Argentine & Brazilian Doctors Suspect Mosquito Insecticide as Cause of Microcephaly

Abrasco - REPORT (Translation to English via Google Translate)

https://www.abrasco.org.br/site/2016/02/nota-tecnica-sobre-microcefalia-e-doencas-vetoriais-relacionadas-ao-aedes-aegypti-os-perigos-das-abordagens-com-larvicidas-e-nebulizacoes-quimicas-fumace/

Technical note on microcephaly and vector related diseases Aedes aegypti: the dangers of approaches with larvicides and chemical sprays - fogging

The Abrasco manifests itself through the agency of the Thematic Groups of Health and Environment; Worker's health; Health Surveillance; Promoting Health and Sustainable Development and also Popular Education in Health, about microcephaly epidemic. The document aims to deepen reflections, questions and make statements that can guide public policy on preventive intervention against the outbreak.

The exponential growth of the dengue epidemic (in 2015, the Ministry of Health recorded 1,649,008 probable cases of the virus in the country and an increase of 82.5% of deaths in the previous year). The territorial expansion of the infestation by Aedes aegypti attest to the failure of national control strategy. With the emergence of the virus zika epidemic, affecting even more harmful to humans, it is urgent to review our policy and of Aedes infestation control program to prevent the occurrence of epidemics by arboviruses. Several factors are involved in causing this health tragedy. It is a complex phenomenon. For Abrasco, degradation of living conditions in cities, inadequate sanitation, particularly with regard to the ongoing difficulty of access to water, poor garbage collection, sewage, neglect of care of public spaces and private - are the main responsible for this disaster.

epidemic rise of context

The health situation in which emerges microcephaly epidemic must be analyzed considering the serious problems that are present in the social and environmental reality in which cases occurred and the operating model of vector control. The spatial distribution by place of residence of mothers of newborns with microcephaly (or suspects) is higher in the poorest areas, with precarious urbanization and environmental sanitation inadequate, with water providing intermittently, a fact that leads these people to store home unsafe water, very favorable conditions for breeding of Aedes aegypti, constituting a "breeding" that should not exist, and which are subject to mechanical removal.

Some facts that need to be questioned and investigated can justify the introduction and spread of Zika virus. It is necessary to assess which contexts and contingencies existed and occurred in 2014 in the emergence of local cases of microcephaly. We can suggest some by leaping to the eye, such as:

1) In the Northeast, especially in the periphery of their metropolitan areas, such as Recife, there may have been increasing environmental degradation, exist in them all the conditions for maintaining the high density of Aedes aegypti, the low environmental sanitation indicators related to water, to sanitation, to the immense presence of solid waste from the households and rainwater drainage deficiencies. Regarding this issue, the Journal RADIS Communication and Health Fiocruz (n.154, July 2015) provides an insightful article on environmental sanitation showing its lag and serious not yet solved problems, which is aggravated by the evidence that there will be a delay years in the National Plan of Sanitation (PLANSAB) with fiscal adjustment. [1]

2) The continued use of larvicidal chemicals in the drinking water of these families for more than 40 years without, however, entail a reduction in the number of cases of diseases caused by Arboviruses. In 2014 it was introduced in the drinking water of the population in households and public roads a new larvicide the pyriproxyfen. As technical guidance of MS [2] this larvicide is a juvenile hormone analogue or juvenoid, with the mechanism of action of inhibiting the development of insect adult characteristics (eg, wings, maturation of the reproductive organs and external genitalia), keeping with aspect "immature" (nymph or larva), that acts on endocrine disruption and is teratogenic and inhibits the formation of the adult insect.

