Robillard Pierre-Yves, Boumahni Brahim, Gérardin Patrick, Michault Alain, Fourmaintraux Alain, Schuffenecker Isabelle, Carbonnier Magali, Djémili Sam, Choker Ghassan, Roge-Wolter Madeleine, Barau Georges
Réanimation néonatale et pédiatrique, Groupe hospitalier Sud-Réunion, Saint-Pierre (97).
Presse Med. 2006 May;35(5 Pt 1):785-8. doi: 10.1016/s0755-4982(06)74690-5.
In March 2005, an epidemic of chikungunya virus began in the southern portion of Reunion Island (French overseas district in the Indian Ocean) and spread to the northern part of the island at the end of 2005. The Reunion-South Hospital Group observed the first cases of pregnant women infected with the virus in June 2005. We report here for the first time maternal-fetal transmission of this virus.
From June 2005 through the end of January 2006, 84 pregnant women had acute chikungunya infections during pregnancy. In 88% of these cases (n=74)--all involving infections relatively distant from delivery--the newborns appeared asymptomatic. Conversely, 10 newborns had severe attacks (4 with meningoencephalitis and 3 with intravascular coagulations) after birth and required prolonged neonatal hospitalization (6 in the neonatal intensive care unit with intubation and assisted ventilation). No infants died, but there was one case of severe intracerebral hemorrhage after severe thrombocytopenia. These cases were confirmed by specific serology testing or PCR or both for mothers and newborns. We note that all severe cases involved women with viremia and fever in the intrapartum period.
2005年3月，留尼汪岛（印度洋上的法国海外行政区）南部爆发基孔肯雅病毒疫情，并于2005年底蔓延至该岛北部。留尼汪岛南部医院集团于2005年6月发现了首例感染该病毒的孕妇。我们在此首次报告该病毒的母婴传播情况。
2005年6月至2006年1月底，84名孕妇在孕期发生急性基孔肯雅病毒感染。其中88%（n = 74）的病例——所有病例的感染时间均与分娩时间相隔较远——新生儿表现无症状。相反，10名新生儿出生后出现严重发作（4例患脑膜脑炎，3例患血管内凝血），需要长时间住院治疗（6例在新生儿重症监护病房，接受插管和辅助通气）。无婴儿死亡，但有1例在严重血小板减少后发生严重脑出血。这些病例通过对母亲和新生儿进行特异性血清学检测或PCR检测或两者同时检测得以确诊。我们注意到，所有严重病例均涉及在分娩期出现病毒血症和发热的女性。
