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Armstrong, M.

Publications and source records attributed to Armstrong, M..

3 recordsLinked to original sources

How Public Transport affected the Propagation of Zika and Microcephaly within Rio de Janeiro early in 2015

From mid-2015 to the end of January 2016, 47 cases of microcephaly were observed in the city of Rio de Janeiro, that were not due to other viral infections (syphilis, toxoplasmosis, herpes & cytomegalovirus). These children were conceived from Dec 2014 to April 2015, far too early to be explained by the officially recorded cases from October 2015 onward. Zika must have been rampant in the city from late 2014 onward. In the first half of the paper we study how the geographic spread of microcephaly cases evolved from mid-2015 to January 2016 (and hence Zika 6-9 months earlier). Cases were not evenly spread in proportion to the number of births; they were preferentially located in the northern suburbs apparently following the public transport routes, with virtually no cases in favelas and none in the southern suburbs (Zona Sul). One key difference between the transport systems in the northern and southern suburbs is that the metro & rail system in the north is above ground in the north whereas in the southern part the metro is underground with air-conditioning in carriages and forced ventilation on the platforms. The train system does not extend to Zona Sul.\n\nIn the second half of the paper we postulate that the air-conditioning and ventilation prevent mosquitos from biting people who are waiting on platforms in Zona Sul. Agent-based simulations are used to test this hypothesis. After confirming this, we postulate that providing air-conditioning and/or forced ventilation on the rail-metro transport hub in the city center (Centro) would significantly delay the propagation of arboviruses in the city, possibly preventing epidemics. One advantage of this proposal is that it does not require the use of insecticides.

epidemiology

Zika: An ongoing threat to women and infants

Recent data from Rio de Janeiro shows a sharp drop in the number of notified cases of Zika in the summer of 2016-17, compared to the previous summer. This is probably due to herd immunity built up after the previous year's epidemic. There is still a much higher incidence among women than men, almost certainly due to sexual transmission. An unexpected feature of the new data is that there are proportionally far more cases in children under 15 months than in older age classes. By comparing the incidence for 2016-17 with that of 2015-16, we can deduce the proportion of reported cases for men and women, and also verify that the disparity of incidence between them is still present. Women and children still represent risk groups with regard to Zika infection, even during a non-epidemic season.

epidemiology

Can Zika Account For The Missing Babies?

The Zika virus (ZIKV) spread rapidly in Brazil in 2015 and 2016. Rio de Janeiro was among the Brazilian cities which were hit the hardest, with more that a hundred thousand confirmed cases up to the end of 2016. Given the severity of the neurological damage caused by ZIKV on fetuses, we wondered whether it would also cause an increase in the number of miscarriages, especially very early ones. As early miscarriages are unlikely to be recorded as a health event, this effect - if it occurred - would only show up as a reduction in the number of live births. In this paper we show that there was a 15% drop in live births between September and December 2016 compared to the previous year, and that this sharp drop from epidemiological week 33 onward is strongly correlated with the number of recorded cases of Zika about 40 weeks earlier. We postulate that ZIKV is directly responsible for this drop in the birth rate. Further work is required to ascertain whether other factors such the fear of having a microcephaly baby or the economic crisis are having a significant effect.

epidemiology