3) The intensification of migration processes by attracting large enterprises whose workers are finding themselves in precarious sanitary conditions in the area around industrial centers (such as the Suape, Pernambuco, with workers from other regions and states of the country and Pecém-CE with the presence of thousands of Koreans);

4) World Cup 2014, large mass event, had a subsede in Recife (Pernambuco Arena). Installed in São Lourenço da Mata (HDI 0.614), it is in an area with poor sanitary conditions. the highest concentration of cases of microcephaly originally notified (600 suspected cases) in these areas was observed;

5) Fragility of epidemiological surveillance of municipalities and states in the differential diagnosis, investigation of arboviruses and entomological differentiation;

6) difficulties in conducting surveillance of Zika and Chinkungunya, to treat them as "soft dengue." Bichon that the vectorial capacity of Aedes aegypti to transmit the virus Zyka and Chikungunya in our country is not yet properly studied or by entomologists in our social and environmental contexts. Hence fit questions: what did the dengue cases become more serious, it was once considered a benign disease from 1779 to 1950, without causing sequelae and no hematological changes, according to the WHO data? How is the immune system of the population before the chemical model of vector control and adopted by the ongoing MS in the country for about 30 years?

The strategies adopted by MS

Despite the reasons and uncertainties that are to determine the occurrence of microcephaly epidemic, the path to what is called "coping" was to strengthen the "fight" against mosquitoes by repeating what has been adopted for more than 40 years without success. We call society's attention to this issue. For what reasons, in spite of all the inefficiency of indicators, the MS continues to use the same approach for the control of mosquito that transmits the dengue virus, a disease whose transmission also depends on other elements? Even triggering various trainings for health professionals working in situation rooms to improve the diagnosis and reporting of cases of the new viral diseases; remains without integrating the actions of Epidemiological Surveillance, Health and Health Promotion. The problem that we want to highlight in this Note alert technology is at the core of vector control model, given the increased use of larvicide and adulticide for the Aedes aegypti, whereas according to the guidelines adopted by MS since 2014, kicks to the orientation of the technique Ultra Low Volume (ULV) [3] with Malathion 30% diluted with water, covering the whole national territory.

One must also question the use of chemicals on a scale that ignores the biological and environmental vulnerability of individuals and communities. The consumption of such substances by the public health care only to their producers and marketers of these poisons. Are inputs produced by a very lucrative business cartel, which operates throughout the world and that even with evidence of the risks caused by organophosphates and pyrethroids, of which we know so many deleterious effects, have had the support of international agencies of Public Health, as the Revolving Fund of the Pan American Health Organization (PAHO) and the World Health Organization (WHO). A simple consultation of the chemical safety data sheets of these products delivered by companies to public health authorities shows that these products, such as the Malathion, are neurotoxic to the central and peripheral nervous system, and cause nausea, vomiting, diarrhea, difficulty breathing and symptoms of muscle weakness, including the concentrations used in vector control. The environmental toxicity is recommended to avoid its use in the environment, which has not been observed since its release is done the way here we denounced. Such agencies constitute decision-makers for the purchase and distribution of poisons to all countries associated with the United Nations (UN). The suppliers are the same cartel producing pesticides companies operating in agriculture, making it also toxic and chemical-dependent. This model, post-World War II, we emphasize also imposed itself to the control of vector-borne diseases in public health.

The chemical control technologies of the vectors were introduced widely in Brazil since 1968 and can not be disregarded that their origin is due to the chemical weapons of mass destruction, widely used by the US Army at that time in Vietnam War . The adoption of a UBV treatment technique was a practice introduced during the same period and, not coincidentally, one of the first documents of its regulation was drafted by the US Army. [4]

This same logic has already been adopted to provide a solution through genetic modification and other inaccurate, unreliable and dangerous biotechnology to ecosystems, focusing on the action only in the mosquito, without taking into account the effects on non-target organisms. Attention should be given to British company Oxitec in research and commercialization of transgenic mosquitoes, whose factory was established in Campinas-SP in 2013 and in 2014 obtained authorization from CTNBio for marketing of Genetically Modified Organism (GMO), and on this question Abrasco published Technical Note [5].

