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Study finds large numbers of microcephaly cases in Brazil before Zika arrived - Or 'Zika might have arrived earlier than we thought in Brazil'

Gert van der Hoek

In Memoriam - Editor, Senior Moderator
February 4, 2016

Charles Simmins

A study released Feb. 4 on the World Health Organization Zika open site seems to corroborate existing statistical work suggesting that Brazil was experiencing cases of microcephaly in large numbers before the arrival in that country of Zika viral illnesses. The study is titled Microcephaly in northeastern Brazil: a review of 16 208 births between 2012 and 2015.

more.....
 
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No Title

From the study above:

Credit:


Soares de Ara?jo JS, Regis CT, Gomes RGS, Tavares TR, Rocha dos Santos C, Assun??o PM, et al.
Microcephaly in northeast Brazil: a review of 16 208 births between 2012 and 2015.
[Submitted] Bull World Health Organ, E-pub: 4 Feb 2016. doi:
http://dx.doi.org/10.2471/BLT.16.170639

Microcephaly in northeastern Brazil: a review of 16 208 births between 2012 and 2015

Juliana Sousa Soares de Ara?jo,a
Cl?udio Teixeira Regis,a
Renata Grig?rio Silva
Gomes,a
Thiago Ribeiro Tavares,a
C?cera Rocha dos Santos,a
Patr?cia Melo
Assun??o,b
Renata Val?ria N?brega,b
Diana de F?tima Alves Pinto,b
Bruno Vin?cius
Dantas Bezerrab
& Sandra da Silva Mattosa
a
C?rculo do Cora??o de Pernambuco, Sandra da Silva Mattos. Av. Agamenon Magalh?es
2760, Paissandu, Recife ? Pernambuco - CEP 52010-902, Brazil.
b
Secretaria de Sa?de do Estado da Para?ba, Jo?o Pessoa, Brazil.
Correspondence to Sandra da Silva Mattos (email: ssmattos@cardiol.br).
(Submitted: 29 January 2016)

...
In this study, classification of microcephaly was based on three different criteria, as follows:

1. Brazilian Health Ministry proposed criteria, where microcephaly equals an OFC smaller
than 32 cm for term neonates.(6)
2. Fenton curves, where microcephaly equals an OFC less than -3 standard deviation (SD)
for age and gender.(7)
3. Proportionality criteria, where microcephaly equals an OFC less than ((height/2) + 10) ?
2.(8)

Microcephaly classification

Neonates were classified with microcephaly according to each one of the three criteria. A
separate group was created for those who fulfilled all three criteria. Finally, those who fell into
the lower third in each criterion were grouped as extreme cases of microcephaly.

...
The distribution of cases of microcephaly between 2012 and 2015 is observed in Fig. 1. A
temporal oscillation is observed which is concordant in all three criteria. The numbers are
greater than expected since the end of 2012 and with its sharpest peak in mid-2014. However
when only the extreme cases of microcephaly are considered a significant (p=0.001) increase
in numbers is observed in recent months as shown on Figure 2.

Untitled.png
 
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http://www.pri.org/stories/2016-02-...ront-lines-cases-microcephaly-may-be-dropping
Good news: On Brazil's Zika front lines, cases of microcephaly may be dropping GlobalPost
February 03, 2016 ? 5:30 PM EST
By Will Carless
...
But Dr. Negreiros says there has also been a trend of ?super-notification? of microcephaly by clinics and doctors in Recife. The region?s pre-natal doctors have been spurred into reporting every single case where a child has a small head, she says, but many cases referred to her hospital have turned out to be babies developing perfectly normally.
GlobalPost drew attention to problems Brazil is having in accurately reporting microcephaly last week. The medical body responsible for monitoring birth defects in Latin America released an eye-opening report in December that raised doubts about the scope of Brazil's Zika outbreak and related health problems. The report says the spike in the number of reported microcephaly cases is likely due to over-diagnosis, driven in part by intense media exposure...
 
http://www.abc.net.au/news/2016-02-...d-microcephaly-cause-brazilian-survey/7147602
AM
By Norman Swan
Updated February 08, 2016 13:11:00
...
The scramble in Brazil to discover the cause led paediatric cardiologist Dr Sandra Mattos to realise she was sitting on a database which could provide some answers.
... "We tried to establish the pattern of microcephaly over the last four years," Dr Mattos said.
Dr Mattos and her colleagues were surprised by the numbers.
"What we expected was that we would have something like three to four cases a year of microcephaly ? that is what has been documented in the official sites.
"But we then noticed that we had much, much higher numbers."
As part of the survey, Dr Mattos' team assessed head size in three ways to ensure it was as accurate as possible.
"Independent of what criteria we used, we had between 2?8 per cent of babies that would fall into the criteria of microcephaly," she said.
This represents between 2,000 and 4,000 babies per year in the state of Para?ba ? about 1,000 times more than the team expected....

...
The survey calls into question whether these microcephaly cases are caused by Zika virus or something else.
If it is Zika virus, it has been in Brazil for a lot longer than people have thought, but that does not explain why after 50 years Zika has only now been linked to microcephaly.
 
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