Materiały źródłowe

• #1 Population-Based Microcephaly Surveillance in the United States, 2009 to 2013: An Analysis of Potential Sources of Variation

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5485911/

  The pooled prevalence of microcephaly was 8.7 per 10,000 live births. […] Differences in methods, population distribution of maternal/infant characteristics, and case definitions for microcephaly can contribute to the wide range of observed prevalence estimates across individual birth defects surveillance programs. […] The purpose of this report is to describe the estimated prevalence of microcephaly in the United States from 2009 to 2013 using data from thirty population-based birth defects surveillance programs and to explore potential reasons for some of the observed variation in prevalence. […] Microcephaly surveillance is particularly challenging when programs use different methods in terms of the settings where cases are identified and the maximum age at which affected children are ascertained.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Microcephaly-Epidemiology.aspx

  Microcephaly is still a rare condition worldwide although there have been surges in the numbers of cases in specific countries. Globally, 1 in every 30,000 to 250,000 babies has microcephaly at birth. In the United States, this is about 2 per 10,000 to 12 per 10,000 of live births. In the UK, there are 1.02 cases of microcephaly per 10,000 births. […] There has been a recent surge of microcephaly cases in some countries. On average, the state of Pernambuco in northeast Brazil reports about 10 cases of microcephaly a year. However, from the beginning of January 2015 to November 2015, 141 cases were reported in 44 of its 185 municipalities. Similarly, Rio Grande de Norte saw an uncharacteristic rise in microcephaly from August 2015 to 16 November 2015 with 35 cases reported. This compares to an average of 163 cases with a standard deviation of 16.9 every year nationwide between 2010 and 2014.

• #1 Microcephaly | MedLink Neurology

  https://www.medlink.com/articles/microcephaly

  Incidence varies among populations, but in searching birth defect registries throughout the world, it has been described as between 1.3 to 150 per 100,000 live births. […] The prevalence of microcephaly in Europe in a population-based study was 1.53 per 10,000 live births. […] An Australian population-based birth defects registry showed a prevalence of microcephaly of 5.5 per 10,000 live births. […] A United States population-based microcephaly surveillance revealed a prevalence of 8.7 per 10,000 live births. […] Before evidence of Zika virus infections, birth defects surveillance programs in New York State reported a prevalence of microcephaly of 7.5 per 10,000 live births and the prevalence of severe congenital microcephaly of 4.2 per 10,000 live births. […] If head circumference had a normal distribution within the population, 2.3% of children would meet the criteria for microcephaly using the definition of two standard deviations below the mean.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Microcephaly-Epidemiology.aspx

  Microcephaly is still a rare condition worldwide although there have been surges in the numbers of cases in specific countries. Globally, 1 in every 30,000 to 250,000 babies has microcephaly at birth. In the United States, this is about 2 per 10,000 to 12 per 10,000 of live births. In the UK, there are 1.02 cases of microcephaly per 10,000 births. […] There has been a recent surge of microcephaly cases in some countries. On average, the state of Pernambuco in northeast Brazil reports about 10 cases of microcephaly a year. However, from the beginning of January 2015 to November 2015, 141 cases were reported in 44 of its 185 municipalities. Similarly, Rio Grande de Norte saw an uncharacteristic rise in microcephaly from August 2015 to 16 November 2015 with 35 cases reported. This compares to an average of 163 cases with a standard deviation of 16.9 every year nationwide between 2010 and 2014.

• #2 Population-based Microcephaly Surveillance in the United States, 2009 to 2013: An Analysis of Potential Sources of Variation

  https://digitalcommons.usf.edu/cfh_facpub/59/

  Background: Congenital microcephaly has been linked to maternal Zika virus infection. However, ascertaining infants diagnosed with microcephaly can be challenging. […] Methods: Thirty birth defects surveillance programs provided data on infants diagnosed with microcephaly born 2009 to 2013. The pooled prevalence of microcephaly per 10,000 live births was estimated overall and by maternal/infant characteristics. Variation in prevalence was examined across case finding methods. Nine programs provided data on head circumference and conditions potentially contributing to microcephaly. […] Results: The pooled prevalence of microcephaly was 8.7 per 10,000 live births. […] Conclusion: Differences in methods, population distribution of maternal/infant characteristics, and case definitions for microcephaly can contribute to the wide range of observed prevalence estimates across individual birth defects surveillance programs. Addressing these factors in the setting of Zika virus infection can improve the quality of prevalence estimates.

• #2 Prevalence and Clinical Attributes of Congenital Microcephaly — New York, 2013–2015 | MMWR

  https://www.cdc.gov/mmwr/volumes/66/wr/mm6605a1.htm

  During 2013-2015, before documentation of widespread introduction of imported Zika virus infection in the continental United States, the prevalence of severe congenital microcephaly in New York was 4.2 per 10,000 live births. […] Administrative data can enhance microcephaly case finding for birth defects surveillance programs. […] A baseline prevalence estimate of severe congenital microcephaly can enable estimation of risk attributable to Zika virus infection. […] During 2013-2015, the overall prevalence of microcephaly in New York was 7.4 per 10,000 live births, and the prevalence of severe congenital microcephaly was 4.2 per 10,000 live births, with elevated prevalence of severe congenital microcephaly noted in Western New York (7.2) and Finger Lakes (5.9) health service areas. […] The findings in this report highlight the value of confirmation of severe congenital microcephaly using anthropometric measurements to apply the NBDPN case definitions.

• #3 Microcephaly: Background, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/2500048-overview

  Microcephaly is not a common condition. State birth defects tracking systems have estimated that microcephaly ranges from 2 babies per 10,000 live births to about 12 babies per 10,000 live births in the Unites States. […] Two large population-based studies have found similar incidences of microcephaly in newborns: 0.56% and 0.54%, respectively.

• #3 Population-based surveillance of severe microcephaly and congenital Zika syndrome in Canada – PubMed

  https://pubmed.ncbi.nlm.nih.gov/33419730/

  Purpose: To estimate the minimum incidence of congenital Zika syndrome (CZS) and severe microcephaly in Canada and describe key clinical, epidemiological, aetiological and outcome features of these conditions. […] Two separate national surveillance studies were conducted on CZS and severe microcephaly using the well-established Canadian Paediatric Surveillance Program from 2016 to 2019. Over 2700 paediatricians across Canada were surveyed monthly and asked to report demographic details, pregnancy and travel history, infant anthropometry, clinical features and laboratory findings of newly identified cases. Reports were reviewed to assign an underlying aetiology of severe microcephaly. Incidence rates were estimated using monthly live birth denominators. […] Thirty-four infants met the case definition for severe microcephaly and 5 met the case definition for CZS. The associated minimum incidence rates were 4.5 per 100 000 live births for severe microcephaly and 0.1-0.5 per 100 000 live births for CZS. […] Severe microcephaly and CZS are both rare in Canada. Minimum incidence rates can be used as a baseline against which novel or re-emergent causes of severe microcephaly or CZS can be compared.

