Vector-borne Disease Scan for Jul 17, 2017

Zika-linked eye defects
Malaria elimination funding
Chikungunya in the Americas
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Infant case series suggests Zika eye problems can occur apart from brain defects

A case series of 112 babies born to Brazilian mothers who had confirmed Zika infections found that 21.4% had eye abnormalities with the potential to impair sight, with the condition sometimes seen on its own without microcephaly or other central nervous system (CNS) problems. Researchers from Brazil reported in JAMA Pediatrics today.

They followed 112 babies who were seen at a referral center for high-risk pregnancies and infectious diseases in Rio de Janeiro until the youngsters were 1 year old. Among the group, 20 had microcephaly and 31 had other CNS abnormalities. Of the mothers, 32 had been sick with Zika virus in the first trimester, 55 in the second, and 25 in the third.

Twenty four (21.4%) of the infants had sight-threatening eye problems; optic nerve and retinal abnormalities were the most common conditions. Ten of the babies who had eye issues did not have microcephaly and eight didn't have any CNS findings.

More than half (58.3%) of the infants who had eye problems were born to women infected in the first trimester, followed by 33.3% in the second, and 8.3% in the third.

The authors acknowledged a referral bias and the lack of a control group, and they wrote that they can't say with certainty that all of the eye problems were linked with Zika infections. However, they said eye abnormalities may be the only initial finding in congenital Zika infection and that all babies possibly exposed to the virus should undergo eye screening, regardless of CNS issues, timing of maternal infection, or lab confirmation.
Jul 17 JAMA press release
Jul 17 JAMA Pediatr


Funding review finds gap that could undermine malaria elimination goals

Global malaria funding is dropping at a time that's crucial for reaching elimination goals, a research team based at the University of California, San Francisco, reported recently in Malaria Journal.

For the study, they looked at both donor funding and government health spending between 1990 and 2013 for 35 countries that are working to eliminate malaria. They also made projections to 2017.

Between 2000 and 2010, donor funding increased from just over $5 million to $176 million, but in 2013, overall funding fell to $62 million. Since 2000, government funding for malaria elimination in the countries has been rising, but it still doesn't fully bridge the gap from the decline in donor funding.

Rima Shretta, MPH, the study's corresponding author, said in a press release from Biomed Central, the journal's publisher, "Our findings demonstrate growing uncertainty about the future availability of donor funding for malaria. The study highlights the need for sustainable financing solutions that bridge the gap between the amount of funding a government can provide based on its economy and the amount donated by external partners, which declines as the country moves closer to becoming malaria-free."

The group also looked at the interventions supported by the malaria elimination funding and found high growth in donor funding for vector-control activities, especially insecticide-treated nets. However, donor money spent on surveillance—considered a key elimination intervention—declined between 2010 and 2012. The researchers said donors will need to assess whether shifting more support to operations such as surveillance and program management will be needed to support progress on malaria elimination goals.
Jul 14 Biomed Central press release
Jul 14 Malar J


Another slight rise noted in Americas chikungunya outbreak

Countries in the Americas reported 317 more chikungunya cases last week, similar to the past several weeks, though not all countries reported their latest numbers, according to an update from the Pan American Health Organization (PAHO).

The weekly total is similar to the 311 cases reported the previous week. Totals can sometimes show large spikes or declines, depending on how frequently countries with high disease burden, such as Brazil, update their cases. For the past few weeks, PAHO's latest report hasn't included new updates from Brazil.

Most of the new illnesses were reported from Central American countries, including Costa Rica, El Salvador, Nicaragua, and Panama. Colombia and Peru also reported a few more chikungunya infections.

Americas countries have now reported 89,563 confirmed, suspected, and imported chikungunya cases this year, most of them from Brazil. The fatality number has held steady at 13.

Since the 2013 start of the outbreak in the Americas and the Caribbean region, the virus has sickened 2,476,274 people.
Jul 17 PAHO update

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