Brazil - Federal Government launches plan to deal with microcephaly - Zika Virus

[Gert van der Hoek]

07/12/2015

Federal Government launches plan for coping microcephaly

Measures will be put in place to contain new cases of microcephaly. Support will be offered to pregnant women and babies and intensified actions to combat the dengue mosquito.

President Dilma Rousseff launches on Saturday (5), Recife (PE), the National Plan to Combat microcephaly. It is a great national mobilization involving different ministries and agencies of the federal government, in partnership with states and municipalities, to contain new cases of microcephaly related to Zika virus. The Plan is the result of creation of the Interministerial Strategic Emergency Group on Public Health National and International Importance (GEI-PHEIC), involving 19 agencies and entities.
With the increasing number of cases of microcephaly in the country, the Health Ministry said last month, Emergencies in Public Health of National Importance in the country. Until November 28, 2015, 1,248 children were born with suspicion of this serious problem, which harms the development of children. Since then, the federal government is mobilized to study and control the situation.

The plan is divided into three lines of action: Mobilization and Combat Mosquito; Meeting the people; and Technological Development, Education and Research. These emergency measures will be put in place to step up actions to combat the mosquito.

MOBILIZE NATIONAL - The fight against the Aedes aegypti mosquito is crucial to the control of microcephaly outbreak that is occurring in the country. For the implementation of the National Plan to Combat microcephaly, the National room will be installed Interagency Coordination, which will work at the National Center for Risk and Disaster Management (Cenad) in the Ministry of National Integration. Also state rooms will be installed, which will be attended by representatives of the Ministry of Health, Departments of Health, Education, Public Security (PM and Fire), Social Welfare, Civil Defense and Armed Forces.
To strengthen the guidance to the public about the fight against mosquitoes in homes, mobilization with community health workers will be held, to combat endemic agents, besides the participation of the population.For this vector control, the Federal Government to acquire and make available equipment to spray insecticides and larvicides and secure the purchase of inputs.
The military and civil defense will give logistical support for transport and distribution of insecticides and health professionals. The two agencies will also act on visits to homes for elimination and vector control, and prevention mobilizations as joint efforts.
The School Health Program will involve teachers, students and families in the fight against mosquitoes. Public and private universities and federal institutes will be encouraged to participate in vector prevention and elimination activities. There will also be mobilizing actions between professionals and users of the Social Assistance Reference Centers, the Food Security Network and Bolsa Fam?lia beneficiaries.

At the same time, it is planned the training of professionals in the areas of health, education, welfare, civil and military defense, and rehabilitation professionals and specialized in epidemiological response and family health teams. They will be enabled also health professionals from hospitals for newborn hearing screening and 27 laboratories State Central Public Health to conduct survey to identify the Zika virus.

The Ministry of Health has recently launched a national campaign to fight the mosquito Aedes aegypti, which draws attention to the importance of cleaning for elimination of dengue mosquito outbreaks. The campaign slogan "Saturday's spring cleaning. Do not give clearance for the dengue mosquito. " There will also be information campaign for pregnant women and women of childbearing age, website and mobile application with information about microcephaly and Zika virus.

ATTENDANCE - To ensure proper care for pregnant women and babies, the Ministry of Health is making available to all health professionals, the Protocol and Clinical Guidelines for the care of microcephaly. In addition, the Ministry of Health will expand the CT scans covering and supporting the creation of regional scheduling of examinations plants.

To treat babies with the malformation, it is planned the expansion of the Living plan of care without limit, which is geared to the disabled, with the deployment of 89 new rehabilitation centers in addition to the 125 existing ones.

Primary Care professionals and professionals Program More Doctors will also be involved in promotion, prevention and patient care. The Stork Network will strengthen the attention to pregnant women and children.Over 4 million Notebooks of Pregnant - with basic guidelines to prenatal care - and 37.5 million rapid pregnancy tests will be sent to health facilities.

NEW TECHNOLOGIES - The federal government will encourage the development of research for the development of technologies aimed at diagnosis of viruses and their correlations, as well as promoting research for the control of the Aedes aegypti mosquito, with innovative techniques. Another area that will be studied is the microcephaly, other birth defects, and neurological syndromes, such as Guillain-Barr?.

ACTIVITIES - The Ministry of Health has intensified the monitoring of the situation and disseminate guidelines for public and population, according to the results of the investigations. Ministry of Health teams are helping the states in investigations Moreover, the Ministry of Health maintains contact with state and municipal departments to coordinate a joint response and, in particular, to mobilize action against Aedes aegypti. All the ministries involved and the Armed forces are also already at work in Pernambuco, with 200 trained soldiers and another 800 in training. They are also ongoing strengthening and improvement of information systems consist of reporting systems, applications and newsletters.