The focus in the mosquito and the consequences for human health

The invisible hand of the damage to the environment and human health arising from the use of chemicals in vector control, has not been properly studied or revealed to vulnerable populations, including public health workers. Its harmful effects are totally disregarded both the worsening of viruses, as the emergence of other diseases such as allergies, immunotoxicity, cancer, hormonal disorders, neurotoxicity, among others.

We stress the simplistic in dealing with the issue on the part of MS that reduces causality Dengue, the Zika and Chicungunya, focusing actions in an attempt to eliminate or reduce the vector, which should be replaced, insist, by the action of nature measures intersectoral to intervene in the social, economic and environmental context. To eliminate the mosquito-oriented action by MS over, too, poisoning humans. But this is not recognized on the contrary, there is a concealment of these dangers. The official voices repeat to make several absurdities as true: "The doses of larvicides are so low and low toxicity that we can put in the drinking water without danger". [6]

This unpreparedness also leads to argue that the epidemic is a public health problem that justifies the use of "fogging", even with known toxic chemicals such as Malathion, a true health nonsense. This product is an organophosphate pesticides considered by the International Agency for Research on Cancer (IARC) as potentially carcinogenic for humans [7].

So, in an attempt to eliminate the mosquito humans are being affected by acute effects (morbidity and mortality) and slow death, gradual, invisible and that is hidden. In addition to the acute illness, chronic caused by such products appear in the medium and long term, most of them so-called "idiopathic", ie, undefined or unknown causes, which are not diagnosed or if you want investigated.

It happens that in the XXI century, in the case of diseases transmitted by Aedes aegypti, there was another complication in terms of Public Health, as two new viruses come into our country, for whose disease - Chikungunya and Zika - had no experience in clinical management and or epidemiological.

Dengue and the epidemiological surveillance system

The surveillance system of most health services not adequately investigated this new reality. Now, with the tragedy of the emergence of cases of microcephaly, it turns out this technical and managerial unpreparedness. Historically these public health issues are immersed in "reasons of state", unknown by most of society. We must ask: What are these reasons? To do so, simply examine the official documents of MS on vector control.

In this sense, it is pedagogical examine the emanating guiding documents of MS. This is the case, for example, the TECHNICAL NOTE No. 109/2010 CGPNCD / DEVEP / SVS / MS [8] to combat dengue, which are well illustrated the misconceptions that signaled here, ie, the increased use of motorized and costal UBV in households and public roads. It reiterates the various absurdities committed in the vector control of Aedes aegypti and MS insists on maintaining and expanding.

Poisoning the poor

In Brazil, Dengue has become an endemic disease outbreaks and this needs to be taken once and for all. What are the specific areas of greatest viral circulation? Precisely those inhabited by the poorest people, who have the worst immune and without adequate sanitation conditions, which will worsen as newspaper news SAO PAULO LEAF, edition of 01/11/2016. And why not disclose these vulnerabilities to its own population? Above technical note mentions the other in No 118/2010, which makes a composite parameter, with which seeks to introduce environmental indicators [9].

Is that it does only for the "delimitation of areas that require further intensification of the actions of combating vector". That is, the application of poison (insecticides and larvicides) has increasing the toxicity on the immune system.

The NT 109/2010 also said that "the controlling shares larval to be implemented are geared mainly to the sources reduction activities creating mosquito (water tanks, many tanks, tires, etc.)." In doing so, it is assumed that water tank is breeding mosquito and therefore must be "treated" with poison. It turns out that drinking water should have guaranteed its potability. Why the shares do not affect the cleaning and protection of reservoirs for storing the most precious liquid for life? How is it possible to accept the loss of potable water to the poorest? Yes the poor, precisely those who are most vulnerable. That equity is that in which those who should be the most protected and are, paradoxically, the most exposed to situations of chemical harm by those who should protect them? The claim that the population is passive also follows this vertical and authoritarian model. It gives priority to power poison against insects disregarding the danger to humans and thus nothing more needs to be done.

