Mi Micr crocephaly a and Zika ka Epidemiological situation and - - PowerPoint PPT Presentation

Mi Micr crocephaly a and Zika ka

Epidemiological situation and Management

ECONOMIC C AND S SOCI CIAL C COUNCIL Bri riefing o

• n

n the he Zika ka Virus us ECOSOC OC Cha hamber, ber, UN Headqua uart rters ers, New York rk Cláud udio M Maier erovitch Dir irector

De Department o

• f Co

Commu mmunica cable Di Disease Su Surveillance Secret etaria iat of Healt lth Sur urve veillanc nce Brasília, february 2015

HISTORY

RY – REPORT TO TO IHR-OPAS/OMS ABOUT OUT ZIKA KA,

, GUILLAIN-BARRÉ E MICROCEPHAL

EPHALY

Around 29 reports to IHR:

• March, 12, 2015 – First report about exanthematous syndrome
• May, 02, 2015 – Report about Zika virus circulation
• June, 26, 2015 – Guillain-Barre information
• October, 23, 2015 – Microcephaly information reported to PAHO
• October, 30, 2015 – OMS starts sharing data with Brazil
• November, 12, 2015 – Health Emergency Declaration
• November, 18, 2015– Communication from ESPIN to WHO
• November, 27, 2015– Communication of identification of zika virus in 2 deaths
• November, 29, 2015– Association between zika and microcephaly
• Week updates on microcephaly since october 22nd to WHO and other requesting

countries.

AUG/2015 EW 31 OCT/2015 EW 41

August/2015 – First microcephaly cases Changes in epidemiologic al profile

OCT/2015 EW 42

22/10 – Pernambuco reports cases to Ministry of Healh 26/10 – Start investigations 17/11 – First national guidelines for microcephaly (33 cm); Zika virus confirmation in amniotic fluid in pregnant PB - Fiocruz 12/11 – Statement of emergency 28/11 – Relation confirmed between microcephaly and Zika virus - IEC/SVS 09/12 – Disclosure of the Protocol of Microcephaly- surveillance – version 1 – changes in CP alteration to 32 cm and

• thers*

14/12 – Disclosure of the Microcephaly Protocol – Health care 12/01 – National guidelines for early stimulation in babies with microcephaly ; CDC: identifcation of 4 zika virus cases 20/01 – Confirmed the passage of the zika virus placental barrier; Protocol of Microcephaly- surveillance – version 1,3

OCT/2015 EW 43 NOV/2015 EW 45 NOV/2015 EW 47 DEC/2015 EW 49 DEC/2015 EW 50 JAN/2016 EW 02 JAN/2016 EW 03

*EW – epidemiological week

HISTORY

NOV/2015 EW 45

April/2015 – Northeast region reporting exanthemat

• us

syndrome

APR/2015 EW 17 NOV- APR/2015

30/04 – detection of Zika virus Camaçari/B A

MAY/2015

May/2015 – First cases

• f Guillain

Barre

WH WHO – INTERNACIONA

NAL EMER ERGE GENCY CY

February 1st 2016: WHO declared a Public Health Emergency of International Concern due to zika epidemic and microcephaly association Recognition of transparency and efficiency on information sharing through the International Health Regulations (IHR/WHO)

RELATION BETWEEN MICRCEPHALY AND ZIKA VIRUS

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• An increase of exanthematous syndrome before microcephaly occurrence

in Northeast of Brazil

• Mothers of Microcephaly cases reporting rash during pregnancy
• Positive zikavirus in amniotic fluid, tissues and blood sample

MICROCEPHALY SURVAILLANCE

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• Newborn with microcephaly
• Suggestive miscarriage of congenital infection
• Stillbirth with microcephaly and / or malformation suggestive of

congenital infection

• Fetus with microcephaly and / or compromised central nervous

system, suggesting congenital infection

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SURVAILLANCE AND HEALTH CARE

Diseases and etiological agents Investigated causes Follow up Report Microcephaly Microcephaly with delay in intellectual development, motor and neurological disorders Suggestive microcephaly of congenital infection Z-STORCH: Zika vírus, syphilis, toxoplasmosis, other viruses (Chikungunya, Dengue , HIV, etc.) , Rubella, Cytomegalovirus and Herpes virus

Microcephaly protocols

 Surveillance: compulsory notification  Care: care to pregnant women and babies with microcephaly  Guidelines for early stimulation

