Zika virus and microcephaly in Brazil: a scientific agenda
Por Mauricio Barreto e Lancet
Since 1981, the Brazilian population has had dengue fever epidemics and all control efforts have been unsuccessful. In 2014, chikungunya fever was reported for the first time in the country. In 2015, the occurrence of Zika virus was also reported, along with an increase of microcephaly and brain damage in newborn babies. The mosquito Aedes aegypti is the most conventional vector of these three viral infections and is widely disseminated in a great part of urban Brazil. Brazilian public health authorities declared a National Public Health Emergency on Nov 11, 2015, and intensified the vector control campaign to tackle the epidemic. A few months later, on Feb 1, 2016, in view of the spread of the Zika virus in several Latin American and Caribbean countries, the report of cases in North American and European citizens upon return from those countries, and concerns about reported clusters of microcephaly and other neurological disorders, WHO declared a Public Health Emergency of International Concern.
In Brazil, Federal and State governments and scientific agencies are implementing initiatives to increase knowledge about this unexpected, unknown, and terrifying situation. Countrywide, scientists from different disciplines are working on the problem and its potentially devastating consequences. Nationally, two coordination activities should be highlighted: a task force set up by Fundação Oswaldo Cruz (FIOCRUZ),
a scientific organisation attached to the Ministry of Health, and the Scientific Working Group on Zika Virus at the Ministry of Science Technology and Innovation. To achieve better chances of success, a strategic plan for governmental action must be put forward, around six central components:
(1) To enlarge the basis of evidence of infection, diseases, and potential outcomes Despite being known for several decades, Zika virus is a neglected subject, possibly because of its mild effects and its limited geographical expansion. Even though Zika virus is circulating in Brazil and most of the Latin American and Caribbean countries, scientific knowledge about its determinants and outcomes is emerging only
slowly and is so far insufficient. Despite the existing evidence, a causal association of microcephaly and brain damage observed in newborn babies has not
been conclusively established.
Foto: Nelson Almeida