Since receiving notification of an unusual number of babies with microcephaly in the State of Pernambuco, the Ministry of Health has concentrated its efforts on case investigations. Since the date of notification, several actions have already been implemented, including confirmation of the relationship between cases of microcephaly and zika virus infection during pregnancy. The Ministry operates on an integrated basis with state and local health departments and has the support of national and international institutions.
Check out the timeline of the actions of the Federal Government:
The Health Minister signs an agreement with the Butantan Institute for development of a dengue vaccine
On the day that the dengue vaccinations by a group of volunteers started, the Minister of Health Marcelo Castro signed an agreement with the Butantan Institute for financing the third and last stage of the clinical research for a dengue vaccine. In total, the Ministry of Health will invest BRL 100 million in the next two years in order to further develop this study. Overall, the forecast is an investment of BRL 300 million from the federal government to the Butantan studies. In addition to the funds provided by the Ministry of Health, funds from the Ministry of Science, Technology and Innovation (BRL 100 million) - to be provided through a FINEP (Studies and Projects Financing Agency) agreement - and from the Brazilian National Development Bank - BNDES (BRL 100 million) are also being considered. In total, 17 000 volunteers from 13 cities in five regions of Brazil will participate in the studies and will be vaccinated over a year. The research results will depend on the circulation of the virus, but Butantan estimates to have the vaccine against dengue available in 2018.
Federal Government mobilizes schools to raise awareness among students
On February 19 a major national mobilization against the Aedes aegypti throughout the school system began, involving pre-school, elementary, secondary and higher education. Ministers, Governors, municipal and state education secretaries, as well as other authorities and armed forces personnel, traveled through Brazilian cities and 115 municipalities considered to be priorities in the fight against mosquitoes. The Ministry of Health also mobilized teams from the Program Health at School to expand health activities to public school students. The program is present in more than 78,000 schools in 4,787 municipalities. Their are currently 32 000 teams from Primary Care involved in the program and they began to be mobilized on the 19th.
Brazil will develop a test to detect zika in blood bags
The Ministry of Health stated that it will include the zika virus in the NAT test carried out in blood bags throughout the country. This test is already capable of identifying the HIV, hepatitis B and hepatitis C viruses in order to control and attest the safety of blood available in national blood banks. This action will be supported by the United States so that the registration processes are executed more quickly, and the expectation is that Brazil will become a reference center for the validation of molecular test or essays that have the zika virus as their target. The production of the NAT with zika virus detection included will be carried out by the Biomanguinhos Lab at Fiocruz, in Rio de January - holder of the NAT platform in the country. Estimates indicate that the test will be made available to public health network labs by the end of the year.
Notification of cases of the zika virus becomes mandatory in Brazil
As from the 18th of February , the notification of suspected cases of zika is mandatory for all of the health services in the country. The change means that all suspected cases of zika should be reported by doctors, health professionals or persons responsible for health facilities, public or private, to health authorities on a weekly basis In cases of pregnant women with suspected infection or suspicious death, notification must be immediate, that is, it must be made within 24 hours. The change in notification is the result of a careful analysis of the monitoring methods of the zika virus in Brazil. Until then, the disease was monitored through a sentinel surveillance system to provide support for measures to prevent the disease.
Brazil and the USA begin studies in Paraiba on microcephaly associated with the zika virus
The study wants to estimate the proportion of newborns with zika virus-related microcephaly, in addition to the risk of zika virus infection. Beginning on February 16, the case-control study of microcephaly related to the zika virus in Brazil counts on the participation of 17 technicians from the CDC, nine from the Ministry of Health, as well as Paraíba government officials. On the same day, the European Union announced the opening of a line of credit for research to the value of EUR 10 million for the study of zika. All institutions worldwide may participate in the tender to be launched on March 15.
15 a 18February
Joint efforts provide continuity for the actions to combat Aedes
About 55,000 soldiers from the Navy, Army and Air Force visited 951,810 homes, between the 15th and 18th of February to combat proliferation breeding sitess of Aedes aegypti mosquitos and to educate the public on preventive measures. The action was carried out in 290 Brazilian cities, in 27 states.
Federal government conducts National Mobilization for Zika Zero.
The mobilization included the participation of 220,000 soldiers from the Army, Navy and Air Force. Along with professionals from states and municipalities, they took to the streets educating the public about the fight against the breeding sites of the mosquito that transmits dengue fever, chikungunya and the zika virus. The reinforcement from the armed forces reached 2.8 million homes in 428 municipalities in the 27 States. About 4 million flyers were distributed during the action. The mobilization featured the personal involvement of President Dilma Rousseff, who inspected houses and talked to residents in Rio de January, and had the participation of over 162 representatives of the federal government in different cities. This number included the top levels of government, such as ministers and heads of government agencies and presidents from federal and state public banks.
Brazil and the USA sign an agreement to develop a vaccine against the zika virus.
