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Microcephaly in infants: what is the relationship with the Zika virus?

Microcephaly in infants: what is the relationship with the Zika virus?

The sudden increase in the number of cases of microcephaly, a rare neurological condition usually identified during the gestation phase, has been warning Brazilian medical authorities. According to the Ministry of Health, while between 2010 and 2014 a total of 781 cases were registered in all countries, during the year 2015 there were registered 2,401 cases of the disease and 29 deaths in 549 municipalities in Brazil, according to the epidemiological bulletin released on the day December 15th. The suspicion is that the increasing number of cases of microcephaly is related to the infection of women by the Zika virus, belonging to the same family of the dengue virus and is also transmitted by the mosquito Aedes aegypti . Microcephaly is diagnosed when the person's head is significantly lower than that of others of the same age and sex. Microcephaly is usually diagnosed early in life and is a result of the brain not growing enough during gestation or after birth.

Alert began in Pernambuco

Most cases are concentrated in Pernambuco, with 804 babies born this year with the condition, being the first state to identify the abnormal increase of the incidence of microcephaly in Brazil. "In one week we had five or six patients hospitalized with microcephaly, when the normal one is a month," says Lucas Alves, a neuropediatrician at the Hospital das Clínicas of the Federal University of Pernambuco, who attended several cases of microcephaly related to the outbreak. > According to the specialist, a good number of these mothers had a fever associated with reddish spots on the body in early pregnancy, both of which were symptoms of Zika virus infection. The physical characteristics of infants with microplate also tend to be similar according to the cause of the condition. "The physiognomy of these babies is similar, which reinforces our suspicion," explains Lucas Alves. "In addition, they did computed tomography and other examinations, and many had similar findings," explains the doctor.

After Pernambuco, the second state with the highest number of cases is Paraíba with 316 notifications, followed by Bahia with 180, Rio Grande do Norte 106, Sergipe 96, Alagoas 81, Ceará 40, Maranhão 37, Piauí 36, Tocantins 29, Rio de Janeiro 23, Mato Grosso do Sul with nine cases, three in Goiás and one in the Federal District. the total number of cases was reported in 19 deaths, seven in the state of Rio Grande do Norte, four in Sergipe, two in Rio de Janeiro, two in Bahia, one in Maranhão, Ceará, Paraíba and Piauí. All of these babies had microcephaly and suspected Zika virus infection. Cases are still under investigation to confirm the cause of the deaths. One of them, of a baby born in Ceará with diagnosis of microcephaly and other congenital malformations by means of ultrasonography, had a positive result for the zika virus. Another five in Rio Grande do Norte and one in Piauí are under investigation to define cause of death.

Confirmed ratio

According to a statement released on November 27, "the Ministry of Health considers the relationship between the virus and the occurrence of microcephaly.This is an unprecedented situation in the world scientific research.The investigations on the subject must continue to clarify issues such as the transmission of this agent, its performance in the human organism, infection of the fetus and period of greater vulnerability to the pregnant woman "In the first analysis, the risk is associated with the first three months of pregnancy."

It has been known since the middle of November, when evidence of the virus was found in amniotic fluid (which involves babies throughout their development), that diseases could be related. However, now with confirmation in blood and tissue samples, the Ministry has confirmed this relationship. Because it is something new, not previously described in the medical literature, it is not yet known exactly how the relationship between problems works.The Flavivirus Laboratory of the Oswaldo Cruz Institute of Fiocruz / RJ participates in the investigations and concluded, on November 17, diagnoses that verified the presence of the Zika virus genome in samples from two pregnant women from Paraíba, whose fetuses were confirmed with microcephaly through ultrasound examinations. The genetic material (RNA) of the virus was detected in samples of amniotic fluid using the real-time RT-PCR technique.

How to prevent microcephaly?

Children with microcephaly have developmental problems. There are no treatments for the condition, but treatments performed since the early years improve the development and quality of life.

There are several causes of microcephaly, from viral infections and use of certain drugs, to genetic conditions. Therefore, "the best way to prevent not only microcephaly, but several other health conditions, is to perform prenatal care," explains the neuropediatrician Paulo Breinis of the São Luiz Hospital. In addition, at the first sign of fever or spotting on the body, the pregnant woman should seek medical attention as soon as possible.

Medical recommendations to prevent microcephaly also include:

Do not ingest alcohol during pregnancy:

"The use of alcohol predisposes the baby to several diseases, such as Fetal Alcohol Syndrome", says the pediatrician Breinis.

Do not use medicines without medical advice:

"It has been known for a long time that some medicines can interfering with fetal formation, including causing a poor formation of the brain such as microcephaly.It is important that the pregnant woman does not take any type of medication without medical advice ", guides the infectious disease Granato.

Avoid contact with people with fever, exanthem or infections : "Theoretically every infection can give some change in the development of the fetus, from a rubella and cytomegalovirus, to dengue fever, zika fever and chikungunya fever. important to avoid general exposure to diseases, "Guidance Granato.

Protect yourself from mosquito bites: Since there is the possibility of microcephaly being caused by the zika virus, which in turn is transmitted by mosquito bite

Aedes aegypti - besides the complications already known in dengue cases, for example - one of the recommendations of the Ministry is to avoid exposing itself to the mosquito. What can be done by eliminating their breeding grounds, ie removing containers with standing water and adequately covering storage sites, and using repellents indicated for pregnant women.

Genetic counseling: "There are forms of microcephaly that are genetic and are not caused by a virus, intoxication or other external agent, and there are several causes of genetic microcephaly, so it is important to do genetic counseling to see what these conditions can cause, "says neurobiologist Breinis. >


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