US, Brazilian health teams go into slums to start Zika study

Teams of US and Brazilian health workers ventured into dicey slums, fought through snarled traffic and braved torrential downpours on the first day of their effort to determine if the Zika virus is causing babies to be born with a birth defect affecting the brain.
The eight teams, each made up of one "disease detective" from the US Centers for Disease Control and Prevention and three Brazilian health workers, went to work Tuesday in Paraiba, the impoverished state in northeastern Brazil that is one of the epicenters of the country's tandem outbreaks of Zika and microcephaly.
Their goal is to persuade about 100 mothers of infants recently born with the defect as well to enroll in the study.

They also need participation as controls of two to three times as many mothers from the same areas who delivered babies without microcephaly at about the same time.
The study aims to determine if the Brazilian government is right that Zika can cause microcephaly, or whether the mosquito-borne virus is not in fact to blame or is only partially responsible, as a growing chorus of doctors in Brazil and beyond have begun to suggest.
The seemingly straightforward task of locating the women and infants was fraught on day one by traffic jams, logistical snags and menacing weather, though the teams soldiered stoically on.

Stuck in the chronic gridlock of the state capital, Joao Pessoa, one team missed its first appointment, and the two home visits that it had scheduled for morning didn't get underway until well after lunchtime.

"Obviously, we've seen the problems of logistics - to be able to reach the families, to have them be there," said Dr. Alexia Harrist, a Boston-born pediatrician who works for the CDC's Epidemic Intelligence Service. "If things take longer, things take longer, but I think we're all really dedicated to getting it done."
Packed into a small sedan, Harrist, three Brazilian health workers and a driver weaved from the CDC's headquarters in a beachfront hotel to the outskirts of Joao Pessoa along pothole-marred streets swimming with runoff from recent rains.

They turned onto a side street lined with trash, then turned again and again onto successively narrower and more pocked streets that carried them deep into the heart of the Taipa shantytown. The Aedes aegypti mosquito that spreads Zika proliferates in such neighborhoods, where omnipresent trash provides breeding grounds in discarded margarine tubs, yogurt containers and plastic bottle caps.