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So many distraught mothers stream into the infant ward clutching babies with abnormally small heads that the receptionist sends them outside, to see if they can find a chair to wait under the mango tree. "There's shade there, at least," said Maria Helena Lopes, 66, as she greeted one young mother after another. "We'll call you when we're ready."
Roziline Ferreira took three buses to get here, grasping her 3-month-old son, Arthur, all the way. Tears swelled as she looked at him, recalling how the symptoms of the Zika virus had struck her during the second month of her pregnancy. How would she ever be able to care for him, she wondered? What kind of life would he have? "It gets me angry when someone on the bus looks at Arthur and asks, 'What's wrong with his head?'" Ferreira said. "I tell them, 'Nothing's wrong, he's just different.' But then I think to myself, 'Yes, something's wrong. My son will never be like the other boys'."
This poverty-stricken city near the Equator is at the centre of a nightmarish health crisis that has set off alarms across the Western Hemisphere. Mothers began showing up at the Oswaldo Cruz Hospital with their affected babies as early as September, stunning doctors and leaving even the most experienced among them scrambling to figure out what was going on.
"I would like to dream it isn't happening," said the head of the infant care unit, Angela Rocha, who began working at the hospital in 1973. "We've had our share of epidemics, but this is unprecedented."
Before last fall, medical reports of babies born with brain damage and unusually small heads - a condition known as microcephaly - were so uncommon in Brazil that only about 150 cases were registered each year in the entire country. Now Brazilian officials are investigating thousands of them, and they contend that the mosquito-borne Zika virus is the cause.
Virus specialists are racing to understand the connection, if any, between Zika and the rash of microcephaly cases in Brazil, an undertaking that international officials warn could take six months or more.
But whatever the cause, "There is no doubt that Brazil is experiencing a significant increase in microcephaly," said an official for Brazil's health ministry who was not authorised to speak publicly. "We wouldn't have declared this situation a health emergency if this increase had not been detected."
The Zika epidemic has spread much faster than science's understanding of it. Researchers here believe that the virus made the leap from Polynesia to Brazil during the 2014 World Cup soccer tournament. Since then, as many as 1.5 million people in Brazil are believed to have been infected.
The most common symptoms are relatively mild, like fever and joint pain, and most people with the virus feel no ill effects at all. But as Zika continued to spread across Brazil, particularly here in the northeast, doctors began to encounter a steady stream of women cradling babies with unusually small heads.
"I saw this dramatic increase in cases with my own eyes," said Vanessa Van Der Linden, a neurologist in Recife who was among the first doctors to detect an increase in microcephaly cases last year.
She said she was shocked when the babies began appearing at the public hospital where she works, the Hospital Barão de Lucena, and at her private practice. Altogether, she has examined about 60 cases in the last six months, she said - 10 times the rate of cases she came across in previous years.
She began suspecting a new cause for the microcephaly after testing the mothers for other possible factors, like toxoplasmosis, HIV and rubella. None of the tests showed that these ailments could have been responsible, prompting researchers to examine the link to Zika.
"This is an emergency because the situation is unprecedented," Van Der Linden said.
Many of the mothers were already overwhelmed by poverty. Now they are grappling with an incurable condition that can involve seizures, impaired cognitive development, delayed motor functions, problems with speech and dwarfism. "Some of the mothers hope the microcephaly is something that will pass, and just have an empty gaze when I tell them it will not," said . Rocha, 67, a pediatrician. "Others simply start to cry when the reality sets in."
The full extent of the crisis is still far from clear. Reporting microcephaly became mandatory across the country only in the last few months, after officials documented the jump in cases here in the northeast. Brazilian officials said this week that reported cases of microcephaly had now climbed to 4,180 since October, a 7 per cent increase from the previous tally last week.
©2016 The New York Times News Service