 

[Gert van der Hoek]

12/14/2015

Ministry launches Care Protocol to health for microcephaly

Document recommends active following of women of reproductive age with suspected pregnancy, in addition to expanding access to rapid tests. Another objective and anticipate prenatal

The Ministry of Health launched on Monday (14), the Protocol of Attention to Health and response to occurrence of microcephaly Related to infection Zika virus, which guides the care from pre-natal to the development of children with microcephaly, throughout the country. The design allows for the mobilization of managers, specialists and health professionals to promote early identification and specialized care of the mother and baby.

Check out the presentation

The main objective of the Protocol is to guide actions to care for women of childbearing age, pregnant and postpartum women, submitted to the Zika virus, and those born with microcephaly. This plan further recommends guidelines for reproductive planning, detection and reporting of symptoms suggestive of microcephaly and rehabilitation of children affected by congenital malformation.

The Plan strengthens the role of health workers in the provision of contraceptive methods and the orientation of women of childbearing age and couples who wish to become pregnant, especially about the necessary precautions to avoid infection Zika virus during pregnancy. The teams will also need to step up active search for pregnant women for the timely initiation of prenatal care and monitor the development of those born with microcephaly.

Another highlight of the Protocol is to increase access to rapid pregnancy tests. The Ministry of Health estimates that will be invested between $ 5 million and R $ 6 million for the tests are available in all units of Primary Care in the country.

PRENATAL - The completion of the pregnancy monitoring, primarily beginning in the first trimester of pregnancy, it is essential to identify risk factors, including infection by Zika virus. Inclusive, are guaranteed all routine tests recommended by the Ministry of Health during pregnancy, including hemoglobin electrophoresis and rapid HIV testing and syphilis.

"We anticipate that prenatal laboratory tests and ultrasound are performed in the first trimester of pregnancy. Goal is to detect fetal development, provide adequate care for pregnant women and promote early stimulation to microc?falas children, "said Secretary of Health Care, Ministry of Health, Alberto Beltrame.

During pregnancy, the community health workers will visit pregnant women, every 30 days - originally visits occurred every 60 days - by guiding to comply with the immunization schedule and attendance at scheduled consulted prenatal and also for prevention and control measures for infection Zika virus. Also it is for health professionals to investigate and record the book of pregnant women, as well as in the medical records of women, the occurrence of red machas, fever and infection of these patients, guiding to seek health services in the event to present these signs and symptoms.

DELIVERY - The Protocol reinforces the maintenance of the guidelines for labor and birth, encourages the adoption of normal birth also for babies with microcephaly, and recommends the maintenance of care to the newborn, such as the guarantee of skin-to-skin, timely cord clamping and breastfeeding in the first hour, and other routine procedures.

Newborns with suspected microcephaly will undergo physical examination, with the measurement of head circumference. Will be considered microcephalic those with smaller circumference of 32 cm. In addition, they will undergo neurological and imaging tests, such as ultrasound transfontanellar (US-TF), the first option indicated for neurological evaluation. As a second option, there is the CT, which has a greater radiation emission and, therefore, is recommended only when the bone structure of the fontanel to make achievement of US-TF.

Among premature infants, they are considered those born with smaller head circumference than two standard deviations, with the need for new measuring between 24-48 hours to confirm the microcephaly. Also, collection of umbilical cord blood and placental children born with suspected microcephaly be made.

The systematized Protocol also the need to neonatal screening, such as brainstem auditory evoked potential of (BAEP) to detect deficiency hearing that may be held in the maternity. The Ministry of Health will provide ABR equipment for 737 hospitals in the country. The absence of ABR does not prevent rising born with microcephaly because the test may be performed in specialized centers in Rehabilitation (CER) throughout the country.

It notes that breastfeeding should happen as a main power source of the newborn up to two years of age, being exclusive to six months. Note that there is no evidence of transmission of Zika virus through breast milk, as well as urine, saliva and semen. As studies applied in French Polynesia, it was not identified virus replication in milk samples as well as the disease can not be classified as sexually transmitted. There is also no saliva for broadcast description.

EARLY STIMULATION - The Protocol also sets guidelines for early stimulation of babies born with microcephaly. All children with this congenital malformation confirmed should be included in the Early Stimulation Programme, from birth to three years, during which the brain develops more rapidly.

Early stimulation aims at maximizing the potential of each child, encompassing physical growth and neurological maturation, behavioral, cognitive, social and emotional, which may be adversely affected by microcephaly. "It is critical accommodate the child with microcephaly and stimulate it as soon as possible, preferably starting after birth, and, if possible, even in maternity, in order to reduce the deficits caused by the malformation," said Secretary of Attention to Cheers.

Those born with microcephaly receive early stimulation in rehabilitation services distributed throughout the country, in the Specialized Rehabilitation Centers (RECs), the Support Center for Family Health (NASF) and Outpatient Newborn Tracking.