• n children with

microcephaly until three years age

REPORT

RTED CA CASES OF MICROCE CEPHA HALY OR MALFOR ORMA MATION ON OF THE THE NE NERVOUS US CENT NTRA RAL SYSTE STEM,

, BRA

RAZI ZIL AND ND RE REGION,

, UNT

UNTIL EW 05/2016

9

Regions Reported cases of microcephaly and/or malformation of nervous central system, suggestive of congenital infection in fetuses , abortions , stillbirths or live births Total cases reported 2015 - 2016 (A+B+C) (A) In investigation (B) Investigated and confirmed (C) Investigated and discarded Brazil 3.852 462 765 5.079 Northeast 3.120 453 595 4.168 Southeast 400 5 75 480 North 126 1 17 144 Midwest 205 2 68 275 South 1 1 10 12

Source: Ministry of Health and State Secretariats of Health

ESPACIAL DISTRIBUTION OF MUNICIPALITIES WITH CONFIRMED

CASES OF MICROCEPHALY, BRAZIL, UNTIL EW 05/2016

10

Total number of municipalities with confirmed cases: 175

Source: Ministry of Health and State Secretariats of Health (last update: 06/02/2016).

Municipalities with confirmed cases

Legend

States with confirmed cases States without confirmed cases

Estratégias de Comunicação - http://combateaedes.saude.gov.br/

Produção final Desenvolvimento BIO MANGUINHOS

• 1. INSTITUTO EVANDRO CHAGAS (IEC/SVS/MS) + UNIVERSIDADE DO TEXAS

MEDICAL BRANCH

• 2. GlaxoSmithKline

INSTITUTO BUTANTÃ

• 1. NATIONAL INSTITUTES OF HEALTH DOS ESTADOS UNIDOS (VACINA

CONTRA DENGUE)

• 2. USP (UNIV. SÃO PAULO)

FIN FINANCIN ING– brazil ilian ian governm nment nt: :

• Brazilian Development Bank (BNDS) – Ministry of Development,

Industry and Foreign Trade (MDIC);

• Financing Agency for Studies and Projects (FINEP) – Ministry of

Science, Technology and Innovation (MCTI)

• Secretariat of Science, Technology and Strategic Inputs

(SCTIE/MS)

Research and Development Iniciatives of vaccines against zika virus supported by the Ministry of Health

Partnerships INSTITUTO EVANDRO CHAGAS

• 1. UNIVERSITY OF TEXAS MEDICAL BRANCH

BIOMANGUINHOS

• 1. GlaxoSmithKline

INSTITUTO BUTANTÃ

• 1. NATIONAL INSTITUTES OF HEALTH OF USA( VACCINE AGAINST

DENGUE)

• 2. USP (UNIV. SÃO PAULO)

NATIONAL COORDINATION AND CONTROL ROOM AGAINST AEDES AND ITS CONSEQUENCES (SNCC)

Goals:

• Intensify the campaign against the mosquito from

December 2015 to June 2016;

• Inspect all households and public and private urban

facilities by the end of February 2016 through a taskforce with participation of agent of endemics, community health agents, armies, civil defense, brigades (of firemen) and military forces;

• Conduct monthly visits until February and bimonthly

visits, starting from March to June 2016 through the taskforce.

• Reduce the rate of infestation by Aedes to less than

1% in all municipalities.

ES CE DF MT TO PE MG MA AC PB SP AL BA PI RJ SE AP GO RS RO MS RN RR AM SC PR

Brazilian Estrategy on zika: in accordange with PAHO/WHO estrategy

Detecting

rapid detection of the virus, its complications, monitoring and report to WHO the evolution of the epidemic

Preventing

Reduction of risk by eliminating the vector and reducing the chances of transmission. #ZIKAZERO

Responding

The response includes preparation of health services, clinical guidelines, communication of risk and research and development

Researche s Evidencies

Notified Dengue Cases by Epidemiological weeks 2013, 2014 e 2015, Brazil

Source: Sinan, *dados atualizados em 29/12/2015.

Number of cases Epi week of first symptoms

Notified cases by month, Rio de Janeiro State, 2013-2015

10000 20000 30000 40000 50000 60000 70000 80000 90000 100000 Janeiro Fevereiro Marco Abril Maio Junho Julho Agosto Setembro Outubro Novembro Dezembro 2013 2014 2015 January February Mars April May June July August September October November December

5000 10000 15000 20000 25000 2013 2014 2015

Notified cases of dengue by month, city of Rio de Janeiro, 2013-2015

January February Mars April May June July August September October November December

Secretariat of Health Surveillance

www.saude.gov.br/svs

Disque Notifica 0800-644-6645 notifica@saude.gov.br

www.resp.saude.gov.br