grande do Sul at PUCRS launched in December 2015 a new front of research on an epidemic that scares the country: the one caused by Zika Virus, the main cause of microcephaly cases. In the latest epidemiological warning issued by the Ministry of Health (issued on 27/7/2016), 8,703 suspected cases of microcephaly were reported in Brazil, most of which in the Northeastern region. Out of these 8,703 suspected cases, 1,749 were confirmed for microcephaly and other nervous system disorders, which suggests congenital infection in the 27 Federative units.
Facing the serious situation that is spreading throughout the country, the Institute’s Director Prof. Jaderson Costa da Costa has called professionals and researchers of different areas to compose the Zika Team. Participants include the director himself; pediatrician Dr. Humberto Fiori; neuropediatrician and BraIns researcher Prof. Magda Lahorgue Nunes; gynecologist/obstetrician Dr. Pedro Zanella; pediatric infectologist Dr. Marcelo Scotta; Prof. Célia Carlini, researcher in cellular and mollecular biology; neuropediatrician Dr. Alessandra Pereira; neuropediatrician Dr. Felipe Kalil; Dr. Daniel Marinowic, BraIns researcher; and neuroradiologist and researcher of the institute Dr. Ricardo Bernardi Soder.
Costa explains that BraIns could become a point of reference for studies on the prevention, diagnosis and treatment of the condition, relying on a skilled team and high-technology equipment that are important at a time of so much uncertainty regarding the condition. “Today, we have a generalized panic situation for women. It is more than just an agent that you can easily eradicate, it is a serious public health issue,” he says. Thus, the Zika Team was created, to work in several battlefronts, in the words of the neuroscientist. “The best way to fight an epidemic like this or even to deal with its consequences is to gather people from our Institution who have experience in obstetrics, fetal medicine and correlated areas, thus ensuring a better and more efficient search for solutions.”
For the pediatric infectologist Dr. Marcelo Scotta, the specialized group to fight the virus is an excellent opportunity to shed some light into the mystery surrounding Zika virus and its consequences, such as microcephaly. “We are asked a series of questions every day, such as whether pregnant women can use insect repellent, whether a woman can get pregnant after acquiring the virus, etc. These are all questions we are trying to answer little by little, it is all very recent.” According to the specialist, one of the great issues is connected to setting apart congenital (intrauterine) cases from perinatal cases (when transmission would take place right after birth). “These are different cases that we need to study further, even to clear up rumors on the disease.”
Obstetrician Dr. Pedro Zanella adds that the recent epidemic can also change scanning standards during pregnancy. “Today we have scans that may be added to the pregnancy calendar, demanding routine scans at twenty weeks and after thirty-two weeks of pregnancy, even for women at low risk, for a more effective monitoring.” The group also states that identifying subtypes of Zika Virus is a necessity, in order to understand whether a type of vaccine could in fact immunize the whole population, or if adopting other measures would be necessary. There is also the possibility of introducing vaginal discharge examinations, since there have been reports of cases of Zika infection through sexual intercourse.
Learn more: how is the head perimeter measured for the characterization of microcephaly?
The measurement of the occipitofrontal circumference or head perimeter is obtained using a non-elastic and flexible measuring tape. The head circumference is measured placing the measuring tape between the most prominent area at the back of the head (occipital bone) and the area just above the eyebrows (frontal bone). The neuroscientist and BraIns director suggests that the tape should be moved up and down aiming at measuring the largest head circumference possible. Recently, the Ministry of Health has determined that children who have a head circumference equal or below 32 cm are considered to have microcephaly.
Read on for more information disclosed by the Ministry of Health about the condition*:
What is Zika Virus?
There are two strains of Zika Virus (ZIKAV): the African and the Asian strain. The primary mode of transmission of the virus is through vectors such as Aedes Aegypti. The Zika fever is described as an acute febrile illness with a duration of three to seven days, usually without severe complications. There have been no reported deaths. The hospitalization rate is potentially low. The main symptoms include intermittent fever, headache, sore throat, cough and skin rash.
How is the virus transmitted?
The primary mode of transmission of the virus is through vectors. However, scientific literature describes the ocurrence of occupational transmission during laboratory research, and perinatal and sexual transmission, in addition to transmission by blood transfusion.
What is the prognosis?
In short, the disease is considered benign, self-limited and without reported deaths, with symptoms generally lasting from three to seven days. No chronic forms of the disease have been described. No specific vaccines or treatment have been developed so far.
How can I prevent the disease in my home?
It is necessary to reduce the density of the main vector, the Aedes Aegypti mosquito, by means of eliminating the possibility of contact between mosquitoes and water stored in any type of container, preventing the access of pregnant females through the use of screens/covers or sealing completely reservoirs or any containers that can hold water. In case a warning is issued or there is a high risk of transmission, individual protection should be implemented by inhabitants through the use of insect repellents. Individually, people can use clothes that minimize skin exposure in order to protect themselves agains mosquito bites during the day, when mosquitoes are most active, as well as during outbreak, in addition to using repellents on exposed skin and clothing.
How do I report mosquito breeding?
Control strategies are similar to those of dengue, therefore aimed primarily at the municipal level. When the presence of the mosquito is detected and it cannot be eliminated by the inhabitants of a given location, the City Department of Health should be notified.
What do I do if I have the symptoms of Zika fever?
Find the nearest health facility for guidance.
*Source: Ministry of Health – Special Report on Zika Virus
Read the paper published on the subject:
19/4 – Nunes ML, Carlini CR, Marinowic D, Neto FK, Fiori HH, Scotta MC, et al. Microcephaly and Zika virus: a clinical and epidemiological analysis of the current outbreak in Brazil. J Pediatr (Rio J). 2016.