US, Brazilian Health Teams Brave Slums to Start Zika Study

Teams of U.S. and Brazilian health workers will collaborate and study and fan out across one of Brazil’s poorest states Tuesday in search of mothers and infants for a study aimed at studying whether the Zika virus is causing babies to be born with unusually small heads.

Brazil’s health minister, Marcelo Castro, says he is “absolutely sure” mosquito-borne Zika is responsible for a spike in cases of the rare birth defect microcephaly, which sees babies born with small heads and brains and can cause severe developmental problems. But with scant scientific literature published on the matter, some doctors in Brazil and elsewhere say there is not yet enough scientific data to prove the connection.

The study is aimed to fill that vacuum by comparing babies with microcephaly and their mothers to babies without the condition. The popular “understanding is that Zika virus (behind the microcephaly spike). How much of that is Zika virus is really one of the important goals of this study,” said Erin Staples, a Colorado-based epidemiologist who heads the CDC contingent in Paraiba state. “I do believe there is something occurring that is unique and knowable, but we really need to understand better, mostly so we can prevent this from happening to other generations.”

Eight teams of “disease detectives” are looking to enroll about 100 mothers of babies with microcephaly, a rare defect that causes newborns to have unusually small heads and damaged brains. They also want to sign up two to three times as many mothers of babies without the birth defect, born in the same area at around the same time.

Maternity hospitals in Paraiba, the impoverished state that is one of the epicenters of Brazil’s tandem outbreaks of Zika and microcephaly, provided the CDC and its Brazilian partners with mothers’ addresses.

A municipal health worker draws blood from 3-month-old Shayde Henrique, who was born with microcephaly, in Joao Pessoa, Brazil, Tuesday, Feb. 23, 2016. U.S. and Brazilian health workers knocked on doors in the poorest neighborhoods of one of Brazil's poorest states Tuesday in a bid to enroll mothers in a study aimed at determining whether the Zika virus is really causing a surge in birth defects. The teams started in Joao Pessoa, the capital of Paraiba state which is one of the epicenters of Brazil's tandem Zika and microcephaly outbreaks. (AP Photo/Andre Penner)

The study has been in the planning stages for several weeks. It will pair researchers at the U.S. Centers for Disease Control and Prevention with Brazilian experts to examine babies already born with microcephaly and their mothers to determine whether Zika or some other infection caused their malady.

“What we’re trying to do is to better define the association between children that have been diagnosed with microcephaly and whether or not they might have evidence of congenital Zika virus infection,” said Dr. Erin Staples, a CDC medical epidemiologist leading the study in Paraíba.

Locked in the city’s chronic traffic, one team missed its first appointment, and the two home visits that were scheduled to take place in the morning didn’t get underway until well after lunchtime.

“Obviously, we’ve seen the problems of logistics — to be able to reach the families, to have them be there,” said Dr. Alexia Harrist, a Boston-born pediatrician who works in the CDC’s Epidemic Intelligence Service. “If things take longer, things take longer, but I think we’re all really dedicated to getting it done.”

Staples estimated that it will take four to five weeks to get the study fully enrolled, but it may take longer. “We need to make sure we have the right number of cases and controls to be able to say with a good degree of certainty what is going on,”

 

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