Many doctors, though, say that the jump is largely illusory — based on massive underreporting of microcephaly and other birth defects in Brazil. What’s more, this poor record-keeping reflects much larger public health problems here: poor prenatal care and woefully inadequate services for children with disabilities. Until the Zika epidemic, these issues were mostly swept under the rug.

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Out of every 10,000 live births in the United States, according to the Centers for Disease Control and Prevention, about 2 to 12 babies are born with microcephaly. In Brazil, where care for pregnant women is much less extensive, official statistics from previous years show a rate of 0.5 per 10,000. That means the country could have thousands of undocumented cases.

“The numbers are stupidly underreported and just get in the way of understanding the effects of the Zika epidemic,” said Salmo Raskin, a professor of genetic medicine at the Pontifical Catholic University of Parana. “Zika is throwing light on historical failures in our health system.”

One reason the numbers for microcephaly were so low is that the government made it mandatory to report the defect only after the potential Zika connection emerged. According to Raskin, data collection was further inhibited by the fact that the official system for registering births offered only a checkbox for the defect, with no field to record the circumference of the baby’s head, thus indicating how serious the problem is. As the president of the Brazilian Society for Genetic Medicine, Raskin said, he had often urged the Health Ministry to implement a system to track and care for congenital defects — to no avail.

Because most Brazilians can’t afford private insurance, they use the country’s chronically underfunded public health service. Free clinics are abundant, but they often fail to treat preventable causes of microcephaly. One is syphilis, which can be cured with a cheap shot of penicillin. “Syphilis had been erradicated here,” Raskin said. “Now we’re seeing 1 in every 100 babies born with syphilis.” He blames the government’s failure to stock penicillin and doctors too poorly trained to identify the disease.

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Another major cause of microcephaly in Brazil is fetal alcohol syndrome. João Monteiro de Pina Neto, a professor of genetic medicine at the University of Sao Paulo in Ribeirao Preto, cited a study showing that 30 percent of new mothers in the region where he is based drank heavily during their pregnancies. But whenever he promoted prevention efforts with local health officials, he says, he was ignored — much as Raskin was.

“We’re preaching in the desert,” Pina Neto said. “This is a hugely serious public health problem, and no one is worrying about it.” More often than not, he says, children with microcephaly — which can cause serious cognitive and motor deficiencies — only show up later in institutions for the disabled.

Teresa Costa d’Amaral, the head of the Brazilian Institute for the Rights of the Disabled, says the government has long fallen short in meeting the needs of children with microcephaly and other congenital defects. “When the child is born, mothers rarely receive instruction on proper care,” she said. “Then she has to wait in line for one of the few spaces available in rehabilitation centers.”

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What’s more, d’Amaral added, facilities for the disabled are usually in big cities far from the rural towns where many poor families live. And in public schools, where special attention is lacking, overburdened teachers often leave children with disabilities sitting ignored in a corner of the classroom.

Amid international alarm over the Zika virus, Brazil’s government is prioritizing research into vaccines and care for pregnant mothers and children affected by the disease. In Rio de Janeiro, authorities are prioritizing Zika-linked microcephaly cases for special treatment at the Paulo Niemeyer State Institute for the Brain. No additional support has been announced for children born with the defect but without a link to the mosquito-borne virus.

D’Amaral hopes that the Zika epidemic will bring attention to the widespread neglect of children with disabilities in Brazil. “But it could just be a passing concern,” she said, “and in six months, it’s no longer making headlines.”