Amid government silence, Venezuela’s microcephaly babies struggle

Ericka Torres holds her 3-months old son Jesus, who was born with microcephaly, at their home in Guarenas, Venezuela

By Alexandra Ulmer

GUARENAS, Venezuela (Reuters) – Deep inside a hilly Venezuelan slum, Ericka Torres rocks her three-month-old son Jesus to soothe his near-constant crying.

Jesus was diagnosed with microcephaly, a birth defect marked by a small head and serious developmental problems, after his mother contracted what was probably the mosquito-borne Zika virus during pregnancy in the poor city of Guarenas.

Torres said her boyfriend left after scans showed their child had birth defects, and she now struggles to afford medicine, clothes and even diapers for Jesus in the midst of Venezuela’s brutal economic crisis.

“It’s intense. But I can’t get stressed, because this struggle is only just beginning,” said Torres, 28, a supermarket security guard who smiles easily despite barely sleeping because of Jesus’ screams and convulsions, common traits of babies born with microcephaly.

The Venezuelan government, however, has not acknowledged a single case of Zika-related microcephaly in the country.

Beyond some health warnings and a handful of televised comments about Zika at the start of the year, the leftist government of President Nicolas Maduro has largely kept quiet about the virus even as neighboring Brazil and Colombia publish weekly bulletins.

Venezuela does provide data to the World Health Organization, which shows it has had some 58,212 suspected Zika cases and 1,964 confirmed ones since the virus emerged in Brazil last year and then spread rapidly through the Americas.

But it has not, however, declared any cases of confirmed congenital syndrome associated with Zika, such as microcephaly, and has not mentioned any suspected cases either.

To be sure, inadequate Zika testing has thwarted efforts to precisely diagnose Zika-caused microcephaly. But countries like Brazil have turned to clinical diagnoses and report “confirmed and probable cases” of Zika-associated congenital syndromes to the WHO, for instance.

Some doctors accuse Venezuela’s unpopular government of hiding the Zika problem amid a deep recession that has everything from flour and rice to antibiotics and chemotherapy medicines running short and spurred fierce criticism of Maduro.

They also say government inaction means kids are missing out on targeted state-sponsored therapy programs that would help to stimulate them.

“This delays the patient’s development, because no matter how much knowledge or drive you have, if you don’t have the physical tools like materials, resources, medicines, well that delays everything,” said Maria Pereira, a doctor in Caracas.

Local media have put the number of babies born with suspected Zika-linked microcephaly so far this year at around 60. Physicians in Caracas, the western city of Maracaibo, and the coastal state of Sucre, confirmed at least 50 cases in interviews with Reuters.

Venezuela’s Institute of Tropical Medicine estimates the real number could be much higher by the end of the year – between 563 and 1,400. That estimate is based on the numbers in Brazil, which has more than 1,800 confirmed cases, and pregnancy rates in Venezuela.

Product shortages have likely aggravated the effects of Zika in Venezuela: lack of contraceptives lead to unwanted pregnancies; lack of bug spray and fumigations lead to bites; and lack of anticonvulsant drugs or state support add to the hardships of children with the birth defect.

Venezuela’s health and information ministries did not respond to multiple requests for comment.

The government says it has one of the best health care systems in the world, pointing to free Cuban-staffed clinics in slums and social programs for maternal and child wellbeing. But it has stopped releasing data as the health sector has crumbled in the last two years.

‘NO RESOURCES’

Dozens of women and babies line up in the hot, dimly lit corridors of the J.M. de los Rios children’s hospital in Caracas, often waiting hours before an overstretched doctor can finally see them.

In the last three months, doctors say some 25 babies with microcephaly have been examined at what was once one of the leading hospitals in Latin America, with the majority of their mothers reporting symptoms including rashes or fevers during pregnancy.

Physicians order exams and prescribe therapies, but the overwhelmingly poor families struggle to scrape together enough money in the face of triple-digit inflation.

That delays early intervention and the discovery of other potential syndromes that have been linked to Zika, like vision problems or joint deformities.

“You feel impotent that you can’t provide anything more because there are no resources,” said Pereira, who works at the J.M. de los Rios hospital. Her family has to send her food and money from the provinces because she only earns around $70 a month between her salary and food tickets.

Other poor Latin American countries have also been criticized for their response to Zika. Brazil was called slow to investigate the initial surge of microcephaly cases and doctors say Zika prevention was spotty in Honduras, which estimates it will have some 340 cases of microcephaly by the end of the year.

Doctors and opposition lawmakers say Venezuela is faring the worst and have called for foreign aid and a stronger stance from the WHO.

Venezuela has rebuffed requests for aid, with officials saying it is an attempt to justify a foreign intervention in the oil-rich country.

When asked about criticism it was not doing enough in Venezuela, the WHO’s regional office for the Americas told Reuters its role was to provide technical cooperation to member countries and that it was working to strengthen that cooperation with Venezuela’s Health Ministry.

In the meantime, families are feeling the squeeze.

Home-based hairdresser Isabel Jimenez, her unemployed husband, and their four kids had already stopped having breakfast before the birth of Joshua, who has microcephaly, two weeks ago.

Now the family in the isolated Caribbean peninsula of Paraguana is under further pressure and has to rely on relatives for help with diapers, milk and medical appointments.

“I cried a lot,” said Jimenez, 28, of learning about Joshua’s condition. “At first I had a lot of anger and sadness, but I have to keep going with my baby because I can’t do anything else.”