Also in NT 109/2010 MS argues that successful control of vector-borne diseases can be attributed to pesticides when cites as a reference for its justification in this document "National Academy of Sciences, National Research Council. Pesticides in the Diets of Infants and Children. National Academy Press, Washington ". We emphasize that MS is the highest authority in health and should be guided by the precautionary principle when it puts the issue related to human exposure to hazardous chemicals.

Also it reads that due to the increasing deterioration of mosquito resistance process to insecticides, one of the main tasks of the Expert Committee on Pesticide WHO (WHOPES) is finding new biocides for which there are no resistant insects, with no opening for other methods, non-hazardous, control. It is well demonstrated that the resistance acquired by the mosquito is demonstrating the unsustainability of chemical-dependent vector control model, as is already known for many years that the poisons develop and / or increase the frequency of carriers insect resistance mechanisms to insecticides and larvicides, as has been happening with the Aedes aegypti.

In addition to NT 109/2010 admits that "all pesticides that are used in public health - for market reasons - are products originally developed for agriculture, and there is none that has been developed exclusively for use in health." And it cites as support parameter of the success of the measure, the research conducted in Singapore to assess possible impact of the use of the various measures used in fighting a dengue epidemic in the country. Why not examine our own experiences, after all we have a time control vector more than 40 years. Are they not edifying?

More poisons, more resistance more poisons

It used the example of the organophosphate insecticide temephos (commercially known as ABATE®), 1%, introduced in Brazil in 1968 as larvicide in drinking water especially in the North and Northeast Brazil, whose impacts on people's health have not been studied. We know that despite the mosquito resistance of finding the MS continued to use it until the exhaustion of its stock, despite having been shown resistance in target insects and abundant toxicological information of potential risks to human health.

The continued addition of other larvicides substitutes in drinking water people give up today without any concerns about its final concentration as a guiding MS standards is indicated dilution of larvicidal only considering the physical volume of the container and not by the amount domestic water in the container. In 1998, a formal warning about this dilution error was made by chemists, doctors and sanitary engineers recognized, but nothing has changed! Stubbornly until today the official documents of MS recommend adding the larvicide in water tanks considering only the physical volume and not the amount of water that actually exists within.

An aggravating fact is that in Pernambuco and other regions of the Northeast there are frequent water rationing. Therefore, it is worth asking: how long the people of these regions drink poisoned water? Not careful and lack of caution, the introduction of larvicides classified as insect growth regulators (IGR) occurs upon further abusive Technical Notes regarding the "despotabilização" drinking water.

We understand that here is the master key to discuss why the MS acknowledges and supports this model. Behind you are the WHO and PAHO to the institutional weight of their committees of "pesticide" that there is no dialogue with the committees: environmental, sanitation and health promotion. Those Committees, who are prescribing the use and regulation of the purchase of the control input vector to the world are imperial. Are such organisms convincing and give the nod to the bidding process by national governments.

The growth regulators larvicides such as diflubenzuron and novaluron, introduced in place of temephos, appear problematic. In Recife, it was conducted effect study on the health of workers that apply found the occurrence of methemoglobinemia; also know its metabolites have several toxic effects, and which are not considered. These results were widely reported in the II Seminar Fiocruz Dengue Network in November 2010 in the city of Rio de Janeiro; the First Health and Environment Symposium in 2010 in the city of Bethlehem and the 10th. Brazilian Public Health Congress in 2012, in Porto Alegre.

With its centralized policy sectors of the MS responsible for vector control contraindicate that municipalities adopt other independent means of chemical use. Even before the conclusion of the ineffectiveness of the model used. Municipalities uselessly spend their meager resources on hazardous chemicals and make the health workers act only at this point, exposing them even to poisons.

Insisting that strategy, there was, in 2014, the introduction of pyriproxyfen larvicide, and even though is its toxicity as teratogenic and endocrine disruption to the mosquito, was considered to have low toxicity. And, once again, the MS suggests its use in drinking water, to be added in tanks and water tanks, irrespective of the amount of water inside, making higher concentration when water shortages situations [10] [11].