• #4 Prevalence and Clinical Attributes of Congenital Microcephaly — New York, 2013–2015 | MMWR

  https://www.cdc.gov/mmwr/volumes/66/wr/mm6605a1.htm

  During 2013-2015, before documentation of widespread introduction of imported Zika virus infection in the continental United States, the prevalence of severe congenital microcephaly in New York was 4.2 per 10,000 live births. […] Administrative data can enhance microcephaly case finding for birth defects surveillance programs. […] A baseline prevalence estimate of severe congenital microcephaly can enable estimation of risk attributable to Zika virus infection. […] During 2013-2015, the overall prevalence of microcephaly in New York was 7.4 per 10,000 live births, and the prevalence of severe congenital microcephaly was 4.2 per 10,000 live births, with elevated prevalence of severe congenital microcephaly noted in Western New York (7.2) and Finger Lakes (5.9) health service areas. […] The findings in this report highlight the value of confirmation of severe congenital microcephaly using anthropometric measurements to apply the NBDPN case definitions.

• #4 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Microcephaly-Epidemiology.aspx

  Microcephaly is still a rare condition worldwide although there have been surges in the numbers of cases in specific countries. Globally, 1 in every 30,000 to 250,000 babies has microcephaly at birth. In the United States, this is about 2 per 10,000 to 12 per 10,000 of live births. In the UK, there are 1.02 cases of microcephaly per 10,000 births. […] There has been a recent surge of microcephaly cases in some countries. On average, the state of Pernambuco in northeast Brazil reports about 10 cases of microcephaly a year. However, from the beginning of January 2015 to November 2015, 141 cases were reported in 44 of its 185 municipalities. Similarly, Rio Grande de Norte saw an uncharacteristic rise in microcephaly from August 2015 to 16 November 2015 with 35 cases reported. This compares to an average of 163 cases with a standard deviation of 16.9 every year nationwide between 2010 and 2014.

• #5 Population-based surveillance of severe microcephaly and congenital Zika syndrome in Canada – PubMed

  https://pubmed.ncbi.nlm.nih.gov/33419730/

  Purpose: To estimate the minimum incidence of congenital Zika syndrome (CZS) and severe microcephaly in Canada and describe key clinical, epidemiological, aetiological and outcome features of these conditions. […] Two separate national surveillance studies were conducted on CZS and severe microcephaly using the well-established Canadian Paediatric Surveillance Program from 2016 to 2019. Over 2700 paediatricians across Canada were surveyed monthly and asked to report demographic details, pregnancy and travel history, infant anthropometry, clinical features and laboratory findings of newly identified cases. Reports were reviewed to assign an underlying aetiology of severe microcephaly. Incidence rates were estimated using monthly live birth denominators. […] Thirty-four infants met the case definition for severe microcephaly and 5 met the case definition for CZS. The associated minimum incidence rates were 4.5 per 100 000 live births for severe microcephaly and 0.1-0.5 per 100 000 live births for CZS. […] Severe microcephaly and CZS are both rare in Canada. Minimum incidence rates can be used as a baseline against which novel or re-emergent causes of severe microcephaly or CZS can be compared.

• #5 Population surveillance for microcephaly | The BMJ

  https://www.bmj.com/content/354/bmj.i4815

  Surveillance is an essential part of the response to Zika and must be improved. […] While we wait for a comprehensive understanding of the phenotypic expression of exposure, considerable activity has focused on the baseline prevalence of central nervous system anomalies, particularly microcephaly. […] The authors conclude that shortcomings in surveillance coupled with the rarity of microcephaly mean that changes in prevalence potentially due to the Zika virus could be missed. […] The EUROCAT study reports a relatively low background prevalence of microcephaly in Europe. […] Yet there was considerable variability across the 24 participating registries. […] Ironically, the National Birth Defects Prevention Network (NBDPN) in the US made the decision to discontinue annual reporting of microcephaly by state beginning with 2007-11 because of extreme variability in state level prevalence reports, and microcephaly was not included among the conditions in the most recent report of US national prevalence estimates.

• #6 Population-Based Microcephaly Surveillance in the United States, 2009 to 2013: An Analysis of Potential Sources of Variation

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5485911/

  The pooled estimated prevalence of microcephaly from 2009 to 2013 among 30 population-based birth defects surveillance programs in the United States was 8.7 per 10,000 live births. […] The data in this report demonstrate several factors that could contribute to the observed variation in the prevalence of microcephaly across U.S. birth defects surveillance programs. […] The estimated prevalence of microcephaly in these data also varied by maternal race/ethnicity, maternal age, and plurality. […] The recent spread of Zika virus highlights the critical role that birth defects surveillance programs can play in response to an emerging epidemic or other public health threat affecting mothers and infants.

• #6 SciELO Brazil – Microcephaly and Zika virus: a clinical and epidemiological analysis of the current outbreak in Brazil^, Microcephaly and Zika virus: a clinical and epidemiological analysis of the current outbreak in Brazilhttps://www.scielo.br/j/jped/a/gRtvM6zDPbj9HJsctGvTHqb/

  On January 20, 2016, the Brazilian Ministry of Health issued an epidemiological report with some relevant and interesting changes, such as changing the name Surveillance and Response Protocol to the Occurrence of Microcephaly related to ZikaV infection to Surveillance and Response Protocol to the Occurrence of Microcephaly, regardless of the cause. […] Another epidemiological report on February 2, 2016 was issued with a cumulative total (2015-2016) of 4783 reported cases of microcephalies and/or other CNS disorders, including possible cases related to ZikaV and other infections. […] The Brazilian Medical Genetics Society-Zika embryopathy Task Force indicates four case report limitations. First, a previous underreporting of actual cases of microcephalies in Brazil and the fact that the notification protocol itself may have favored the increase of reported cases. […] In conclusion, there is a clear temporal association between the increased reporting of cases of microcephaly and the ZikaV epidemic, mainly in the Northeast of Brazil.

• #7 Population surveillance for microcephaly | The BMJ

  https://www.bmj.com/content/354/bmj.i4815

  Surveillance is an essential part of the response to Zika and must be improved. […] While we wait for a comprehensive understanding of the phenotypic expression of exposure, considerable activity has focused on the baseline prevalence of central nervous system anomalies, particularly microcephaly. […] The authors conclude that shortcomings in surveillance coupled with the rarity of microcephaly mean that changes in prevalence potentially due to the Zika virus could be missed. […] The EUROCAT study reports a relatively low background prevalence of microcephaly in Europe. […] Yet there was considerable variability across the 24 participating registries. […] Ironically, the National Birth Defects Prevention Network (NBDPN) in the US made the decision to discontinue annual reporting of microcephaly by state beginning with 2007-11 because of extreme variability in state level prevalence reports, and microcephaly was not included among the conditions in the most recent report of US national prevalence estimates.

• #7 Preliminary Report of Microcephaly Potentially Associated with Zika Virus Infection During Pregnancy — Colombia, January–November 2016 | MMWR

  http://med.iiab.me/modules/en-cdc/www.cdc.gov/mmwr/volumes/65/wr/mm6549e1.htm_s_cid=mm6549e1_w

  Zika virus infection during pregnancy can cause microcephaly and serious brain abnormalities in fetuses and infants exposed in utero. […] Colombia’s Instituto Nacional de Salud maintains national surveillance for birth defects, including microcephaly. […] This report provides preliminary national birth defects surveillance data on congenital microcephaly following a large outbreak of Zika virus infection in Colombia. Microcephaly prevalence increased more than fourfold overall in 2016 compared with 2015, with a ninefold increase in July 2016 (the peak month) compared with July 2015. […] Ongoing population-based birth defects surveillance is essential for monitoring the impact of Zika virus infection during pregnancy on birth defects prevalence and measuring the success in preventing Zika virus infection and its consequences, including microcephaly.

