Microcephaly in Infants, Ceará State, Brazil, 2015-2016

Abstract

In late 2015, the Brazilian Ministry of Health officially announced the association between microcephaly in infants and Zika virus infection of the mother during pregnancy. We describe preliminary findings of this outbreak in Ceará, Northeast Brazil and it’s clinical characteristics in each medical speciality. We report epidemiological findings of 317 cases of microcephaly outbreak potentially associated with ZIKV infection in Ceara, State, Brazil. From mid-2015 to the end of June of 2016, a total of 417 cases of microcephaly were suspected, with 317 confirmed. Among those reported cases, 83.2% (347/417) were detected in the postpartum. Rash during pregnancy was reported by (29.6%) of pregnant women, most commonly in the 1st trimester (18.4%).  The proportion of microcephaly cases increased from less than 1% to 25.8% of the registered cases of genetic abnormalities. The prevalence increased from 0.06/1000 live births in 2010 to 0.56 in 2015 and to 3.22 in January and February of 2016. In addition to microcephaly other associated malformations were detected, such as arthrogryposis, hyperexcitability, irritability with strong and frequent crying. The microcephaly phenotype caused by the zika virus is different from other congenital conditions. The infection in the prenatal period is a new teratogen reported. There is a predominance of neurological impairment, in which neuroimaging plays a crucial role in confirming the clinical suspicion of Congenital Zika Syndrome.