On products that have teratogenic effect on arthropods, which the norms for registration of pesticides would be prohibited its use in agriculture, for food safety reasons, we ask how to accept the use of drinking water for human consumption? What about this usage in an epidemic context of birth defects? In the State of Emergency in Public Health of National Importance, recently decreed by MS, as the mainstream media news is being advocated the use of larvicide directly into cars kites distributing water in regions of the Agreste and Sertao the Northeast. We caution that this is the latest absurd and reckless health measure imposed by the managers of the chemical model of vector control.

Although the NT 109/2010 recognizes that "The inclusion of intersectoral actions such as regular water supply and solid waste collection, constitutes a fundamental activity to impact on reducing vector density Aedes aegypti," little is proposed in this sense. We insist on the question: why is maintained vector control centered on a program that for over 40 years has shown ineffective and inefficient to do it? It must be, therefore, a strategy focused on the identification and elimination of breeding and Environmental Sanitation. What in fact is being done for the regular supply of water on the outskirts of cities? How can people protect waters reserved for consumption? Why although many cities have regular garbage collection is still observed a tremendous amount of solid waste disposed in the daily environment? What is being done to take care of this issue? And urban rainwater drainage? And the sewage?

Another noteworthy NT 109/2010 when he says that "the biggest problem lies in" space and residual adulticide ", regretting that the poisons available are restricted only to" groups of organophosphates and pyrethroids. In organophosphate the offer is restricted to Malathion (space) and Fenitrothion (residual) ". We clarify that the reference to the term "space" refers to use in nebulizers (Ultra Low Volume - UBV, known as "fogging" or costal equipment). The above poisons, it is known, as I have said, that the Malathion is a potent carcinogen for animals and has recently been recognized as potentially carcinogenic to humans by IARC WHO [12]. It is worth highlighting that many products used in vector control of Aedes aegypti as Fenitrothion, Malathion and temephos have been studied since 1998, the Fundamental Chemistry Department of UFPE and shown to have potentially carcinogenic effects for humans. The recommendations by the Ministry of the use of Malathion are in the document Recommendations on the use of Malathion emulsion Aqueous-EA 44% for Aedes aegypti control in space applications Ultra Low Volume UBV, 2014 [13]. With the adoption of these sprays poisoning is potentially even wider and more dangerous.

No pun intended, so we arrive at the bottom, in terms of lack of understanding of environmental determination procedures and care in the prevention of diseases related to vectors, to which are added the national and international interests strangers to public health issues and related to consumption of pesticides agendas.

Where is the environmental sanitation?

A question that begs to be put here with complete outrage: why were not prioritized until now the environmental sanitation activities, a strategy that seems to get further away?

By the way, if you visit the outskirts of large cities and so-called special areas socially vulnerable where the needs are of all kinds, will see itself as serious health situation that no amount of poison can resolve the vector control, it added the fact that people will have a severely compromised health.

Urban and sanitation policies are generally disjointed. The precarious living conditions, urbanization and environmental sanitation, characteristic context of the vast majority of cases of microcephaly, reflect a model of development and urban policies that reaches the poor, as historically disenfranchised by abysmal social inequality in Brazil. Unfit housing suitable for household water storage, located on steep or wet areas with poor infrastructure and urbanization and poor sanitation. A context that reflects the social illness that meant better infrastructure and better services for the middle and upper classes. The example of inequality in access to drinking water in Brazil is emblematic of this asymmetry of access. The per capita consumption can vary in a city from 30 to 500 liters / person / day. One of the expressions of this inequality is the weekly rotation of access or intermittent water supply. The vast majority of cases of microcephaly occurred in cities with serious problems casters or flashing, where the poorest are more days without water per week and the richest or has no rotation or flashing or have a few days. The water crisis and poor management of sanitation services also has imposed the rotation or flashing the entire cities, and even the collapse of supply, the scene of many cases of microcephaly in the Northeast.

