Hancock W Thane, Soeters Heidi M, Hills Susan L, Link-Gelles Ruth, Evans Mary E, Daley W Randolph, Piercefield Emily, Anesi Magele Scott, Mataia Mary Aseta, Uso Anaise M, Sili Benjamin, Tufa Aifili John, Solaita Jacqueline, Irvin-Barnwell Elizabeth, Meaney-Delman Dana, Wilken Jason, Weidle Paul, Toews Karrie-Ann E, Walker William, Talboy Phillip M, Gallo William K, Krishna Nevin, Laws Rebecca L, Reynolds Megan R, Koneru Alaya, Gould Carolyn V
MMWR Morb Mortal Wkly Rep. 2017 Mar 24;66(11):299-301. doi: 10.15585/mmwr.mm6611a5.
The first patients with laboratory-confirmed cases of Zika virus disease in American Samoa had symptom onset in January 2016 (1). In response, the American Samoa Department of Health (ASDoH) implemented mosquito control measures (1), strategies to protect pregnant women (1), syndromic surveillance based on electronic health record (EHR) reports (1), Zika virus testing of persons with one or more signs or symptoms of Zika virus disease (fever, rash, arthralgia, or conjunctivitis) (1-3), and routine testing of all asymptomatic pregnant women in accordance with CDC guidance (2,3) All collected blood and urine specimens were shipped to the Hawaii Department of Health Laboratory for Zika virus testing and to CDC for confirmatory testing. Early in the response, collection and testing of specimens from pregnant women was prioritized over the collection from symptomatic nonpregnant patients because of limited testing and shipping capacity. The weekly numbers of suspected Zika virus disease cases declined from an average of six per week in January-February 2016 to one per week in May 2016. By August, the EHR-based syndromic surveillance (1) indicated a return to pre-outbreak levels. The last Zika virus disease case detected by real-time, reverse transcription-polymerase chain reaction (rRT-PCR) occurred in a patient who had symptom onset on June 19, 2016. In August 2016, ASDoH requested CDC support in assessing whether local transmission had been reduced or interrupted and in proposing a timeline for discontinuation of routine testing of asymptomatic pregnant women. An end date (October 15, 2016) was determined for active mosquito-borne transmission of Zika virus and a timeline was developed for discontinuation of routine screening of asymptomatic pregnant women in American Samoa (conception after December 10, 2016, with permissive testing for asymptomatic women who conceive through April 15, 2017).
美属萨摩亚第一例实验室确诊的寨卡病毒病患者于2016年1月出现症状（1）。作为应对措施，美属萨摩亚卫生部（ASDoH）实施了蚊虫控制措施（1）、保护孕妇的策略（1）、基于电子健康记录（EHR）报告的症状监测（1）、对出现寨卡病毒病一种或多种体征或症状（发热、皮疹、关节痛或结膜炎）的人员进行寨卡病毒检测（1 - 3），并根据美国疾病控制与预防中心（CDC）的指导对所有无症状孕妇进行常规检测（2,3）。所有采集的血液和尿液标本均被送往夏威夷州卫生部实验室进行寨卡病毒检测，并送往疾病预防控制中心进行确认检测。在应对初期，由于检测和运输能力有限，孕妇标本的采集和检测优先于有症状的非孕妇患者的标本采集。疑似寨卡病毒病病例的周数从2016年1月至2月的平均每周6例下降到2016年5月的每周1例。到8月，基于电子健康记录的症状监测（1）显示已恢复到疫情暴发前的水平。通过实时逆转录聚合酶链反应（rRT-PCR）检测到的最后一例寨卡病毒病病例发生在一名于2016年6月19日出现症状的患者身上。2016年8月，美属萨摩亚卫生部请求疾病预防控制中心提供支持，以评估当地传播是否已减少或中断，并提出停止对无症状孕妇进行常规检测的时间表。确定了寨卡病毒通过蚊虫传播的活动结束日期（2016年10月15日），并制定了美属萨摩亚停止对无症状孕妇进行常规筛查的时间表（2016年12月10日之后受孕，允许对在2017年4月15日前受孕的无症状妇女进行检测）。
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