Abstract
To determine completeness of fatal congenital Zika syndrome reporting in Mexico, we examined data from the Mexican National Institute of Statistics and Geography. We found that an estimated 50% more infants died from microcephaly attributable to congenital Zika syndrome during 2016–2017 than were reported by the existing surveillance system.
Highlights
To determine completeness of fatal congenital Zika syndrome reporting in Mexico, we examined data from the Mexican National Institute of Statistics and Geography
Infant deaths possibly resulting from the Zika virus epidemic were estimated by using the attributable risk and compared with the number of fatal Congenital Zika syndrome (CZS) cases reported by the existing CZS surveillance system
We found evidence that the Zika virus epidemic reversed the declining trend of infant deaths from microcephaly in Mexico and that the number of deaths from microcephaly associated with Zika virus was 50% higher than that reported by the existing CZS surveillance system
Summary
If the 5% prevalence of CZS among neonates of infected pregnant women found in population studies [3,5,6,7] were applied to the 7,113 pregnant women reported in Mexico as being Zika virus infected [10], one would expect ≈355 CZS cases, not the 51 reported as of November 2018 [11]. To improve the public health surveillance and research of CZS, we assessed the effects of the Zika virus epidemic on rates of infant death from microcephaly and estimated the completeness of reporting of fatal CZS cases in Mexico. Using the International Classification of Diseases, 10th Revision, we selected records for infants whose underlying cause of death was coded as microcephaly (Q02X).
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