Faced with the ineffectiveness of the Aedes aegypti control methods, the gravity of the situation deepens. In Pernambuco, the State Department of Health (SES) has notified MS, on October 28, 2015, the existence of 29 cases of microcephaly that year, which was more than double what had been happening in previous years. It is noteworthy that only 07 states had the practice of mandatory reporting of congenital malformation. In December 2015 it was confirmed that 14 states had a prevalence of high microcephaly. The proportion of new cases in Pernambuco became frightening. On November 18, 2015, the Ministry decreed the state of emergency in Public Health of National Importance, a situation that had been adopted only in 1917, with the occurrence of Spanish flu. As reported by the Diario de Pernambuco, on 01.20.2016, the number of suspected cases of microcephaly rose to 3,893. The recordings were made in 764 municipalities distributed in 21 Brazilian states. Until that date, it was reported 49 deaths from this malformation. The total of such deaths, 05 had confirmed the presence of Zika virus. Although we know that, in a situation of maternal exposure to the virus, and this surpassing the placental barrier, it is expected that the fetus also expose. In this field there are still many issues in the research process. According to MS information, Pernambuco remains the state with the highest number of suspected cases (1,306), representing 33% of total registered across the country. [14]

Should be alert and noted that the entry into Brazil of Zika virus was not accompanied by a knowledge of its dispersion by epidemiological and entomological surveillance. A series of measures, all centered on the practice of using poisons intensified, upon acceptance of a direct relationship between microcephaly and Zika virus. As an additive have a recommendation for repellent use of pregnant women [15]. With that DEET (N, N-dimethyl-meta-toluamide) is being sold without restriction for pregnant women, another trivialization of chemical exposure [16].

The epidemiological situation of crisis of diseases transmitted by Aedes aegypti is even more serious and important to say that here in Brazil, between 2014 and 2015, there were about 1.5 million cases, half the state of São Paulo. Because in this state, which occur periodically Dengue epidemics that previously recorded very few deaths, and in that period there was unusually more than 400 deaths associated with complications of dengue? Does this fact is related to the information that, in São Paulo, has intensified vector control with the use of Malathion in chemical fogging? This poison has been used since 2001 to 30% in the final formulation, in nebulization process, the Superintendency of Endemic Disease Control (SUCEN), and in the second half of 2014, was introduced by MS a new formulation of Malathion diluted in water [ 17] containing undeclared emulsifiers and stabilizers. The rationale for this substitution was the lowest cost. Can there be some association between exposure to Malathion and considered this as mortality increased by complications of Dengue? Who are those who died? Are elderly, those with chronic diseases, children? You need to know more. The population exposed to malathion was investigated? The possibility of these deaths are associated with exposure to Malathion was suggested and researched? We emphasize that due to the massive and continuous use of such toxic substance that research needs to be performed.

Finally, we claim from the competent authorities to adopt the following measures:

1) Immediate review of vector control model. The focus should be on BREEDING THE DISPOSAL not the mosquito as the center of the action; with the suspension of the use of chemicals and the adoption of mechanical cleaning methods and environmental sanitation. The reservoirs of drinking water use cleaning measures and water quality protection and guarantee its potability;

2) In public health campaigns to control Aedes aegypti, immediate suspension of the use of malathion or any other organophosphate, carbamate, pyrethroid or organopersistente, either in air or mist curtains treated with poison (impregnated mosquito nets). Replace the use of these products by mechanical barriers, cleaning, vacuuming, telagem windows, doors and other measures;

3) In the measures taken by the Ministry to control Aedes aegypti in their larval and adult forms, immediate suspension of pyriproxyfen (0.5 L) and all growth inhibitors such as diflubenzuron and novaluron, or any other chemical or biological product in drinking water. The concept of drinking water quality can not be lost, it is the key to participatory action vectors disposal.