• #8 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Microcephaly-Epidemiology.aspx

  Microcephaly is still a rare condition worldwide although there have been surges in the numbers of cases in specific countries. Globally, 1 in every 30,000 to 250,000 babies has microcephaly at birth. In the United States, this is about 2 per 10,000 to 12 per 10,000 of live births. In the UK, there are 1.02 cases of microcephaly per 10,000 births. […] There has been a recent surge of microcephaly cases in some countries. On average, the state of Pernambuco in northeast Brazil reports about 10 cases of microcephaly a year. However, from the beginning of January 2015 to November 2015, 141 cases were reported in 44 of its 185 municipalities. Similarly, Rio Grande de Norte saw an uncharacteristic rise in microcephaly from August 2015 to 16 November 2015 with 35 cases reported. This compares to an average of 163 cases with a standard deviation of 16.9 every year nationwide between 2010 and 2014.

• #8 Microcephaly | MedLink Neurology

  https://www.medlink.com/articles/microcephaly

  Incidence varies among populations, but in searching birth defect registries throughout the world, it has been described as between 1.3 to 150 per 100,000 live births. […] The prevalence of microcephaly in Europe in a population-based study was 1.53 per 10,000 live births. […] An Australian population-based birth defects registry showed a prevalence of microcephaly of 5.5 per 10,000 live births. […] A United States population-based microcephaly surveillance revealed a prevalence of 8.7 per 10,000 live births. […] Before evidence of Zika virus infections, birth defects surveillance programs in New York State reported a prevalence of microcephaly of 7.5 per 10,000 live births and the prevalence of severe congenital microcephaly of 4.2 per 10,000 live births. […] If head circumference had a normal distribution within the population, 2.3% of children would meet the criteria for microcephaly using the definition of two standard deviations below the mean.

• #9 Population-based microcephaly surveillance in the United States, 2009 to 2013 | RTI

  https://www.rti.org/publication/population-based-microcephaly-surveillance-united-states-2009-2013-analysis-potential-sources-variat

  Background: Congenital microcephaly has been linked to maternal Zika virus infection. […] The pooled prevalence of microcephaly was 8.7 per 10,000 live births. […] Median prevalence (per 10,000 live births) was similar among programs using active (6.7) and passive (6.6) methods; the interdecile range of prevalence estimates was wider among programs using passive methods for all race/ethnicity categories except Hispanic. […] Prevalence (per 10,000 live births) was lowest among non-Hispanic Whites (6.5) and highest among non-Hispanic Blacks and Hispanics (11.2 and 11.9, respectively); estimates followed a U-shaped distribution by maternal age with the highest prevalence among mothers.

• #9

  https://he02.tci-thaijo.org/index.php/OSIR/article/view/262958

  Microcephaly became of high concern after Zika outbreaks occurred worldwide. An estimation of its prevalence is crucial for public health preparedness and response. The objectives of this study were to estimate the prevalence of neonatal microcephaly in Thailand during 2014-2018, describe its epidemiological characteristics, and identify associated factors. This study was a cross-sectional study using data from the Health Data Center, Ministry of Public Health, Thailand. During 2014-2018, 121,448 newborns were identified and the prevalence of neonatal microcephaly was 14.5%. Multivariate analysis showed that small for gestational age (adjusted odds ratio (Adjusted OR) 5.34, 95% confidence interval (CI) 3.24, 8.81), birth length less than the 10th percentile (Adjusted OR 2.92, 95% CI 1.36, 6.29), elderly pregnancy (Adjusted OR 1.84, 95% CI 1.07, 3.18), and primigravida (Adjusted OR 2.01, 95% CI 1.37, 2.95) were significantly associated with neonatal microcephaly. The prevalence of neonatal microcephaly in Thailand was higher than expected. […] The international head circumference chart may not be suitable for Thai newborns suggesting that a head circumference growth standard for Thai newborns is needed.

• #10 Population-based microcephaly surveillance in the United States, 2009 to 2013 | RTI

  https://www.rti.org/publication/population-based-microcephaly-surveillance-united-states-2009-2013-analysis-potential-sources-variat

  Background: Congenital microcephaly has been linked to maternal Zika virus infection. […] The pooled prevalence of microcephaly was 8.7 per 10,000 live births. […] Median prevalence (per 10,000 live births) was similar among programs using active (6.7) and passive (6.6) methods; the interdecile range of prevalence estimates was wider among programs using passive methods for all race/ethnicity categories except Hispanic. […] Prevalence (per 10,000 live births) was lowest among non-Hispanic Whites (6.5) and highest among non-Hispanic Blacks and Hispanics (11.2 and 11.9, respectively); estimates followed a U-shaped distribution by maternal age with the highest prevalence among mothers.

• #11 Prevalence of congenital microcephaly and its risk factors in an area at risk of Zika outbreaks | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-03705-9

  This multi-center study found that the prevalence of microcephaly was 0.33%, which is higher than the expected risk of 0.13% in a population with normally distributed HC and using a definition of HC Z score smaller than 3. Microcephaly was associated with maternal HBV carrier status, primiparity, FGR, and preterm birth, which together contributed to two-thirds of the risk of microcephaly. […] This study is the first to report the association between maternal HBV carrier status and a higher risk of microcephaly.

• #12 Population-Based Microcephaly Surveillance in the United States, 2009 to 2013: An Analysis of Potential Sources of Variation

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5485911/

  The pooled prevalence of microcephaly was 8.7 per 10,000 live births. […] Differences in methods, population distribution of maternal/infant characteristics, and case definitions for microcephaly can contribute to the wide range of observed prevalence estimates across individual birth defects surveillance programs. […] The purpose of this report is to describe the estimated prevalence of microcephaly in the United States from 2009 to 2013 using data from thirty population-based birth defects surveillance programs and to explore potential reasons for some of the observed variation in prevalence. […] Microcephaly surveillance is particularly challenging when programs use different methods in terms of the settings where cases are identified and the maximum age at which affected children are ascertained.

• #13 Population-Based Microcephaly Surveillance in the United States, 2009 to 2013: An Analysis of Potential Sources of Variation

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5485911/

  The pooled prevalence of microcephaly was 8.7 per 10,000 live births. […] Differences in methods, population distribution of maternal/infant characteristics, and case definitions for microcephaly can contribute to the wide range of observed prevalence estimates across individual birth defects surveillance programs. […] The purpose of this report is to describe the estimated prevalence of microcephaly in the United States from 2009 to 2013 using data from thirty population-based birth defects surveillance programs and to explore potential reasons for some of the observed variation in prevalence. […] Microcephaly surveillance is particularly challenging when programs use different methods in terms of the settings where cases are identified and the maximum age at which affected children are ascertained.

