Thailand investigates suspected cases of Zika-linked microcephaly

https://www.theguardian.com/world/2016/sep/27/thailand-investigates-suspected-cases-of-zika-linked-microcephaly

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Thailand is investigating four suspected cases of Zika-related microcephaly in three babies and a 36-week old unborn baby, the public health minister has said, in what could be the first such cases in south-east Asia.

Several countries in the region have reported cases of infection from the mosquito-borne Zika virus. Thailand has one of the highest numbers, with 349 confirmed since January, including 25 pregnant women.

The public health minister, Piyasakon Sakolsatayadorn, said authorities needed to be thorough in investigating the cases as confirmation would be “sensitive”.

“The lab results will take at least two days because we have to be thorough with this as it is a big deal and a link hasn’t been detected before,” Piyasakon said. “This is a sensitive matter for Thailand.”

US health officials have concluded that Zika infections in pregnant women can cause microcephaly, a birth defect marked by small head size that can lead to severe developmental problems in babies.

Piyasakon said the three babies were born with small heads and an ultrasound appeared to indicate the unborn baby had the same issue.

Of the four mothers, two were diagnosed with Zika when they were pregnant but the infection had not been confirmed in the other two, said Apichai Mongkol, director-general of the ministry’s medical sciences department.

If a Thai case were confirmed, it would be the first case of Zika-linked microcephaly in south-east Asia, the World Health Organization (WHO) said in a statement to Reuters.

The connection between Zika and microcephaly first came to light last year in Brazil, which has more than 1,600 cases of microcephaly that it considers to be related to Zika infections in the mothers.

Some health experts have accused Thailand, which has a thriving tourist industry, of playing down the risk from Zika. But officials dismiss this, saying the response has been adequate and that another mosquito-borne disease, dengue, which can be deadly, is a bigger threat.

The director-general of Thailand’s disease control department, Amnuay Gajeena, said the four cases were being monitored but he declined to say exactly where they were suspected of contracting the virus.

“It is not in Bangkok,” Amnuay said. “Both the mothers and babies are being tested and we have sent the tests to several labs.”

There are no specific tests to determine if a baby will be born with microcephaly, but ultrasound scans in the third trimester can identify the problem, according to the WHO.

It lists Singapore, the Philippines, Malaysia, Thailand and Vietnam as countries reporting new Zika cases. Singapore has recorded 393 cases since diagnosing its first in August. It has confirmed that there are 16 pregnant women with the virus.

The WHO has also said there is strong scientific consensus that Zika can cause Guillain-Barre, a rare neurological syndrome that causes temporary paralysis in adults.

According to the WHO, there are two major lineages of Zika: an African lineage, which has only been reported in Africa, where the virus was first discovered in 1947, and an Asian lineage of strains.

There is no vaccine or treatment for Zika, which is a close cousin of dengue and chikungunya and causes mild fever, rash and red eyes. An estimated 80% of people have no symptoms, making it difficult for pregnant women to know whether they have been infected.