sharon sanders
Editor-in-Chief & President
[h=1]Congenital Zika virus syndrome in Brazil: a case series of the first 1501 live births with complete investigation[/h] [FONT="] Giovanny V A Fran?a, PhD
, Prof Lavinia Schuler-Faccini, PhD
, Wanderson K Oliveira, MSc
, Claudio M P Henriques, MD
, Eduardo H Carmo, PhD
, Vaneide D Pedi, MSc
, Mar?lia L Nunes, DVM
, Marcia C Castro, PhD
, Suzanne Serruya, PhD
, Mari?ngela F Silveira, MD
, Prof Fernando C Barros, MD
, Prof Cesar G Victora, MD
snip
[h=3]Findings[/h] [FONT="]Between Nov 19, 2015, and Feb 27, 2015, investigations were completed for 1501 suspected cases reported to the Brazilian Ministry of Health, of whom 899 were discarded. Of the remainder 602 cases, 76 were definite, 54 highly probable, 181 moderately probable, and 291 somewhat probable of congenital Zika virus syndrome. Clinical, anthropometric, and survival differences were small among the four groups. Compared with these four groups, the 899 discarded cases had larger head circumferences (mean Z scores −1?54 vs −3?13, difference 1?58 [95% CI 1?45?1?72]); lower first-week mortality (14 per 1000 vs 51 per 1000; rate ratio 0?28 [95% CI 0?14?0?56]); and were less likely to have a history of rash during pregnancy (20?7% vs 61?4%, ratio 0?34 [95% CI 0?27?0?42]). Rashes in the third trimester of pregnancy were associated with brain abnormalities despite normal sized heads. One in five definite or probable cases presented head circumferences in the normal range (above −2 SD below the median of the InterGrowth standard) and for one third of definite and probable cases there was no history of a rash during pregnancy. The peak of the epidemic occurred in late November, 2015.[/FONT]
[h=3]Interpretation[/h] [FONT="]Zika virus congenital syndrome is a new teratogenic disease. Because many definite or probable cases present normal head circumference values and their mothers do not report having a rash, screening criteria must be revised in order to detect all affected newborn babies.[/FONT]
[FONT="]http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30902-3/abstract
[/FONT]
[/FONT]
, Prof Lavinia Schuler-Faccini, PhD
, Wanderson K Oliveira, MSc
, Claudio M P Henriques, MD
, Eduardo H Carmo, PhD
, Vaneide D Pedi, MSc
, Mar?lia L Nunes, DVM
, Marcia C Castro, PhD
, Suzanne Serruya, PhD
, Mari?ngela F Silveira, MD
, Prof Fernando C Barros, MD
, Prof Cesar G Victora, MD
snip
[h=3]Findings[/h] [FONT="]Between Nov 19, 2015, and Feb 27, 2015, investigations were completed for 1501 suspected cases reported to the Brazilian Ministry of Health, of whom 899 were discarded. Of the remainder 602 cases, 76 were definite, 54 highly probable, 181 moderately probable, and 291 somewhat probable of congenital Zika virus syndrome. Clinical, anthropometric, and survival differences were small among the four groups. Compared with these four groups, the 899 discarded cases had larger head circumferences (mean Z scores −1?54 vs −3?13, difference 1?58 [95% CI 1?45?1?72]); lower first-week mortality (14 per 1000 vs 51 per 1000; rate ratio 0?28 [95% CI 0?14?0?56]); and were less likely to have a history of rash during pregnancy (20?7% vs 61?4%, ratio 0?34 [95% CI 0?27?0?42]). Rashes in the third trimester of pregnancy were associated with brain abnormalities despite normal sized heads. One in five definite or probable cases presented head circumferences in the normal range (above −2 SD below the median of the InterGrowth standard) and for one third of definite and probable cases there was no history of a rash during pregnancy. The peak of the epidemic occurred in late November, 2015.[/FONT]
[h=3]Interpretation[/h] [FONT="]Zika virus congenital syndrome is a new teratogenic disease. Because many definite or probable cases present normal head circumference values and their mothers do not report having a rash, screening criteria must be revised in order to detect all affected newborn babies.[/FONT]
[FONT="]http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30902-3/abstract
[/FONT]
[/FONT]