944. Perinatal Case Fatality Rate Related to Congenital Zika Syndrome in Brazil: a Cross-Sectional Study
Session: Oral Abstract Session: Emerging Paradigms: Pediatric Viral Infections
Friday, October 6, 2017: 8:30 AM
Room: 01AB
Background:

Many studies have demonstrated a causal link between Zika virus (ZIKV) infection, microcephaly (MCP) and other congenital abnormalities (CA). This study aimed to determine perinatal case fatality rate in cases of Congenital Zika Syndrome (CZS) in the Rio Grande do Norte State (RN), a Brazilian Northeast State highly impacted by the Zika virus outbreak.

Methods:

A cross-sectional study was conducted using data obtained through the State Health Department (SHD) for cases of MCP and CA in Rio Grande do Norte from April 2015 to February 05, 2016. Definition of perinatal period: commences at 22 completed weeks (154 days) of gestation and ends seven completed days after birth.

Results:

During the study period, there were 486 cases of MCP and others CA notified in RN, of which 142 were confirmed and 108 remain under investigation. The remaining 236 cases have been ruled out by presenting normal exams or due to presenting microcephaly by non-infectious causes. Of the total confirmed cases, 26.7% (38/142) died after birth or during pregnancy. 15.78% (06/38) of confirmed deaths had ZIKV infection during pregnancy and 2.63% (01/38) had a positive TORCH blood test. The 6 cases related to ZIKV were confirmed by RT-PCR and/or IgM/IgG antibodies against ZIKV. The remaining cases of deaths remain either under investigation or have been ruled out.

Conclusion:

This study highlights a high rate of perinatal lethality (15.78%) in cases of CZS. Despite the growing number of CZS cases, the real incidence and prevalence might be higher due to the underreporting and lack of resources for confirmatory diagnostic tests (laboratory and imaging). Due to the high rate of lethality and the ongoing uncontrolled ZIKV outbreak, this study predicts an increase in the infant mortality rate in Brazil and highlights the need for developing public health programs to control the ZIKV outbreak.

Igor Thiago Queiroz, MD, PhD1, Jessika Thais Da Silva Maia, MS2, Gleysson Rosa, RN , MD3, Tatyana Vidal Mendes, RN4, S. Jayne Alves Vidal, RN5, Maria Goretti Lins, MD6, Marcelo Rodrigues Zacarkim, MD, MS3, David Aronoff, MD, FIDSA7, A. Desiree Labeaud, MD, MS8 and Nilson N. Mendes Neto, MD9, (1)Universidade Potiguar, natal, Brazil, (2)Universidade Potiguar, Natal - RN, Brazil, (3)Harvard Medical School, Boston, MA, (4)Secretaria Municipal de Saude, Cajazeiras-PB, cajazeiras-PB, Brazil, (5)SESAP - Rio Grande do Norte, Natal, Brazil, (6)Hospital Infantil Varela Santiago, Natal, Brazil, (7)Medicine, Vanderbilt University School of Medicine, Division of Infectious Diseases, Nashville, TN, (8)Pediatric Infectious Diseases, Stanford University, Stanford, CA, (9)Extension Center, University of California, Davis, Davis, CA

Disclosures:

I. Thiago Queiroz, None

J. Thais Da Silva Maia, None

G. Rosa, None

T. Vidal Mendes, None

S. J. Alves Vidal, None

M. G. Lins, None

M. Rodrigues Zacarkim, None

D. Aronoff, None

A. Desiree Labeaud, None

N. N. Mendes Neto, None

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