巴西南里奥格兰德州的新兴虫媒病毒:2014-2016 年基孔肯雅热和寨卡病毒疫情。
Emerging arboviruses in Rio Grande do Sul, Brazil: Chikungunya and Zika outbreaks, 2014-2016.
机构信息
Laboratório Central de Saúde Pública do Estado do Rio Grande do Sul, IPB-LACEN/RS, Secretaria de Saúde do Estado do Rio Grande do Sul - SES/RS, Porto Alegre, RS, Brazil.
Centro Estadual de Vigilância em Saúde - CEVS, Secretaria de Saúde do Estado do Rio Grande do Sul - SES/RS, Rio Grande do Sul, Porto Alegre, RS, Brazil.
出版信息
Rev Med Virol. 2017 Nov;27(6). doi: 10.1002/rmv.1943. Epub 2017 Sep 20.
QUESTIONS INVESTIGATED
The recent emergence of arboviruses such as Chikungunya virus (CHIKV) and Zika virus (ZIKV) in Brazil has posed a threat to human health and to the country's economy. Outbreaks occur mainly in tropical areas; however, increasing number of cases have been observed in Rio Grande do Sul (RS), the Southernmost state; therefore, surveillance of these arboviruses is essential for public health measures.
DESIGN
In this study, we analyzed 1276 samples from patients with clinically suspected arboviral diseases between 2014 and 2016. Demographic and clinical data were collected and described; cases of microcephaly associated with congenital infection were analyzed.
ESSENTIAL FINDINGS
Results show that CHIKV and ZIKV entered RS in 2014 and 2015, respectively, with imported cases confirmed. Autochthonous infections occurred in 2016 for both viruses, with a total of 5 autochthonous cases for CHIKV and 44 for ZIKV. Most patients were older than 21 years; the main symptoms were fever, arthralgia, myalgia, and headache; rash, conjunctivitis, and pruritus were also reported in ZIKV cases. Three cases of congenital Zika syndrome were confirmed in our study, while another 20 cases of microcephaly associated with congenital infection were confirmed (10 positive for syphilis, 6 for toxoplasmosis and 4 for cytomegalovirus).
MAIN CONCLUSIONS
Considering co-circulation of different arbovirus in RS, including Dengue virus, CHIKV, and ZIKV, and the presence of Aedes aegypti and Aedes albopictus in the area, surveillance of patients infected by these viruses contributes to the control and prevention of such diseases. Practical difficulties in diagnosing these infections are discussed.
研究目的
巴西近来出现了基孔肯雅热病毒(CHIKV)和寨卡病毒(ZIKV)等虫媒病毒,对人类健康和国家经济构成了威胁。这些病毒的暴发主要发生在热带地区,但在巴西南部的南里奥格兰德州(RS),也观察到了越来越多的病例;因此,对这些虫媒病毒进行监测对于公共卫生措施至关重要。
设计
本研究分析了 2014 年至 2016 年间 1276 例临床疑似虫媒病毒病患者的样本。收集并描述了人口统计学和临床数据;分析了与先天性感染相关的小头畸形病例。
重要发现
结果表明,CHIKV 和 ZIKV 分别于 2014 年和 2015 年进入 RS,均确认有输入性病例。2016 年,两种病毒均发生了本地感染,CHIKV 共有 5 例本地感染病例,ZIKV 有 44 例。大多数患者年龄大于 21 岁;主要症状为发热、关节痛、肌痛和头痛;ZIKV 病例还报告了皮疹、结膜炎和瘙痒。本研究共确诊 3 例先天性寨卡综合征病例,另确诊 20 例与先天性感染相关的小头畸形(10 例梅毒阳性,6 例弓形体病阳性,4 例巨细胞病毒阳性)。
主要结论
鉴于 RS 中存在不同的虫媒病毒(包括登革热病毒、CHIKV 和 ZIKV)的循环,以及该地区存在埃及伊蚊和白纹伊蚊,对这些病毒感染患者的监测有助于控制和预防此类疾病。文中还讨论了诊断这些感染的实际困难。