Although it detected 260 cases of microcephaly in India since February 2016, during an investigation to study the link between the condition and the Zika virus, the Health Ministry did not test the babies for the virus citing shortage of laboratory capacity.
On Tuesday, a three month old Delhi baby detected with ‘severe microcephaly’ tested negative for Zika, making it the first case where the Ministry ran blood work for Zika since the 2015-16 global outbreak
Microcephaly is a rare congenital defect where a baby’s head is much smaller than what is normal for its age and sex.
The requisite tests to investigate cause-and-effect between the virus and microcephaly, however, could not be carried out due to lack of laboratory strength, Ministry officials said. Surveillance was set up at 55 centres in the country after the WHO declared Zika a Public Health Emergency of International Concern (PHEIC) in February 2016.
“We could not check any of the cases for link with Zika because the programme had not evolved to that point. We will start checking microcephaly cases for Zika links from now,” said Dr. Ajay Khera, Deputy Commissioner for Child Health, health ministry.
Severe microcephaly can occur because a baby’s brain has not developed during pregnancy or because it was damaged during pregnancy. Based on available evidence, the WHO has said the most likely explanation is that Zika virus infection during pregnancy causes microcephaly. The Health Ministry started tracking cases of microcephaly in India in February 2016, after the World health Organization (WHO) requested countries to track and report cases.
Aetiology testing (investigation to establish the cause of the condition) of these babies was not done because laboratories were not available, said Dr. Soumya Swaminathan, Director General of Indian Council of Medical Research (ICMR). “We don’t have baseline data for microcephaly. The government has only recently started collecting data on congenital birth defects. When we found cases of microcephaly, we could not test them for causes as labs were not available,” she added.
“The Indian government set up 55 sentinel sites across India. Over the year, we found sporadic cases, but without clustering,” said Dr. P.Ravindran, Director, Emergency Medical Relief (EMR), Health Ministry.
Call for data reporting
In 2016, a base line estimate of microcephaly-affected births in India was determined after a systematic review and meta-analysis of several studies. The pooled birth prevalence of microcephaly was shown as 2.30 per 10,000 births among 97,155 births. This study, however, was rejected by WHO and the Centre.
Researchers want microcephaly data in the public domain, to aid public health intervention. Prof. Anita Kar Director of the School of Health Sciences, University of Pune, said, “If the government has been collecting this data, the national health portal would be the ideal place to store it so that the publiccan get information.”