• #14 Population-based Microcephaly Surveillance in the United States, 2009 to 2013: An Analysis of Potential Sources of Variation

  https://digitalcommons.usf.edu/cfh_facpub/59/

  Background: Congenital microcephaly has been linked to maternal Zika virus infection. However, ascertaining infants diagnosed with microcephaly can be challenging. […] Methods: Thirty birth defects surveillance programs provided data on infants diagnosed with microcephaly born 2009 to 2013. The pooled prevalence of microcephaly per 10,000 live births was estimated overall and by maternal/infant characteristics. Variation in prevalence was examined across case finding methods. Nine programs provided data on head circumference and conditions potentially contributing to microcephaly. […] Results: The pooled prevalence of microcephaly was 8.7 per 10,000 live births. […] Conclusion: Differences in methods, population distribution of maternal/infant characteristics, and case definitions for microcephaly can contribute to the wide range of observed prevalence estimates across individual birth defects surveillance programs. Addressing these factors in the setting of Zika virus infection can improve the quality of prevalence estimates.

• #15 Microcephaly – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/microcephaly

  Microcephaly is a rare condition. One baby in several thousand is born with microcephaly. The most reliable way to assess whether a baby has microcephaly is to measure head circumference 24 hours after birth, compare the value with WHO growth standards, and continue to measure the rate of head growth in early infancy. PAHO/WHO calls on countries to strengthen surveillance of birth defects, including microcephaly […] PAHO/WHO calls on countries to strengthen surveillance of birth defects, including microcephaly.

• #16 Guangzhou Surveillance and Clinical Study in Microcephaly (GSCSM) | Clinical Research Trial Listing

  https://www.centerwatch.com/clinical-trials/listings/NCT03651687/guangzhou-surveillance-and-clinical-study-in-microcephaly-gscsm

  Screening for microcephaly is important at birth and during early childhood. The Guangzhou Surveillance and Clinical Study in Microcephaly (GSCSM) aims to establish a multicentric surveillance system for microcephaly in newborns and infants, to develop a new head circumference reference and microcephaly criteria basing on the local population in Guangzhou, to improve the prediction model of microcephaly, and to follow up the outcomes of the children diagnosed with microcephaly. […] Microcephaly is associated with neurological dysfunctions in infants and children. There is not a uniform diagnostic criteria for microcephaly. The World Health Organization (WHO) recommended a criteria of head circumference (HC) less than 2 standard deviations (SD) below the mean of the Intergrowth-21 standard, which was found not applicable to the newborns and infants in Guangzhou. In the GSCSM, the HC measures of newborns are conducted by trained midwives using a standard tool, and extensive information including adverse perinatal outcomes are collected. Longitudinal follow up of infants’ neurodevelopment in cognitive, motor, emotional and other domains are also to be conducted. The GSCSM intends to find out the infants who are 'real microcephaly’ and most at risk of short-term or long-term adverse outcomes in Guangzhou.

• #17 Measurement of Head Circumference: Implications for Microcephaly Surveillance in Zika-Affected Areas

  https://www.mdpi.com/2414-6366/6/1/5

  Microcephaly at birth was defined as HC more than 2SD below the mean, more than 3SD below the mean (severe microcephaly), or below the 3rd percentile for sex and gestational age. […] In this study, training and use of insertion tapes had little effect on digit preference, nor were overall HC curves sufficient to detect an increase in microcephaly during the Zika epidemic in Honduras. […] We conclude that researchers may want to interpret HC data with caution. Under circumstances when microcephaly prevalence needs to be carefully analyzed and trends determined, such as the Zika epidemic, researchers might consider developing and evaluating new measurement methods.

• #18 Measurement of Head Circumference: Implications for Microcephaly Surveillance in Zika-Affected Areas

  https://www.mdpi.com/2414-6366/6/1/5

  Worldwide recognition of the Zika virus outbreak in the Americas was triggered by an unexplained increase in the frequency of microcephaly. […] The major indicator that Zika virus (ZIKV) infection during pregnancy was affecting fetal brain development was an increase in microcephaly. […] Population estimates of microcephaly were between 0.3 and 12 per 10,000 prior to the Zika epidemic, and in areas unaffected by Zika, substantially below the 15–300 per 10,000 that would be expected mathematically. […] Accurate measurement of HC is challenging. […] Surveillance for microcephaly, generally or to assess trends in Zika-related illness, therefore becomes difficult. […] In this analysis, we examine HC measured values and digit preference in those values, and, by extension, the prevalence of microcephaly at birth in two groups.

• #19 Measurement of Head Circumference: Implications for Microcephaly Surveillance in Zika-Affected Areas

  https://www.mdpi.com/2414-6366/6/1/5

  Microcephaly at birth was defined as HC more than 2SD below the mean, more than 3SD below the mean (severe microcephaly), or below the 3rd percentile for sex and gestational age. […] In this study, training and use of insertion tapes had little effect on digit preference, nor were overall HC curves sufficient to detect an increase in microcephaly during the Zika epidemic in Honduras. […] We conclude that researchers may want to interpret HC data with caution. Under circumstances when microcephaly prevalence needs to be carefully analyzed and trends determined, such as the Zika epidemic, researchers might consider developing and evaluating new measurement methods.

• #20 Evaluation of a health information exchange system for microcephaly case-finding — New York City, 2013—2015 | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237392

  Birth defects surveillance in the United States is conducted principally by review of routine but lagged reporting to statewide congenital malformations registries of diagnoses by hospitals or other health care providers, a process that is not designed to rapidly detect changes in prevalence. […] Health information exchange (HIE) systems are well suited for rapid surveillance, but information is limited about their effectiveness at detecting birth defects. […] We evaluated HIE data to detect microcephaly diagnosed at birth during January 1, 2013December 31, 2015 before known introduction of Zika virus in North America. […] Despite limitations, HIE systems could be used for rapid newborn microcephaly surveillance, especially in the many jurisdictions where more labor-intensive approaches are not feasible.

• #21 Evaluation of a health information exchange system for microcephaly case-finding — New York City, 2013—2015 | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237392

  Birth defects surveillance in the United States is conducted principally by review of routine but lagged reporting to statewide congenital malformations registries of diagnoses by hospitals or other health care providers, a process that is not designed to rapidly detect changes in prevalence. […] Health information exchange (HIE) systems are well suited for rapid surveillance, but information is limited about their effectiveness at detecting birth defects. […] We evaluated HIE data to detect microcephaly diagnosed at birth during January 1, 2013December 31, 2015 before known introduction of Zika virus in North America. […] Despite limitations, HIE systems could be used for rapid newborn microcephaly surveillance, especially in the many jurisdictions where more labor-intensive approaches are not feasible.

• #22 Surveillance unlikely to detect European changes in birth defect linked to Zika virus | ScienceDaily

  https://www.sciencedaily.com/releases/2016/09/160916103944.htm

  The researchers found that the reported prevalence of microcephaly across Europe varied considerably, due to the different diagnostic criteria applied and varying levels of ascertainment. […] The prevalence of microcephaly in Europe would need to increase by over 35% in one year or by over 300% in a single registry to be identified as a statistically significant increase. […] In a linked editorial, Dr Russell Kirby at the University of South Florida says that surveillance is an essential part of the response to Zika and must be improved. […] While birth defects registries perform a vital population health function, registers of pregnancies affected by Zika virus with long term follow-up of both mother and child „must be set up urgently to fully understand the natural history of the Zika syndrome and its impact on child growth and development,” he concludes.

