Kantor Isabel N
Comité de Redacción, Medicina (Buenos Aires), Argentina. E-mail:
Medicina (B Aires). 2018;78(1):23-28.
Dengue (DENV), zika (ZIKV) and chikungunya (CHIKV), three arbovirosis transmitted by Aedes mosquitoes, have spread in recent decades in humid tropical and subtropical zones. Dengue is epidemic in subtropical areas of Argentina. DENV infection confers lasting immunity against the infecting serotype but increases the risk of serious disease upon reinfection by any of the other three. The recombinant tetravalent vaccine Dengvaxia® prevents severe dengue and hospitalization in seropositive subjects. In 2017, Dengvaxia was approved in Argentina, for ages 9 to 45, but is not included in the national vaccination calendar. Two other vaccines are in Phase III evaluation: one developed by NIAID / Instituto Butantan and the other by Takeda. ZIKV, a virus associated with microcephaly in newborns in Brazil, circulates since 2016 in Argentina. There is still not effective treatment nor vaccine with proven activity against ZIKV. There has been no active circulation of CHIKV in Argentina in 2017. Outbreaks of CHIKV fever have a complication: the development of chronic post-disease rheumatism. There are not approved vaccines for humans nor effective antiviral therapies. The seriousness of these virosis has contributed to a rapid progress in the knowledge of the infection processes and the immune response. For now, Aedes aegypti and A. albopictus vectors continue to expand, suggesting that the vaccine will be the most effective means of controlling these viruses. Here we summarize information about these arbovirosis in Argentina and Brazil and describe advances in the development and evaluation of vaccines.
登革热(DENV)、寨卡病毒(ZIKV)和基孔肯雅病毒(CHIKV)这三种由伊蚊传播的虫媒病毒,在近几十年里已在潮湿的热带和亚热带地区蔓延。登革热在阿根廷的亚热带地区呈流行态势。登革热病毒感染可使机体对感染的血清型产生持久免疫力,但再次感染其他三种血清型中的任何一种时,会增加患严重疾病的风险。重组四价疫苗登革热疫苗(Dengvaxia®)可预防血清阳性个体发生严重登革热和住院。2017年,登革热疫苗在阿根廷获批用于9至45岁人群,但未被纳入国家疫苗接种计划。另外两种疫苗正处于III期评估阶段:一种由美国国立过敏和传染病研究所/布坦坦研究所研发,另一种由武田公司研发。寨卡病毒自2016年起在阿根廷传播,该病毒在巴西与新生儿小头畸形有关。目前仍没有针对寨卡病毒的有效治疗方法或经证实有效的疫苗。2017年基孔肯雅病毒在阿根廷未出现活跃传播。基孔肯雅热疫情有一个并发症:病后慢性风湿的发展。目前尚无获批的人用疫苗,也没有有效的抗病毒疗法。这些病毒病的严重性推动了对感染过程和免疫反应认识的快速进展。目前,埃及伊蚊和白纹伊蚊这两种病媒仍在继续扩散,这表明疫苗将是控制这些病毒的最有效手段。在此,我们总结了阿根廷和巴西有关这些虫媒病毒的信息,并描述了疫苗研发和评估方面的进展。