(Additional reporting by Mircely Guanipa in Punto Fijo, Liamar Ramos and Daniel Kai in Caracas, Gustavo Palencia in Tegucigalpa, Ivan Castro in Managua, Paulo Prada in Rio de Janeiro, and Julia Symmes Cobb in Bogota; Writing by Alexandra Ulmer; Editing by Kieran Murray)

Thailand confirms first Zika-linked microcephaly in Southeast Asia

City worker fumigates area to get rid of mosquitoes carrying Zika

By Aukkarapon Niyomyat

BANGKOK (Reuters) – Thailand reported on Friday the first confirmed cases in Southeast Asia of microcephaly linked to mosquito-borne Zika, as the World Health Organization urged action against the virus across the region.

The confirmation of two case of microcephaly, a birth defect marked by small head size, came a day after U.S. health officials recommended that pregnant women postpone non-essential travel to 11 Southeast Asian countries because of the risk of Zika.

“We have found two cases of small heads linked to Zika, the first cases in Thailand,” Prasert Thongcharoen, an adviser to the Department of Disease Control, told reporters in Bangkok.

He declined to say where in Thailand the cases were found but officials have said they were not in Bangkok.

The World Health Organisation (WHO) said the cases were the first of Zika-linked microcephaly in Southeast Asia and the virus infection represented a serious threat to pregnant women and their unborn children.

“Countries across the region must continue to strengthen measures aimed at preventing, detecting and responding to Zika virus transmission,” Dr Poonam Khetrapal Singh, the WHO’s regional director, said in a statement.

U.S. health officials have concluded that Zika infections in pregnant women can cause microcephaly, which can lead to severe developmental problems in babies.

VIRUS SPREADING

The connection between Zika and microcephaly first came to light last year in Brazil, which has confirmed more than 1,800 cases of microcephaly that it considers to be related to Zika infections in the mothers.

Zika has spread extensively in Latin American and the Caribbean over the past year or so, and more recently it has been cropping up in Southeast Asia.

Thailand has confirmed 349 Zika cases since January, including 33 pregnant women, and Singapore has recorded 393 Zika cases, including 16 pregnant women.

Some health experts have accused Thai officials of playing down the risk of Zika to protect its thriving tourist industry, but Prasert dismissed that.

“Thailand is not hiding anything and is ready to disclose everything,” he said, adding that other countries in Southeast Asia might also have cases of Zika-linked microcephaly that they have not disclosed.

The WHO said Thailand’s response was an example for the region.

“Thailand’s diligence underscores the commitment of health authorities to the health and wellbeing of the Thai public, and provides a positive example to be emulated,” Singh said.

The U.S. Centers for Disease Control and Prevention (CDC) said on Thursday people should consider postponing travel to Brunei, Myanmar, Cambodia, Indonesia, Laos, Malaysia, Maldives, Philippines, Thailand, Timor-Leste (East Timor), and Vietnam.

The CDC has already issued a “travel notice” for Singapore, and said such a warning would be considered for the new countries if the number of cases rose to the level of an outbreak.

Thailand’s confirmation of Zika-linked microcephaly comes ahead of China’s week-long “Golden Week” holiday with Thailand expecting 220,000 Chinese visitors, up from 168,000 for the week in 2015, Tourism Authority of Thailand governor Yuthasak Supasorn told Reuters.

NO VACCINE

There is no vaccine or treatment for Zika. An estimated 80 percent of people infected have no symptoms, making it difficult for pregnant women to know whether they have been infected.

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

Zika is commonly transmitted through mosquitoes but can also be transmitted sexually.

Another Thai health ministry adviser urged everyone to work to stop the spread of mosquitoes but said people should not panic.

“Don’t have sex with a Zika-infected person. If you don’t know if they are infected, then use a condom,” the adviser, Pornthep Siriwanarangsan, told reporters. “We can’t stop women from becoming pregnant … but we mustn’t panic.”

Health authorities in the region said they were stepping up monitoring, but there has been little testing and officials said the real number of cases was bound to be higher than the confirmed figure.

“We do not test everybody, we test only those who are symptomatic,” said Paulyn Jean Rosell-Ubia, health secretary in the Philippines, which has reported 12 Zika cases.

“Yes, we are positive that the number is higher because we are not testing everyone.”

Malaysia, which has reported six cases of Zika, including two in pregnant women, said it would seek information from Thailand on the particular strain of the Zika virus there.

“We are taking serious notice of the reports in Thailand, and we will reach out to the Thai authorities for more information … so that we can be more prepared,” Malaysia’s health minister, Subramaniam Sathasivam, told Reuters.

Authorities in Vietnam, which has reported three cases of Zika, ordered stepped up monitoring of pregnant women.

In Indonesia’s capital, Jakarta, head of disease outbreak and surveillance Dwi Oktavia said there had been no sign of any increase in birth defects there. Indonesia had one Zika case in 2015 but has confirmed none since then.

Microcephaly in babies can lead to respiratory problems related to malformation of the brain, a serious threat to the lives of babies. Children with microcephaly face lifelong difficulties, including intellectual impairment.

Zika was first identified in Uganda in 1947 and first isolated in Asia in the 1960s. It was unknown in the Americas until 2014.

(Additional reporting by Amy Sawitta Lefevre, Juarawee Kittisilpa and Panarat Thepgumpanat, Kanupriya Kapoor in JAKARTA, Roxanna Latiff in KUALA LUMPUR, Karen Lima in MANILA and Pham Thi Huyen My in HANOI; Writing by Robert Birsel; Editing by Alex Richardson)