O vírus zika está se espalhando rapidamente pelas Américas e poderia chegar a todos os países, exceto o Canadá e o Chile continental, afirmou a diretora da Organização Pan-Americana da Saúde (OPAS), Carissa F. Etienne, às autoridades de saúde de todo o mundo nesta quinta-feira (28) durante uma sessão informativa do Conselho Executivo da Organização Mundial da Saúde (OMS), em Genebra, na Suíça. Etienne acrescentou, no entanto, que os países das Américas têm respondido robustamente à ameaça de zika em colaboração com a OPAS/OMS e outros parceiros internacionais.
Essa cooperação continuará enquanto os países trabalharem para mitigar o impacto do vírus na vida das pessoas que moram nos países membros da OPAS/OMS. A prevenção mais importante é o controle eficaz do mosquito, que requer ação por parte dos governos nacionais e locais, mas também por indivíduos, famílias e comunidades para eliminar potenciais criadouros do mosquito dentro e em torno de casas, locais de trabalho e escolas.
“A OPAS é uma região com longa experiência na luta contra doenças transmitidas por mosquitos, incluindo dengue e chikungunya”, disse Etienne. “Felicito o Brasil – e todos os outros países das Américas – pela notificação imediata no marco do Regulamento Sanitário Internacional.” RSI, como os regulamentos são conhecidos, é o sistema global gerido pela OMS por meio do qual os Estados-Membros notificam surtos de potencial preocupação internacional.
A diretora da OMS, Margaret Chan, anunciou que vai convocar uma reunião do Comitê de Emergência do RSI na próxima segunda-feira (1/2) para discutir a epidemia de zika e o que precisa ser feito a nível global para lidar com a doença. O comitê vai verificar se o surto constitui uma emergência de saúde pública de importância internacional.
Ações da OPAS/OMS
Desde maio de 2015, 23 países e territórios nas Américas têm relatado a OPAS/OMS transmissão local de infecções por zika. A OPAS/OMS prevê que o vírus possa se espalhar para todos os países da região que têm mosquitos Aedes, os mosquitos responsáveis pela transmissão do vírus. O mosquito está presente em toda a região, exceto Canadá e Chile continental.
Etienne observou que a ação colaborativa pró-ativa sobre os surtos a nível regional está em andamento desde que o Brasil registrou a transmissão local de zika à OPAS em maio de 2015. A OPAS/OMS tem trabalhado estreitamente com os países membros afetados desde então, mobilizando a Rede Mundial de Alerta e Resposta a Surtos (GOARN, na sigla em inglês) para ajudar os ministérios da saúde no reforço de suas capacidades para detectar a chegada e a circulação do vírus zika por meio de testes laboratoriais e notificação rápida. O objetivo tem sido assegurar um diagnóstico clínico preciso e tratamento para os pacientes, a fim de se controlar a propagação do vírus e do mosquito que o transmite, bem como promover a prevenção, especialmente por meio do controle do mosquito.
A OPAS/OMS tem trabalhado com os países membros há anos no controle do vetor e, nas próximas semanas, reunirá especialistas de todo o continente americano para discutir estratégias novas, mais eficazes e integradas de controle de mosquitos para ajudar a reduzir não apenas as infecções por zika, mas também casos de dengue, chikungunya, febre amarela e vírus do Nilo Ocidental – os quais são propagados por mosquitos e causam problemas de saúde pública significativos nas Américas.
A OPAS/OMS também está apoiando a ampliação e fortalecimento dos sistemas de vigilância em países que têm relatado casos de zika e de microcefalia e outras condições neurológicas que podem estar associadas ao vírus. A vigilância também está sendo aumentada nos países onde o vírus pode se propagar.
Além disso, a OPAS/OMS tem trabalhado com as autoridades de saúde brasileiras, a Fundação Oswaldo Cruz (Fiocruz), no Brasil, e os Centers for Disease Control and Prevention (CDC), dos Estados Unidos, para apoiar a pesquisa e investigação sobre zika, gravidez e microcefalia.
Dificuldade na contagem de casos
Em uma coletiva de imprensa após a apresentação de Etienne, os especialistas da OPAS/OMS explicaram que a contagem confiável de casos de infecção pelo vírus zika eram difíceis de obter por várias razões: apenas aproximadamente uma em cada quatro pessoas infectadas desenvolvem sintomas; o vírus só é detectável por alguns dias no sangue das pessoas infectadas; testes para anticorpos – que podem ser detectados por um período muito mais longo após a infecção – não conseguem distinguir bem entre zika e infecções com vírus similares, como dengue e chikungunya; e os clínicos enfrentam grandes desafios em distinguir casos de zika dos casos de doenças como dengue e chikungunya, que têm sintomas semelhantes.
Suspeita de ligação com microcefalia
Embora as infecções por zika tipicamente causem apenas sintomas leves, as preocupações têm sido agravadas pelos relatórios do Brasil de aumento significativo de microcefalia – incomum tamanho pequeno da cabeça – em bebês nascidos em áreas onde o vírus está circulando. Desde outubro, o Brasil registrou mais de 4 mil casos suspeitos de microcefalia em áreas com circulação de zika. Outras complicações são também suspeitas de estarem ligadas ao vírus, incluindo a síndrome de Guillain-Barré, uma síndrome auto-imune.
“Existem muitas perguntas não respondidas sobre as ligações entre a doença do vírus da zika, microcefalia e Síndrome de Guillain-Barré”, observou Etienne. “Embora nós ainda estejamos trabalhando para estabelecer a causalidade com o zika, não podemos tolerar a perspectiva de mais bebês nascendo com malformações neurológicas e de outros tipos, e mais pessoas que enfrentam a ameaça de paralisia devido a Síndrome de Guillain-Barré. Devemos todos trabalhar juntos para impedir a propagação desta doença potencialmente debilitante.”
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