De Carvalho Newton Sérgio, De Carvalho Beatriz Freitas, Fugaça Cyllian Arias, Dóris Bruna, Biscaia Evellyn Silverio
Department of Gynecology and Obstetrics, Universidade Federal do Paraná (UFPR), Infectious Diseases in Gynecology and Obstetrics Sector, Clinics Hospital and Postgraduate Education Program in Obstetrics and Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
Pontifícia Universidade Católica do Paraná (PUC-PR), Curitiba, PR, Brazil.
Braz J Infect Dis. 2016 May-Jun;20(3):282-9. doi: 10.1016/j.bjid.2016.02.006. Epub 2016 Apr 18.
In November of 2015, the Ministry of Health of Brazil published an announcement confirming the relationship between Zika virus and the microcephaly outbreak in the Northeast, suggesting that infected pregnant women might have transmitted the virus to their fetuses. The objectives of this study were to conduct a literature review about Zika virus infection and microcephaly, evaluate national and international epidemiological data, as well as the current recommendations for the health teams. Zika virus is an arbovirus, whose main vector is the Aedes sp. The main symptoms of the infection are maculopapular rash, fever, non-purulent conjunctivitis, and arthralgia. Transmission of this pathogen occurs mainly by mosquito bite, but there are also reports via the placenta. Microcephaly is defined as a measure of occipto-frontal circumference being more than two standard deviations below the mean for age and gender. The presence of microcephaly demands evaluation of the patient, in order to diagnose the etiology. Health authorities issued protocols, reports and notes concerning the management of microcephaly caused by Zika virus, but there is still controversy about managing the cases. The Ministry of Health advises notifying any suspected or confirmed cases of children with microcephaly related to the pathogen, which is confirmed by a positive specific laboratory test for the virus. The first choice for imaging exam in children with this malformation is transfontanellar ultrasound. The most effective way to control this outbreak of microcephaly probably caused by this virus is to combat the vector. Since there is still uncertainty about the period of vulnerability of transmission via placenta, the use of repellents is crucial throughout pregnancy. More investigations studying the consequences of this viral infection on the body of newborns and in their development are required.
2015年11月,巴西卫生部发布一项公告,确认寨卡病毒与东北部小头畸形疫情之间的关联,表明受感染的孕妇可能已将该病毒传播给其胎儿。本研究的目的是对寨卡病毒感染和小头畸形进行文献综述,评估国家和国际流行病学数据,以及针对卫生团队的当前建议。寨卡病毒是一种虫媒病毒,其主要传播媒介是伊蚊属。该感染的主要症状为斑丘疹、发热、非化脓性结膜炎和关节痛。这种病原体主要通过蚊虫叮咬传播,但也有经胎盘传播的报道。小头畸形的定义为枕额周长比年龄和性别的均值低两个标准差以上。小头畸形的出现需要对患者进行评估,以诊断病因。卫生当局发布了有关寨卡病毒所致小头畸形管理的方案、报告和说明,但在病例管理方面仍存在争议。卫生部建议通报任何与该病原体相关的小头畸形儿童疑似或确诊病例,该病例需经病毒特异性实验室检测呈阳性来确认。对于患有这种畸形的儿童,影像学检查的首选是经囟门超声检查。控制这次可能由该病毒引起的小头畸形疫情的最有效方法是消灭传播媒介。由于经胎盘传播的易感染期仍不确定,整个孕期使用驱虫剂至关重要。需要开展更多研究,以探究这种病毒感染对新生儿身体及其发育的影响。