4) go through intersectoral efforts to stop the flashing of the water supply in the areas of precarious urbanization. Water is a human right. The most vulnerable populations must, in equity, be the most protected;

5) that the vector control activities on the environment is an assignment of sanitation agencies and environmental control local, state and national, not just the SUS, which should act in the entomological surveillance, health, environmental, epidemiological, virological and health worker, checking if environmental sanitation measures are resulting in improved health conditions;

6) That the urban and environmental sanitation policies promote integrated programs for solving the housing problems, sanitation and urbanization;

7) That the surveillance is carried out by experienced professionals in a clinic, pathophysiology and epidemiology at various levels of SUS. This proposition is given to strengthen the integration and coordinated action of health monitoring areas with the areas of knowledge production.

8) which are carried out clinical research and informed other malfunctions or defects on the Dengue viruses, the Zika and Chincungunya and that the effects of exposure to chemicals used in vector control of Aedes aegypti are studied;

9) That the support to families affected by microcephaly outbreak be given by a perennial public policy and not transient. This support is integral, including attention in this family by psychological trauma arising from the pregnancy outcome.

10) What is performed an audit of control models vector by a multidisciplinary committee of independent experts, including evaluation of operated modes Revolving Fund PAHO / WHO to be requested by the Brazilian government, perhaps in conjunction with other Latin American countries suffering the same taxes, to the United Nations;

12) What is ratified immediate preparation by the Ministry of Health technical guidance for Health Care of Health Workers PAST were exposed to pesticides used for controlling the Aedes aegypti, to be adopted by State Departments and Municipal Health in according to the National Health Policy Labour and successful experience;

13) which is created by MS, a Portal for broad population access to all processes and events associated with the vector control, epidemics related to the action of Aedes aegypti and microcephaly epidemic. It must also be informed when used, the volume, the types of chemicals, the number of households and nebulized real estate Unit of the Federation and by municipality, as they are in the best interest of the health professionals and society.

Finally, we call attention of civil society, given the current declaration of State of Emergency in Public Health of National Importance for microcephaly epidemic and arboviruses that: a) all vector control measures are carried out with social mobilization towards the protection and respect of citizenship for Public Health, prioritizing the environmental sanitation measures, with a guarantee of drinking water potability, as part of the respect for human rights and guided by the principles of the National Policy for Popular Education in Health; b) that the NHS should review the strategies and content of the media to the public, taking the focus on individual responsibility and families, explaining the responsibilities of the various state sectors, with emphasis on the importance of sanitation measures, waste collection, Greetings solid waste policies, water supply security; c) improving the quality of care to families and affected children and prenatal care because it worsens the observed weakness that was already known - the example of cases of congenital syphilis - and that proves the occurrence of cases of microcephaly identified after birth.

Thematic Groups Abrasco:

Working Group on Health and Environment

GT Occupational Health

GT Sanitary Surveillance

GT Promoting Health and Sustainable Development

GT Popular Education and Health

GT Food and Nutrition in Public Health

[1] Paper published by the CNBB at the end of 2015.

[2] Available in http://u.saude.gov.br/images/pdf/2014/julho/15/Instrucoes-para-uso-de-pyriproxifennmaio-2014.pdf)

[3] UBV is a technique that uses motorized equipment or costal high pressure causing the particles are smaller, increasing its dispersion in the environment and penetration into the lungs by inhalation of exposed persons.

