Zika virus has been spreading rapidly in Brazil and the Americas, with a sharp increase in the number of notified microcephaly cases since September, 2015.1x1Faria, NR, Azevedo Rdo, S, Kraemer, MU et al. Zika virus in the Americas: early epidemiological and genetic findings. Science. 2016; 352: 345–349
See all References,2x2Heukelbach, J, Alencar, CH, Kelvin, AA, De Oliveira, WK, and Cavalcanti, LPG. Zika virus outbreak in Brazil. J Infect Dev Ctries. 2016; 10: 116–120
See all References Based on the high number of cases, and the association between Zika virus infection and microcephaly,3x3Rasmussen, SA, Jamieson, DJ, Honein, MA, and Petersen, LR. Zika virus and birth defects—reviewing the evidence for causality. N Engl J Med. 2016; 374: 1981–1987
See all References,4x4Brasil, P, Pereira, JP Jr, Raja Gabaglia, C et al. Zika virus infection in pregnant women in Rio de Janeiro—preliminary report. N Engl J Med. 2016; DOI: http://dx.doi.org/10.1056/NEJMoa1602412 ()
See all References WHO on Feb 1, 2016, declared a Public Health Emergency of International Concern.5x5WHO. WHO Director-General summarizes the outcome of the Emergency Committee regarding clusters of microcephaly and Guillain-Barré syndrome. World Health Organization, Geneva; 2016http://www.who.int/mediacentre/news/statements/2016/emergency-committee-zika-microcephaly/en/. ()
See all References5 Recently, animal models have shown that the Brazilian Zika virus strain causes intrauterine growth restriction and microcephaly.6x6Cugola, FR, Fernandes, IR, Russo, FB et al. The Brazilian Zika virus strain causes birth defects in experimental models. Nature. 2016; 534: 267–271
See all References6
An emerging disease such as Zika virus infection, with severe consequences for newborn babies, is already a major challenge for public health authorities for countries as large as Brazil. But the effect of the current epidemic is expected to be even more devastating, considering the current Brazilian economic crisis and its potential impact on the already chronically underfunded Brazilian health system.7x7Paim, J, Travassos, C, Almeida, C, Bahia, L, and Macinko, J. The Brazilian health system: history, advances, and challenges. Lancet. 2011; 377: 1778–1797
See all References7 Effective evidence-based health surveillance systems are needed.
In the context of several scientific and public health uncertainties regarding Zika virus infection, Giovanny França and colleagues'8x8França, GVA, Schuler-Faccini, L, Oliveira, WK et al. Congenital Zika virus syndrome in Brazil: a case series of the first 1501 livebirths with complete investigation. Lancet. 2016; ()http://dx.doi.org/10.1016/S0140-6736(16)30902-3.
See all References8 paper in The Lancet is welcome. Using data from the Brazilian Ministry of Health surveillance system for microcephaly, the study describes clinical and anthropometric characteristics of the largest case series of suspected Zika virus infection reported so far. Among a total of 5554 liveborn infants with suspected microcephaly, the study includes data for all 1501 suspected cases (27%) with a complete investigation.
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