The Ministry of Health signed the first international agreement for the development of a vaccine against the zika virus. This research will be carried out in conjunction with the Brazilian government and the University of Texas Medical Branch, in the United States. For this, the Brazilian government will make US$ 1.9 million available over the next five years. According to the work schedule, the forecast is for the development of the product in two years. On the occasion, the Minister of Health, Marcelo Castro also announced a partnership between the Ministry of Health, the government of the State of Paraiba and the the United States Health Department and Human Services (CDC) to identify associated factors between zika and microcephaly.
The Ministry of Health offers training to Mercosur countries for zika virus tests
The declaration took place in Montevideo, Uruguay, during an extraordinary meeting between Healthcare representatives of the Mercosur countries. This training will be provided by Brazilian national institutes through an exam using the PCR (Polymerase Chain Reaction) process. The purpose is to strengthen the region's epidemiological monitoring capabilities, monitoring the behavior of the virus and suggesting actions deemed necessart for protecting the population. In January, technicians from Paraguay, Peru, Uruguay and Ecuador were trained at the Evandro Chagas Institute (IEC).
The Ministry of Health offers a communication channel (0800 645 3308) to guide endemics agents, health workers and military personnel in their activities towards the elimination of breading sites.
On the same day, the Federal Government published decree No. 8662 defining actions to eliminate mosquito breeding sites in public agencies, and the health minister Marcelo Castro defined a strategic agenda for research development for diagnostics, vaccine and treatment against the zika virus with the US health secretary, Sylvia Burbell.
Provisional Measure No. 712
The Federal government published Provisional Measure No. 712 authorizing forced entry for agents into public or private buildings that are abandoned, or in the absence of a person who can allow access to the site.
The country's federal agencies held a "Cleaning day.” The action is part of the national mobilization to fight and prevent Aedes aegypti
Military mobilization and repellents for Pregnant Women
The Health Minister announced the mobilization of 220,000 soldiers from the three branches of the armed forces and offered repellents to pregnant women who are enrolled in the Bolsa Família program.
The Health Minister launched the fight against Aedes aegypti caravan for Ceara and Piaui
The Minister of Health, Marcelo Castro, started the mobilization caravan to confront Aedes aegypti and microcephaly in the municipalities of Crato (Ceara) and Teresina (Piaui). On the same day, The Ministry of Health reported that, to date, 15% of Brazilian households were visited to control mosquito breeding sites. This data is now published weekly.
The Ministry of Health expands the testing capacity of national laboratories
The Ministry of Health announced the distribution of 500 thousand tests to diagnose PCR (molecular biology) for the zika virus. Therefore, public laboratories will increase their capacity of exams by 20 fold, from one thousand to 20 thousand monthly diagnoses. The first 250,000 units were delivered in February to 27 laboratories, being four reference and 23 Central Public Health Laboratories (LACEN). The forecast is that the other 250,000 tests will be available from the second half of the year. In total, the Ministry of Health invested BRL 6 million in the acquisition of products.
Tests for diagnosing zika, chikungunya and dengue
The Ministry of Health order 500 000 tests for the diagnosis of zika, chikungunya and dengue
The federal government allocates BRL 500 million extra to fight Aedes aegypti and microcephaly
President Dilma Rousseff sanctioned resources of BRL 1.27 billion for the development of health surveillance activities, including the fight against Aedes aegypti in 2016. To this amount will be added BRL 600 million earmarked for Supplementary Financial Assistance to the Union for the Agents to Combat Endemic Diseases. To intensify the actions and measures of surveillance, prevention and control of dengue, chikungunya and zika an extra BRL 500 million was approved, in addition to the existing amount, due to the emergency situation in the public health system which is of national importance.
Launch of guidelines for early stimulation of babies with microcephaly
The Ministry of Health has made the Early Stimulation Guidelines available to all professionals and managers in the country: Children of up to 3 years old with delayed neuropsychomotor development due to microcephaly. They are guidelines for professional teams of Primary Care and Specialized Care for early stimulation. The content is aimed at children with microcephaly, and may also apply to other conditions or health disorders that interfere with neurodevelopment.
An emergency plan to fight the diseases transmitted by Aedes aegypti is launched in Maranhão
The state of Maranhão launched an Emergency Plan to fight the diseases transmitted by Aedes aegypti. In order to strengthen the health care network to combat dengue, chikungunya and zika. The state plan aimed to program actions and goals in order to stop the short term transmission of the diseases through vector control.
Reinforcing the fight against Aedes aegypti in Mato Grosso do Sul
The actions against Aedes aegypti were reinforced in Mato Grosso do Sul. The Emergency Plan to Combat Aedes aegypti in the State of Mato Grosso do Sul provided a survey of mosquito breeding sites by region. The survey was inserted into the state's e-Endemic system, and the information - such as data regarding combat procedures, control, prevention and reduction of the mosquito infestation index - it serves to guide the actions that will be developed in each municipality.