[4] Armed Forces Pest Management Board, through Memorandum No. 13 - TECHNICAL INFORMATION MEMORANDUM ON. 13 Medical Center Walter Reed Army Institute). Available in: http://www.afpmb.org/pubs/tims/tim13.htm#Equipment

[5] See NT Abrasco 2014 https://goo.gl/GbAXx7

[6] Available at: http://u.saude.gov.br/images/pdf/2014/maio/30/Instrucoes-para-uso-de-pyriproxifen-maio-2014.pdf

[7] Available at: https://www.iarc.fr/en/media-centre/iarcnews/pdf/MonographVolume112.pdf

[8] General Coordination of the National Program for Dengue Control / Department of Health Surveillance / Secretariat of Health Surveillance

[9] Available at: http://www.saude.mppr.mp.br/arquivos/File/dengue/nt_aval_vul_epid_dengue_verao_10_11.pdf

[10] Available at: http://u.saude.gov.br/images/pdf/2014/maio/30/Instrucoes-para-uso-de-pyriproxifen-maio-2014.pdf

[12] Available at: https://www.iarc.fr/en/media-centre/iarcnews/pdf/MonographVolume112.pdf

[13] Available at: http://u.saude.gov.br/images/pdf/2014/setembro/02/Recomenda--es-para-o-uso-de-malathion-EW.pdf

[14] Available at: http://www.diariodepernambuco.com.br/app/noticia/brasil/2016/01/20/interna_brasil,622575/sobe-para-3-893-o-numero-de-casos-de-microcefalia-no-pais.shtml

[15] Available at: http://ecdc.europa.eu/en/publications/Publications/zika-microcephaly-Brazil-rapid-risk-assessment-Nov-2015.pdf

[16] See toxicological aspects of DEET in: http://www.health.state.mn.us/divs/eh/risk/guidance/gw/deet.pdf

[17] Manufactured by Bayer.

PLOS - Suppression of a Field Population of Aedes aegypti in Brazil by Sustained Release of Transgenic Male Mosquitoes

http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003864

A link to the World Health Organization's page on Dispelling rumours around Zika and microcephaly:

http://www.who.int/emergencies/zika-virus/articles/rumours/en/

CLICK HERE - The Case for Pyriproxyfen as a Potential Cause of Microcephaly; From Biology to Epidemiology

necsi.edu - March 15, 2017

Yaneer Bar-Yam, H. Frederik Nijhout, Raphael Parens, Felipe Costa, Alfredo J. Morales, The case for pyriproxyfen as a potential cause of microcephaly; from biology to epidemiology, arXiv (2017).

Abstract

The Zika virus has been the primary suspect in the large increase in incidence of microcephaly in 2015-6 in Brazil. However its role is not confirmed despite individual cases in which viral infections were found in neural tissue. Recently, the disparity between the incidences in different geographic locations has led to questions about the virus's role. Here we consider the alternative possibility that the use of the insecticide pyriproxyfen for control of mosquito populations in Brazilian drinking water is the primary cause. Pyriproxifen is a juvenile hormone analog which has been shown to correspond in mammals to a number of fat soluble regulatory molecules including retinoic acid, a metabolite of vitamin A, with which it has cross-reactivity and whose application during development has been shown to cause microcephaly. Methoprene, another juvenile hormone analog that was approved as an insecticide based upon tests performed in the 1970s, has metabolites that bind to the mammalian retinoid X receptor, and has been shown to cause developmental disorders in mammals. Isotretinoin is another example of a retinoid causing microcephaly in human babies via maternal exposure and activation of the retinoid X receptor in developing fetuses. Moreover, tests of pyriproxyfen by the manufacturer, Sumitomo, widely quoted as giving no evidence for developmental toxicity, actually found some evidence for such an effect, including low brain mass and arhinencephaly—incomplete formation of the anterior cerebral hemispheres—in exposed rat pups. Finally, the pyriproxyfen use in Brazil is unprecedented—it has never before been applied to a water supply on such a scale. Claims that it is not being used in Recife, the epicenter of microcephaly cases, do not distinguish the metropolitan area of Recife, where it is widely used, and the municipality, and have not been adequately confirmed. Given this combination of information about molecular mechanisms and toxicological evidence, we strongly recommend that the use of pyriproxyfen in Brazil be suspended until the potential causal link to microcephaly is investigated further.