On the afternoon of November 17, 2015, The Ministry of Health announced that for the first time, the zika virus was confirmed by microcephaly which until then scared the country – especially in the northeast.
Since then, the number of cases has decreased, but doubts about virus problems and children who contracted it have only increased. Many questions remain unanswered after these three years.
Currently, it is known that microcephaly is only one of the problems of the so-called Zika congenital syndrome, which affects the neurological side of infants with infected mothers.
According to the Ministry of Health, from the beginning of the investigations in October 2015 until 6 October this year, 3,267 cases of changes in growth and development, possibly related to zika infection and other infectious etiologies, have been confirmed. Of this, there were 345 confirmed deaths, including fetal, neonatal and child deaths.
The discovery of the relationship between zika and microcephaly was made by Adriana Melo, from Campina Grande (PB), when she collects amniotic fluid from pregnant mothers of children already diagnosed with microcephaly. The result was zika's presence in the material.
"When I saw the pictures in the fetus, I expected more damage, in the first cases I thought there would be children who would stay in bed." Expectations were very low, but some surprised us. severe, but the result was better for most patients, "she said.
case number one of the disease, girl Catherine, was counted by the UOL in August. She has more than she expected to develop, she can go and began attending school in the middle of this year.
For the forefront of the discovery, after all these years, the great challenge in the field of rehabilitation lies in the development of therapies.
"What microcephaly was the tip of the iceberg, we write the natural history of the disease." What is the life of these children for one, two or three years and what therapies can we do to improve the quality of their lives? you know how these kids get sick and how we can avoid it. The big challenge is the neurological side, "explains Melo.
How to detect the disease?
Researchers are looking for answers to questions that affect those who study the syndrome and who coexist with its consequences.
According to the pediatrician and researcher of the Fernando Figueira Institute in Fiocruz (Oswaldo Cruz Foundation), there are still many problems that challenge science.
"To quote an example, 50% to 60% of people with zika are asymptomatic and we do not have a good serological test to detect the virus." There are no tests capable of detecting antibodies after the infection, "he says.
"It is necessary to have a more sensory serological test, because what we have today is giving a lot of dengue cross reactions," he adds.
In addition, the doctor claims that little is known about the problems caused when babies are infected with the virus. "This is unclear. We still do not know what's going on with the kids in their first year of life when they get zika."
Another regional question is: "Why have there been more cases in the Northeast? We probably have a coffer, but we do not know what the risk is," he says, noting that problems related to lack of basic health and malnutrition contribute to aggravation of any infections.
Infectologist Artur Timerman, president of the Brazilian Dengue Society and Arbovirus, says the reduction in speed in responses was due to the reduction of resources. "Of course, this prevents the elucidation of doubts," he says.
Timerman also agrees that the lack of more accurate tests is important: "We have major deficiencies."
"A wonderful discussion we have and we need to investigate is that we know that anyone who suffered a dengue once and has come into contact the second time has greater chances of having the most severe form." Because dengue and zika viruses are structurally similar, there is speculation that this anti-dengue antibody to a mother who is infected with zika would be more likely to transmit this virus to his child and generate a child with malformations, "says the doctor.
The infectious scientist continues to report that more research is missing for the time after the disease was acquired. "How does the virus behave now? What is the percentage of people in the Southeast who have been exposed to the virus and what percentage is infected?"
An old bastard
Another point is that the country has not advanced in the fight against mosquitoes Aedes aegypti. "Nobody is talking about basic sanitation, waterproofing cities, less green areas, anything that correlates with mosquitoes, that's what's behind this problem," says Timerman.
He says there must be a possible link between zika and dengue. "Today, it is known that zika has this correlation of fetal malformations, but there are more recent studies showing that dengue infections during pregnancy are also associated with this in chikungunya, too, ie we can not increase the actual magnitude of problem, "he says.
For researcher Fernando Figueira, however, time is a limiting factor. "Science is not so fast. The epidemic is over, but we know we have 30 years of dengue in the country and we can not stop the mosquito yet.
What the Ministry of Health says
According to the Ministry of Health, in November 2015, "R $ 465 million was allocated for the research and development of vaccines and new technologies involving zika and Zika congenital syndrome."
The Agency says that "another part of the ongoing action is in the network of assistance, organized by states and municipalities." "To draw attention to this population, the file was sent in R $ 27 million, and the federal government granted 2,200 continuous benefits that guarantee a monthly income for the child's family," the note continues.
"It is necessary to understand that constitutional SUS is tripartite, ie with shared administration between federal entities: municipalities, states and federal government." Federal resources are transferred to states and municipalities in charge of managing assistance, "he explained.