de Carvalho Newton Sérgio, de Carvalho Beatriz Freitas, Dóris Bruna, Silverio Biscaia Evellyn, Arias Fugaça Cyllian, de Noronha Lúcia
Department of Gynecology and Obstetrics, Infectious Diseases in Gynecology and Obstetrics Sector, Clinics Hospital, Federal University of Parana, Curitiba, PR, Brazil.
Pontifical Catholic University of Parana, Curitiba, PR, Brazil.
Am J Reprod Immunol. 2017 Feb;77(2). doi: 10.1111/aji.12616. Epub 2017 Jan 3.
In May 2015, the first episodes of Zika virus infection of the Latin America were confirmed in Brazil, where currently 196 976 cases were reported. The main route of transmission occurs by Aedes mosquitoes, and the most common symptoms are maculopapular rash, fever, conjunctivitis, polyarthralgia, and periarticular edema. However, the infection is asymptomatic in 80% of the cases. The congenital infection is characterized when the transmission to the fetus occurs during pregnancy, but the mechanisms of how the virus infects the placenta remain unclear. Anatomopathological findings were described in first- and third-trimester human placentas; however, the major affected tissue of the baby is the neural. Several clinical situations were listed in these fetuses, such as neurological, ophthalmological, auditory, and articular alterations. The World Health Organization proposed a new congenital syndrome caused by Zika virus. The virus has an important neurotropism and the main manifestation observed in the syndrome is microcephaly, which is usually severe and associated with other neurological injuries. The appearance of sudden rash in pregnant women determines immediate investigation through RT-PCR and serological analysis. Moreover, the prevention consists in using repellents and avoiding endemic areas, considering that the vaccine is still under development.
2015年5月,拉丁美洲的首批寨卡病毒感染病例在巴西得到确认,目前巴西已报告196976例病例。主要传播途径是通过伊蚊,最常见的症状是斑丘疹、发热、结膜炎、多关节痛和关节周围水肿。然而,80%的病例感染是无症状的。先天性感染是指孕期病毒传播给胎儿的情况,但病毒感染胎盘的机制仍不清楚。已描述了孕早期和孕晚期人类胎盘的解剖病理学发现;然而,婴儿主要受影响的组织是神经组织。这些胎儿出现了几种临床情况,如神经、眼科、听觉和关节改变。世界卫生组织提出了一种由寨卡病毒引起的新的先天性综合征。该病毒具有重要的嗜神经性,该综合征中观察到的主要表现是小头畸形,通常较为严重并伴有其他神经损伤。孕妇突然出现皮疹需通过逆转录聚合酶链反应(RT-PCR)和血清学分析立即进行检查。此外,预防措施包括使用驱虫剂和避免前往流行地区,因为疫苗仍在研发中。