Marco Cáceres di Iorio

Brazil at Odds With WHO and CDC on Zika-Microcephaly Link

Brazil’s Minister of Public Health Marcelo Castro, MD confirmed that the epidemic of microcephaly cases in his country during the past year are due to the Zika virus being transmitted by Aedes aegypti mosquitoes. In an interview with the Associated Press on Feb. 12, 2016, Minister Castro said,

We are absolutely sure of the causal relationship between microcephaly and Zika. It has nothing to do with the environment, nothing to do with race, nothing to do with gender.1

Dr. Castro’s conclusion appears to conflict with data released by the Brazilian government on Feb. 12 citing that of the 5,079 “suspected cases” of microcephaly reported since October 2015, 462 of the cases have been confirmed as microcephaly and 765 have been determined to have been misdiagnosed and were not, in fact, microcephaly.1

Of the 462 confirmed cases, 41 have been linked to Zika—not necessarily caused by Zika, but linked.1 In other words, there is a correlation between the occurrence of the microcephaly and the presence of the Zika virus.

The conclusion by Dr. Castro, a trained psychiatrist, also clearly conflicts with the Feb. 12 situation report by the World Health Organization (WHO) stating,

No scientific evidence to date confirms a link between Zika virus and microcephaly…2 

Dr. Castro’s conclusion is also at odds with the position of the U.S. Centers for Disease Control and Prevention (CDC). According to the CDC:

Additional studies are needed to determine the degree to which Zika might be linked with microcephaly. More lab testing and other studies are planned to learn more about the risks of Zika virus infection during pregnancy.3

On Feb. 11, CDC director Thomas Frieden, MD testified before the U.S. House Foreign Affairs Committee. Dr. Frieden spoke of the two cases in which the CDC was able to “identify the genetic material of the Zika virus in the brain tissues of the two infants who died of microcephaly.” He pointed to these two cases as being the “strongest evidence to date that Zika is the cause of microcephaly.”4

Note that’s two cases out of the 5,079 “suspected cases” since October, and that even in those two cases it has not been established that the babies developed microcephaly as a result of the Zika virus. This is the basis for Dr. Castro’s conclusion, and it is the basis of the U.S. government’s rationale for spending $1.8 billion.

Think about it. There is no science involved here, only an effort to try and force a square peg into a round hole. Then there’s the bucketful of money at stake for the CDC.

Dr. Frieden is lobbying Congress to approve the $1.8 billion in emergency funds proposed by the U.S. government on Feb. 85 to help fight the Zika virus. Of that amount, Dr. Frieden said the CDC would receive $828 million4 5 to understand the “clinical and epidemiological patterns to make [the causal connection between Zika and microcephaly] definitive.”4

That’s $828 million in supplemental funds for an agency with an annual budget of about $7 billion.6 That’s a 12% budget increase. Not a bad supplement, and certainly one worth lobbying for—regardless of its merits.

On Feb. 11, Dr. Castro signed an agreement with the University of Texas Medical Branch in Galveston to jointly develop a vaccine against Zika with the Evandro Chagas Institute in Belem, Brazil. The Brazilian government, which will invest $1.9 million (versus $1.8 billion by the U.S.) in the research, will also be partnering with the CDC on a Zika vaccine. Additionally, it is considering working  on Zika with pharmaceutical company GlaxoSmithKline plc (GSK) of the United Kingdom.7

The Brazilian government already has a working relationship on vaccines with GSK. Brazil’s Butantan Institute, a major biomedical research center affiliated with the Brazilian Ministry of Public Health, has a technology transfer agreement with the British firm on production of the diphtheria, tetanus and pertussis (Tdap) vaccine.8


References:

1 Health minister in Brazil confirms Zika microcephaly connection. Fox News Latino(AP release) Feb. 13, 2016.
2 World Health Organization (WHO). Zika situation report. WHO.int Feb. 12, 2016.
3 U.S. Centers for Disease Control and Prevention (CDC). Question and Answers: Zika virus infection (Zika) and pregnancy. CDC.gov.
4 Fromson N. CDC: Strong evidence of link between Zika and microcephaly. United Press International Feb. 11, 2016.
5 GoThe White House. FACT SHEET: Preparing for and Responding to the Zika Virus at Home and Abroad. Office of the Press Secretary Feb. 8, 2016.
6 Nather D, Scott D. Congress ready to give NIH its biggest increase in 12 years. STATDec. 16, 2015.
7 Goodman J. Brazil, Texas State Hospital Reach Deal on Zika Vaccine. ABC News (APrelease) Feb. 11, 2016.
8 Instituto Butantan. vaccines. Butantan.gov.br.

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