MORTALITY IN NEWBORNS WITH MICROCEPHALY DUE TO MATERNAL ZIKA VIRUS INFECTION IN RIO GRANDE DO NORTE STATE – NORTHEAST BRAZIL: A CROSSSECTIONAL STUDY (S40.003)

Objective: To assess the mortality in newborns with microcephaly due to ZIKV congenital infection from April 2015 to September 2016 in the Rio Grande do Norte State (RN), a Brazilian Northeast State that has an estimated population of 3,400,000 inhabitants. Background: An increase in the number of newborns with microcephaly (MCP) was noted in 2015 in regions of Northeast Brazil. Design/Methods: Data were obtained through epidemiological bulletin from Brazilian Ministry of Health (BMH) during the period from April 2015 to September 24, 2016. Results: During the study period, there were 464 cases of MCP notified in RN, of which 138 were already confirmed and 132 remain under investigation. Of the total confirmed cases, 24,6% (34/138) died after birth or during pregnancy. Of the total of confirmed deaths, 61,8% (21/34) had ZIKV infection during pregnancy as the causal agent: 15 had a CT scan showing abnormalities of the central nervous system (presence of typical and indicative alterations of congenital ZIKV infection) and 6 were confirmed by RT-PCR and/or IgM/IgG antibodies against ZIKV. The remaining 13 cases of deaths remain under investigation. Conclusions: Our findings show a high rate of mortality (61,8%) in newborns with MCP due to ZIKV congenital infection. An increase in the prevalence of microcephaly was seen especially from September 2015, with the highest rate in November 2015 (20.1 cases per 1,000 live births). Before this ZIKV outbreak, the records in RN between 2010 and 2014 was around 1,8 cases/year. Despite the growing number of cases of microcephaly caused by ZIKV, it is difficult to assess the real increase in the prevalence of MCP in RN. It is related to the underreporting cases and lack of resources for diagnostic tests (laboratory and imaging) and research development. Because the ZIKV outbreak is still not under control, it might increase the infant mortality rate in Brazil. Disclosure: Dr. da Silva Maia has nothing to disclose. Dr. Rodrigues Zacarkim has nothing to disclose. Dr. Duarte Rolim has nothing to disclose. Dr. Linz has nothing to disclose. Dr. Gomes Trindade has nothing to disclose. Dr. Luz has nothing to disclose. Dr. Fulco has nothing to disclose. Dr. Vidal Mendes has nothing to disclose. Dr. Alves Vidal has nothing to disclose. Dr. Cortez Muniz has nothing to disclose. Dr. Pinheiro de Souza has nothing to disclose. Dr. Queiroz has nothing to disclose. Dr. Nogueira Mendes Neto has nothing to disclose. Dr. Desiree LaBeaud has nothing to disclose.