• #23 Surveillance unlikely to detect European changes in birth defect linked to Zika virus | ScienceDaily

  https://www.sciencedaily.com/releases/2016/09/160916103944.htm

  The researchers found that the reported prevalence of microcephaly across Europe varied considerably, due to the different diagnostic criteria applied and varying levels of ascertainment. […] The prevalence of microcephaly in Europe would need to increase by over 35% in one year or by over 300% in a single registry to be identified as a statistically significant increase. […] In a linked editorial, Dr Russell Kirby at the University of South Florida says that surveillance is an essential part of the response to Zika and must be improved. […] While birth defects registries perform a vital population health function, registers of pregnancies affected by Zika virus with long term follow-up of both mother and child „must be set up urgently to fully understand the natural history of the Zika syndrome and its impact on child growth and development,” he concludes.

• #24 SciELO Brazil – Microcephaly and Zika virus: a clinical and epidemiological analysis of the current outbreak in Brazil^, Microcephaly and Zika virus: a clinical and epidemiological analysis of the current outbreak in Brazilhttps://www.scielo.br/j/jped/a/gRtvM6zDPbj9HJsctGvTHqb/

  Epidemiological data suggest a temporal association between the increased number of microcephaly notifications in Brazil and outbreak of Zika virus, primarily in the Brazil’s Northeast. […] The observed association between fetal infection by ZikaV and the occurrence of microcephaly at birth has increased the importance of an accurate diagnosis of microcephaly. […] In October 2015, the Brazilian government initiated joint investigations with the state of Pernambuco after observing the increasing number of cases of microcephaly, especially in that state, after confirmation of the alteration in the pattern of microcephaly cases. […] The suspected microcephaly cases must be reported immediately to the health authorities and registered at the Public Health Event Registration Form (Registro de Eventos de Saúde Pública [RESP] Microcephalies).

• #25 SciELO Brazil – Microcephaly and Zika virus: a clinical and epidemiological analysis of the current outbreak in Brazil^, Microcephaly and Zika virus: a clinical and epidemiological analysis of the current outbreak in Brazilhttps://www.scielo.br/j/jped/a/gRtvM6zDPbj9HJsctGvTHqb/

  Epidemiological data suggest a temporal association between the increased number of microcephaly notifications in Brazil and outbreak of Zika virus, primarily in the Brazil’s Northeast. […] The observed association between fetal infection by ZikaV and the occurrence of microcephaly at birth has increased the importance of an accurate diagnosis of microcephaly. […] In October 2015, the Brazilian government initiated joint investigations with the state of Pernambuco after observing the increasing number of cases of microcephaly, especially in that state, after confirmation of the alteration in the pattern of microcephaly cases. […] The suspected microcephaly cases must be reported immediately to the health authorities and registered at the Public Health Event Registration Form (Registro de Eventos de Saúde Pública [RESP] Microcephalies).

• #26 The association between Zika virus infection and microcephaly in Brazil 2015–2017: An observational analysis of over 4 million births | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002755

  In 2015, high rates of microcephaly were reported in Northeast Brazil following the first South American Zika virus (ZIKV) outbreak. […] We found no evidence for alternative non-ZIKV causes of the 2015-2017 microcephaly outbreak, nor that concurrent exposure to arbovirus infection or vaccination modified risk. […] This study strengthens the evidence that congenital ZIKV infection, particularly in the first 2 trimesters of pregnancy, is associated with microcephaly and less frequently with other birth defects. […] Women infected with Zika virus early in pregnancy were 17 times (95% confidence interval 3-69) more likely to have a child with microcephaly. […] These findings add to the growing evidence that Zika infection early in pregnancy has a generalisable association with microcephaly and, to a lesser extent, a range of other birth defects.

• #27 The association between Zika virus infection and microcephaly in Brazil 2015–2017: An observational analysis of over 4 million births | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002755

  In 2015, high rates of microcephaly were reported in Northeast Brazil following the first South American Zika virus (ZIKV) outbreak. […] We found no evidence for alternative non-ZIKV causes of the 2015-2017 microcephaly outbreak, nor that concurrent exposure to arbovirus infection or vaccination modified risk. […] This study strengthens the evidence that congenital ZIKV infection, particularly in the first 2 trimesters of pregnancy, is associated with microcephaly and less frequently with other birth defects. […] Women infected with Zika virus early in pregnancy were 17 times (95% confidence interval 3-69) more likely to have a child with microcephaly. […] These findings add to the growing evidence that Zika infection early in pregnancy has a generalisable association with microcephaly and, to a lesser extent, a range of other birth defects.

• #28

  https://www.who.int/publications/i/item/WHO-ZIKV-SUR-16.2-Rev.1

  This document provides interim WHO recommendations for the surveillance of Zika virus and potentially related complications. […] It has been developed in consideration of the declaration on 1 February 2016 by the WHO Director-General of a Public Health Emergency of International Concern with regard to clusters of microcephaly and neurological disorders potentially associated with Zika virus. […] This document provides interim recommendations for the surveillance of Zika virus infection, microcephaly and Guillain-Barr syndrome, in four different contexts and describes reporting requirements to WHO.

• #29 SciELO Brazil – Epidemia de microcefalia e vírus Zika: a construção do conhecimento em epidemiologia Epidemia de microcefalia e vírus Zika: a construção do conhecimento em epidemiologia

  https://www.scielo.br/j/csp/a/qxpH3vtWSnHV5WfCBGGGfyd/?lang=en

  In August 2015, pediatric neurologists at public hospitals in Recife, Pernambuco State, Brazil, observed an increase in the number of disproportional microcephaly cases associated with other congenital anomalies. […] The Brazilian Ministry of Health declared a national public health emergency, followed by the declaration of a Public Health Emergency of International Concern by the World Health Organization. […] The first case-control study demonstrated a strong association between microcephaly and congenital ZIKV infection. […] The knowledge built with the epidemiological paradigm was supported by the scientific community, thereby establishing the consensus for a causal relationship between ZIKV and the microcephaly epidemic. […] An epidemic is defined as the occurrence of cases of a disease, specific behaviors, or other health-related events that are clearly above normally expected levels for a given community or region.

• #30 SciELO Brazil – Epidemia de microcefalia e vírus Zika: a construção do conhecimento em epidemiologia Epidemia de microcefalia e vírus Zika: a construção do conhecimento em epidemiologia

  https://www.scielo.br/j/csp/a/qxpH3vtWSnHV5WfCBGGGfyd/?lang=en

  In August 2015, pediatric neurologists at public hospitals in Recife, Pernambuco State, Brazil, observed an increase in the number of disproportional microcephaly cases associated with other congenital anomalies. […] The Brazilian Ministry of Health declared a national public health emergency, followed by the declaration of a Public Health Emergency of International Concern by the World Health Organization. […] The first case-control study demonstrated a strong association between microcephaly and congenital ZIKV infection. […] The knowledge built with the epidemiological paradigm was supported by the scientific community, thereby establishing the consensus for a causal relationship between ZIKV and the microcephaly epidemic. […] An epidemic is defined as the occurrence of cases of a disease, specific behaviors, or other health-related events that are clearly above normally expected levels for a given community or region.