Creation of the National Coordination and Control Room, to confront dengue, chikungunya the zika virus and microcephaly
The Federal Government set up the National Coordination and Control Room, to confront dengue, chikungunya the zika virus and microcephaly, to manage and monitor the intensification of the mobilization actions and to combat the Aedes aegypti mosquito, which transmits dengue fever, chikungunya fever and the Zika virus, as well as the implementation of the actions of the National Plan for Confronting Microcephaly. Coordinated by the Ministry of Health, the room includes the participation of representatives of the Ministries of Integration, Defense, Social Development, Education and the General Secretariat of the Presidency, as well as other guests organs. Every week, the National Room coordinates the mobilization actions with the State Rooms through videoconferences.
16 laboratories working towards the diagnoses of Zika
The Ministry of Health has trained 11 public laboratories for the diagnosis of zika, plus the five reference units in Brazil that are already performing this type of examination. Totaling 16 centers with the knowledge needed to perform the test.
Clarification of Internet rumors
To clarify the rumors circulating on social networks use the chat and inform the population application, the Ministry of Health has intensified its network actions. Check out the article published in the Health Portal by clicking here.
Protocol for Attention to Health and Response to Occurrences of Microcephaly Related to Zika Virus Infection
Ministry of Health launched the Protocol for Attention to Health and Response to Occurrences of Microcephaly Related to Zika Virus Infection provides guidelines to medical assistance, from pre-natal care to the development of children with microcephaly throughout the country. The main goal of the Protocol is to provide guidelines to actions directed at the care of women of reproductive age, pregnant women and parturients submitted to the zika virus and children with microcephaly.
Sending of larvicide to the states
The Ministry of Health sent larvicide to the states in the Northeastern and Southeastern parts of Brazil, in sufficient quantities to treat a volume of water equivalent to 3,560 olympic sized swimming pools. The 17.9 tonnes of the product used to eliminate the Aedes aegypti larvae is sufficient to protect 8.9 billion liters of water. The larvicide is used when it is not possible to eliminate the focus from stagnant water, the breeding site of the mosquito.
President Dilma Rousseff has a meeting with the governors
Emergency protocol for monitoring and response to occurrences of microcephaly related to a zika virus infection.
The emergency protocol for monitoring and response to cases of microcephaly related to infection by zika was launched for the purpose of passing on information, technical guidance and guidelines to health professionals and surveillance teams. The protocol contains orientations such as the definition of suspected cases of microcephaly during pregnancy, suspected cases during childbirth or after birth, criteria for ruling out suspected cases, notification system and laboratory investigations.
Launch of the National Plan for Confronting Microcephaly
The plan created by the Interministerial Executive Group for Emergency in Public Health of National and International Importance (GEI-PHEIC), involves 19 agencies and entities and covers three areas: Mobilization and Combating the Mosquito; Assistance to People; and Technological Development, Education and Research. These emergency measures were put in place to step up actions to combat the mosquito.
Arrival of the Armed Forces in Pernambuco
Confirmation of the relationship between the zika virus and microcephaly
An examination of a baby who died shortly after birth in Ceará with microcephaly and other congenital malformations confirmed the relationship between the zika virus and the microcephaly outbreak. The Evandro Chagas Institute identified the presence of the zika virus in blood and tissue samples. It was an unprecedented discovery in the scientific research world and crucial to continue the clarification on issues such as the transmission of this agent, its activity in the human body, the infection of the fetus and the period of greatest vulnerability for pregnant women.
Online form for the immediate notification of health departments
To increase the efficiency of the reporting of cases of microcephaly an online form was provided for use by managers and health professionals in each state. The Interministerial Executive Group for Emergency in Public Health of National and International Importance was put into action.
Epidemiological Bulletin on microcephaly is now published monthly by the Ministry of Health
The first epidemiological bulletin on microcephaly was printed. Until then, 399 cases of the disease in newborns had been reported in seven states in the Northeastern region of Brazil.
Initial guidelines for pregnant women
For the immediate start of prevention, the Ministry of Health launched a series of recommendations for pregnant women in order to reduce infections from the zika virus. Check out the relevant guidelines in the Health Blog by clicking here.
State of Emergency in Public Health of National Importance
Given the situation, the Ministry of Health declared a State of Emergency in Public Health of National Importance to provide more agility to the investigations. A mechanism is provided by law for cases of emergencies in public health that require urgent measures to prevent, control and contain risk, damage and harm to public health.
Activation of the Health Emergency Operations Centre (COES)
The Ministry of Health has activated the Health Emergency Operations Centre (COES), in Brasilia. A crisis management mechanism, which brings together the various areas to determine a response in a way that the matter can be treated as a priority.
The Ministry of Health investigates cases in the state of Pernambuco.
The Ministry of Health sends a team to monitor the investigation of cases in the state of Pernambuco. The situation was reported to the Pan American Health Organization (PAHO) and World Health Organization (WHO).
Reporting and investigation of cases of microcephaly in Pernambuco
Immediately after the notification, a Rapid Response Team to Emergencies in Public Health of the Ministry of Health - initially made up of six professional epidemiologists - they traveled to Recife to support the state and municipal Health Departments with field investigations. The fact was also reported to the World Health Organization and the Pan American Health Organization, according to international protocols for disease notification.