• #31 The association between Zika virus infection and microcephaly in Brazil 2015–2017: An observational analysis of over 4 million births | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002755

  In 2015, high rates of microcephaly were reported in Northeast Brazil following the first South American Zika virus (ZIKV) outbreak. […] We found no evidence for alternative non-ZIKV causes of the 2015-2017 microcephaly outbreak, nor that concurrent exposure to arbovirus infection or vaccination modified risk. […] This study strengthens the evidence that congenital ZIKV infection, particularly in the first 2 trimesters of pregnancy, is associated with microcephaly and less frequently with other birth defects. […] Women infected with Zika virus early in pregnancy were 17 times (95% confidence interval 3-69) more likely to have a child with microcephaly. […] These findings add to the growing evidence that Zika infection early in pregnancy has a generalisable association with microcephaly and, to a lesser extent, a range of other birth defects.

• #32 The association between Zika virus infection and microcephaly in Brazil 2015–2017: An observational analysis of over 4 million births | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002755

  The finding of no alternative causes for geographic differences in microcephaly rate leads us to hypothesize that the Northeast region was disproportionately affected by this Zika outbreak, with 94% of an estimated 8.5 million total cases occurring in this region. […] We found that ZIKV infection preconception (up to 10 weeks) may also confer elevated risk, but at a lower level than infection in trimester 1 or 2. […] The observational nature of the analysis also means it may be subject to unmeasured confounding, especially given the multiple causes of microcephaly. […] We found that risk of MWSD was highest when ZIKV infection occurred in the first 2 trimesters of pregnancy. […] This study adds further evidence that ZIKV infection in the early stages of pregnancy is associated with an elevated risk of microcephaly, with relative risk 16.80 (95% CI 3.21-69.10).

• #33 Study bolsters Zika-microcephaly link, rules out others | CIDRAP

  https://www.cidrap.umn.edu/zika/study-bolsters-zika-microcephaly-link-rules-out-others

  A new Brazilian study adds further evidence to the link between Zika and microcephaly while ruling out for the first time an association between microcephaly and an important insecticide and between the condition and vaccines. […] In the new report, the authors highlight several birth conditions tied to Zika, most notably microcephaly. They found that 32 of the 91 cases (35%) involved a lab-confirmed Zika infection, compared with none in the control group. This translated to about a 73-times-higher risk of microcephaly in babies who had a Zika infection. […] The authors also reported that 99 (57%) of the 173 mothers of control infants tested positive for Zika antibodies in their blood. That finding suggests that a high prevalence of Zika infection in northeast Brazil in early 2015 could have contributed to the subsequent rise in microcephaly, according to the commentary authors, two Brazilian experts who were not involved in the study.

• #34 Population-based surveillance for congenital zika virus syndrome: a latent class analysis of recorded cases from 2015–2018 | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-022-04860-3

  This study aims to describe clinical findings and determine the medium-term survival of congenital zika syndrome (CZS) suspected cases. […] We followed 11,850 suspected cases of CZS, of which 28.3% were confirmed, 9.3% inconclusive and 62.4% unconfirmed. Confirmed cases had almost two times higher mortality when compared with unconfirmed cases. […] Abnormal imaging and head circumference appear to be the main drivers of the increased mortality among suspected cases of CZS. […] After a cluster of microcephaly cases was first reported in Northeast Brazil in 2015, a causal relationship with Zika virus (ZIKV) was suspected, and the Brazilian Ministry of Health used the Public Health Events Register (RESP) to record data on all suspected cases of this new condition, later called Congenital Zika Syndrome (CZS).

• #35 Population-based surveillance for congenital zika virus syndrome: a latent class analysis of recorded cases from 2015–2018 | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-022-04860-3

  Recorded suspected cases were thus later classified as (a) Confirmed cases due to aetiological identification (laboratory confirmation for ZIKV in a molecular or serological test of a sample from the mother, fetus, or newborn) or imaging and clinical examination. […] The classification of suspected cases relied initially on clinical observation and imaging. […] This study is based on national data on all suspected Congenital Zika Syndrome cases in Brazil from 2015-2018. […] We hypothesise that unconfirmed cases with abnormal anthropometric measures at birth and abnormal imaging findings have an increased risk of death, either because they are cases of atypical CZS or because they have other severe pathologies. […] We included all suspected cases of CZS with a complete epidemiological investigation and excluded cases that did not link with a birth registry from the SINASC.

• #36 Spatiotemporal Analysis of the Population Risk of Congenital Microcephaly in Pernambuco State, Brazil

  https://www.mdpi.com/1660-4601/17/3/700

  Since an outbreak in Brazil, which started in 2015, Zika has been recognized as an important cause of microcephaly. The prevalence of congenital microcephaly in Pernambuco state was estimated from the RESP (Registro de Eventos em Saúde Pública) surveillance system, from August 2015 to August 2016 inclusive. Microcephaly was defined as a neonatal head circumference below the 3rd percentile of the Intergrowth standards. In November 2015, an epidemic of congenital microcephaly, associated with the Zika virus, was declared a Public Health Emergency of National Importance by the Brazilian Ministry of Health. The Centers for Disease Control and Prevention of the USA has concluded that ‘There is now scientific consensus that Zika virus infection during pregnancy is a cause of microcephaly’. In October 2015, the State Secretariat of Health in Pernambuco launched the first online registry to report microcephaly and STORCH due to the excess of these events at a state level. This initiative was followed in November 2015 by a national-level system with an electronic database for the notification of cases and deaths with suspected relation to Zika infection: RESP (Registro de Eventos em Saúde Pública or Public Health Events Registry). The analysis included 742 cases, which were selected as shown in Figure 2. These results show that the outbreak of microcephaly in Pernambuco state, as reported in the RESP surveillance system, was not only concentrated in the coastal Recife Metropolitan Area. The current analysis shows that prevalence peaked early as well as high in this inland region. This study emphasizes the burden of microcephaly during the outbreak in Pernambuco, with estimates higher than in some previous studies, and with high risk in an inland region of the state for reasons which are yet to be clarified. […] The descriptive methodology of the current paper for the spatial and temporal distribution of the microcephaly cases does not include the evaluation of the association with congenital Zika infection, and doing so would require another set of statistical methods.

• #37 Preliminary Report of Microcephaly Potentially Associated with Zika Virus Infection During Pregnancy — Colombia, January–November 2016 | MMWR

  http://med.iiab.me/modules/en-cdc/www.cdc.gov/mmwr/volumes/65/wr/mm6549e1.htm_s_cid=mm6549e1_w

  Colombia’s Instituto Nacional de Salud (INS) maintains national surveillance for birth defects, including microcephaly and other central nervous system defects. […] The temporal association between reported Zika virus infections and the occurrence of microcephaly, with the peak number of reported microcephaly cases occurring approximately 24 weeks after the peak of the Zika virus disease outbreak, provides evidence suggesting that the period of highest risk is during the first trimester of pregnancy and early in the second trimester of pregnancy. […] Ongoing population-based birth defects surveillance provides critical data for monitoring the impact of teratogens, including Zika virus infection, and will be an essential tool to evaluate success in preventing microcephaly and congenital Zika syndrome.

• #38 Microcephaly case series points to need for expanded Zika screening | CIDRAP

  https://www.cidrap.umn.edu/zika/microcephaly-case-series-points-need-expanded-zika-screening

  Microcephaly screening for Zika complications in newborns might miss some birth defects, according to a long-awaited analysis of the first 1,500 suspected cases in Brazil, which revealed instances of brain damage in babies with normal head circumference, a team from Brazil reported yesterday. […] In the largest case series to date, published in The Lancet, researchers from Brazil said screening criteria should be adjusted to include signs and symptoms of brain abnormalities. […] In the surveillance study, the researchers analyzed investigations completed as of Feb 27 by medical teams of 1,501 live-born babies with suspected microcephaly. […] The analysis also revealed brain abnormalities in babies with normal head size who were born to mothers who had a Zika-like rash in late pregnancy.

• #39 Microcephaly case series points to need for expanded Zika screening | CIDRAP

  https://www.cidrap.umn.edu/zika/microcephaly-case-series-points-need-expanded-zika-screening

  Microcephaly screening for Zika complications in newborns might miss some birth defects, according to a long-awaited analysis of the first 1,500 suspected cases in Brazil, which revealed instances of brain damage in babies with normal head circumference, a team from Brazil reported yesterday. […] In the largest case series to date, published in The Lancet, researchers from Brazil said screening criteria should be adjusted to include signs and symptoms of brain abnormalities. […] In the surveillance study, the researchers analyzed investigations completed as of Feb 27 by medical teams of 1,501 live-born babies with suspected microcephaly. […] The analysis also revealed brain abnormalities in babies with normal head size who were born to mothers who had a Zika-like rash in late pregnancy.

• #40 Microcephaly case series points to need for expanded Zika screening | CIDRAP

  https://www.cidrap.umn.edu/zika/microcephaly-case-series-points-need-expanded-zika-screening

  Examination of all newborns during epidemic waves should be considered, Victora said, and he warned that because southern Brazil experienced a wave of Zika in early 2016, the country could see a second spike in microcephaly at the end of the year. […] The authors said the mechanism that causes the birth defects still isn’t clear, but it is probably related to the virus attacking the nervous system, resulting in brain damage and muscle impairment. […] They said more detailed pathology studies are needed to identify the full spectrum of Zika virus infection and to confirm the link to perinatal complications.

• #41 On the temporal association of outbreaks of Zika virus infection, newborn microcephaly, and Guillain-Barré syndrome – Bautista – Journal of Public Health and Emergency

  https://jphe.amegroups.org/article/view/4037/4870

  The reports discussed exemplify the use of surveillance data to formulate causal link hypotheses and to guide health policies in a context of uncertainty. However, they also call attention to the need for caution in both instances. Surveillance data are usually not collected for the purpose of identifying causal links. In consequence, the potential for information, selection, confounding, and confirmation biases is exacerbated when surveillance data is used for this purpose. […] In summary, CPGM and ICM reports do not support the occurrence of microcephaly outbreaks in these populations or that the apparent outbreaks were linked to ZIKV infection outbreaks.

• #42 Zika virus in Brazil and microcephaly: the importance of neglected tropical disease surveillance and control – Somatosphere

  https://somatosphere.com/forumpost/zika-virus-in-brazil-and-microcephaly-the-importance-of-neglected-tropical-disease-surveillance-and-control/

  In this piece, I focus on Brazil, and in particular, the country’s socio-economic context, public health infrastructure, and its experience of the Zika virus epidemic to date. […] Brazil has had a rampant dengue epidemic since the 1980s. […] Nine months later, medical professionals in the state of Pernambuco reported an increase in the number of newborns with microcephaly, using the Brazilian system of newborn notification. […] The existence of the newborn notification system was the primary reason why Brazil was the first country to detect instances of microcephaly. […] Therefore, temporal-spatial distribution is one method by which people are drawing the epidemiological relationship between microcephaly and the Zika virus. […] The increased number and pattern of distribution of microcephaly cases were also compatible with the locations where Zika was circulating. […] Further support came when French Polynesia subsequently reported cases of Zika-induced microcephaly to the WHO.

• #43 Prevalence and Clinical Attributes of Congenital Microcephaly — New York, 2013–2015 | MMWR

  https://www.cdc.gov/mmwr/volumes/66/wr/mm6605a1.htm

  During 2013-2015, before documentation of widespread introduction of imported Zika virus infection in the continental United States, the prevalence of severe congenital microcephaly in New York was 4.2 per 10,000 live births. […] Administrative data can enhance microcephaly case finding for birth defects surveillance programs. […] A baseline prevalence estimate of severe congenital microcephaly can enable estimation of risk attributable to Zika virus infection. […] During 2013-2015, the overall prevalence of microcephaly in New York was 7.4 per 10,000 live births, and the prevalence of severe congenital microcephaly was 4.2 per 10,000 live births, with elevated prevalence of severe congenital microcephaly noted in Western New York (7.2) and Finger Lakes (5.9) health service areas. […] The findings in this report highlight the value of confirmation of severe congenital microcephaly using anthropometric measurements to apply the NBDPN case definitions.

• #44 Prevalence and Clinical Attributes of Congenital Microcephaly — New York, 2013–2015 | MMWR

  https://www.cdc.gov/mmwr/volumes/66/wr/mm6605a1.htm

  Use of administrative discharge data can enhance case finding for birth defects surveillance, although it is not yet available in many states and, when available, is not always utilized. […] The 2013-2015 New York prevalence estimate of severe congenital microcephaly will enable comparison with future severe congenital microcephaly prevalence estimates and estimation of attributable risk after Zika virus importation.

• #45 Incidence, aetiology and neurodisability associated with severe microcephaly: a national surveillance study | Archives of Disease in Childhood

  https://adc.bmj.com/content/108/3/211

  Objective To determine the incidence, causes and neurodevelopmental impact of severe microcephaly (head circumference 3SD) up to age 2 years. […] Design Binational active paediatric surveillance study undertaken in 20172018 to identify and characterise new diagnoses of severe microcephaly. […] Main outcome measures Incidence, aetiology and neurodevelopmental outcomes at age 2years. […] Incidence of severe microcephaly was 5.5 per 100 000 infants (95% CI 4.0 to 7.3). […] Although severe microcephaly is uncommon, it is associated with high mortality, complex multimorbidity and neurodisability, thus representing a significant ongoing burden for families and healthcare services. […] Clinical guidelines are essential to standardise aetiological investigation and optimise multidisciplinary management.

• #46 Incidence, aetiology and neurodisability associated with severe microcephaly: a national surveillance study | Archives of Disease in Childhood

  https://adc.bmj.com/content/108/3/211

  Objective To determine the incidence, causes and neurodevelopmental impact of severe microcephaly (head circumference 3SD) up to age 2 years. […] Design Binational active paediatric surveillance study undertaken in 20172018 to identify and characterise new diagnoses of severe microcephaly. […] Main outcome measures Incidence, aetiology and neurodevelopmental outcomes at age 2years. […] Incidence of severe microcephaly was 5.5 per 100 000 infants (95% CI 4.0 to 7.3). […] Although severe microcephaly is uncommon, it is associated with high mortality, complex multimorbidity and neurodisability, thus representing a significant ongoing burden for families and healthcare services. […] Clinical guidelines are essential to standardise aetiological investigation and optimise multidisciplinary management.

• #47 Population-Based Microcephaly Surveillance in the United States, 2009 to 2013: An Analysis of Potential Sources of Variation

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5485911/

  The pooled estimated prevalence of microcephaly from 2009 to 2013 among 30 population-based birth defects surveillance programs in the United States was 8.7 per 10,000 live births. […] The data in this report demonstrate several factors that could contribute to the observed variation in the prevalence of microcephaly across U.S. birth defects surveillance programs. […] The estimated prevalence of microcephaly in these data also varied by maternal race/ethnicity, maternal age, and plurality. […] The recent spread of Zika virus highlights the critical role that birth defects surveillance programs can play in response to an emerging epidemic or other public health threat affecting mothers and infants.

• #48 Prevalence and Clinical Attributes of Congenital Microcephaly — New York, 2013–2015 | MMWR

  https://www.cdc.gov/mmwr/volumes/66/wr/mm6605a1.htm

  Use of administrative discharge data can enhance case finding for birth defects surveillance, although it is not yet available in many states and, when available, is not always utilized. […] The 2013-2015 New York prevalence estimate of severe congenital microcephaly will enable comparison with future severe congenital microcephaly prevalence estimates and estimation of attributable risk after Zika virus importation.

• #49 Evaluation of a health information exchange system for microcephaly case-finding — New York City, 2013—2015 | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237392

  These findings suggest that HIE systems could support the continuation of rapid newborn microcephaly surveillance through near real-time monitoring of clinical data without the burden of managing multiple healthcare settings and systems. […] Jurisdictions considering the use of HIE data to monitor trends in microcephaly or Zika-related birth defects more generally will need to evaluate the sensitivity and specificity of HIE reporting relative to cases identified by their current Zika-related Birth Defects Surveillance systems.

• #50 Evaluation of a health information exchange system for microcephaly case-finding — New York City, 2013—2015 | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237392

  These findings suggest that HIE systems could support the continuation of rapid newborn microcephaly surveillance through near real-time monitoring of clinical data without the burden of managing multiple healthcare settings and systems. […] Jurisdictions considering the use of HIE data to monitor trends in microcephaly or Zika-related birth defects more generally will need to evaluate the sensitivity and specificity of HIE reporting relative to cases identified by their current Zika-related Birth Defects Surveillance systems.

• #51 Surveillance unlikely to detect European changes in birth defect linked to Zika virus | ScienceDaily

  https://www.sciencedaily.com/releases/2016/09/160916103944.htm

  The researchers found that the reported prevalence of microcephaly across Europe varied considerably, due to the different diagnostic criteria applied and varying levels of ascertainment. […] The prevalence of microcephaly in Europe would need to increase by over 35% in one year or by over 300% in a single registry to be identified as a statistically significant increase. […] In a linked editorial, Dr Russell Kirby at the University of South Florida says that surveillance is an essential part of the response to Zika and must be improved. […] While birth defects registries perform a vital population health function, registers of pregnancies affected by Zika virus with long term follow-up of both mother and child „must be set up urgently to fully understand the natural history of the Zika syndrome and its impact on child growth and development,” he concludes.

• #52 Microcephaly – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/microcephaly

  Microcephaly is a rare condition. One baby in several thousand is born with microcephaly. The most reliable way to assess whether a baby has microcephaly is to measure head circumference 24 hours after birth, compare the value with WHO growth standards, and continue to measure the rate of head growth in early infancy. PAHO/WHO calls on countries to strengthen surveillance of birth defects, including microcephaly […] PAHO/WHO calls on countries to strengthen surveillance of birth defects, including microcephaly.

• #53

  https://www.who.int/publications/i/item/WHO-ZIKV-SUR-16.2-Rev.1

  This document provides interim WHO recommendations for the surveillance of Zika virus and potentially related complications. […] It has been developed in consideration of the declaration on 1 February 2016 by the WHO Director-General of a Public Health Emergency of International Concern with regard to clusters of microcephaly and neurological disorders potentially associated with Zika virus. […] This document provides interim recommendations for the surveillance of Zika virus infection, microcephaly and Guillain-Barr syndrome, in four different contexts and describes reporting requirements to WHO.

• #54 The Zika virus linked to microcephaly, discovered on the African continent | Department of Biology

  https://www.biology.ox.ac.uk/article/the-zika-virus-linked-to-microcephaly-discovered-on-the-african-continent

  Researchers from the Department of Zoology at the University of Oxford teamed up with the Angolan Ministry of Health to study the introduction and circulation of the Asian genotype of Zika virus in Angola, southwestern Africa. […] Published today in The Lancet Infectious Diseases, they discovered that the Asian genotype of the Zika virus has been circulating in Angola since at least 2016, and is likely linked to an upsurge in microcephaly cases in newborns in the country. […] In 2017 Angola started reporting cases of microcephaly in newborns. […] Researchers from Oxfords and the Instituto Nacional de Investigao em Sade in Luanda followed up on reports of microcephaly cases in Angola, which they suspected could be caused by Zika virus infection in pregnancy. […] By combining molecular testing and genome sequencing to best understand the virus genetic make-up and its epidemiology, they found that the Asian lineage was introduced from Brazil into Angola in 2016, probably by a traveller infected with Zika. This virus then led to the recent upsurge in microcephaly cases in the country.

• #55 The Zika virus linked to microcephaly, discovered on the African continent | University of Oxford

  https://www.ox.ac.uk/news/2019-09-26-zika-virus-linked-microcephaly-discovered-african-continent-0

  Researchers from the University of Oxford teamed up with the Angolan Ministry of Health to study the introduction and circulation of the Asian genotype of Zika virus in Angola, southwestern Africa. […] In 2017 Angola started reporting cases of microcephaly in newborns. […] They found that the Asian genotype of Zika virus is likely linked to an upsurge in microcephaly cases in Angola. […] By carrying our molecular testing and genome sequencing to understand the virus genetic make-up and its epidemiology, we found that the Asian lineage was introduced from Brazil into Angola in 2016, probably by a traveller infected with Zika. This virus then led to the recent upsurge in microcephaly cases in the country. […] During 2017, Angola began reporting an increased number of babies born with suspected microcephaly.

• #56 The Zika virus linked to microcephaly, discovered on the African continent | Department of Biology

  https://www.biology.ox.ac.uk/article/the-zika-virus-linked-to-microcephaly-discovered-on-the-african-continent

  These results are significant in that they demonstrated the introduction of the Asian genotype into continental Africa, demonstrating the ongoing spread of Zika virus worldwide and our continued need to remain vigilant to Zika virus infection and its impact on pregnant women and infants. […] This study highlights the need of increased surveillance in areas that are connected by travellers to regions where Zika and other mosquito-borne viruses circulate Improved surveillance is key to anticipate and prevent future epidemics of mosquito-borne viruses, especially in areas connected by air travel that have high abundance of mosquitoes capable of transmitting viruses.

• #57 The Zika virus linked to microcephaly, discovered on the African continent | University of Oxford

  https://www.ox.ac.uk/news/2019-09-26-zika-virus-linked-microcephaly-discovered-african-continent-0

  Techniques such as on-site portable DNA sequencing and computational analysis, linked with traditional molecular diagnostics, allowed us to get a better understanding of the virus epidemiology and its link with microcephaly in our country. […] These results are significant in that they demonstrated the introduction of the Asian genotype into continental Africa, demonstrating the ongoing spread of Zika virus worldwide and our continued need to remain vigilant to Zika virus infection and its impact on pregnant women and infants.

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