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寨卡病毒感染:对孕妇和婴儿的媒介传播威胁。

Zika Virus Infection: A Vector-Borne Threat to Pregnant Women and Infants.

作者信息

Grazel Regina, Harris-Haman Pamela

机构信息

New Jersey Chapter, American Academy of Pediatrics, East Windsor, and former consultant, New Jersey Department of Health Critical Congenital Heart Defects Screening Program and Zika Infant Surveillance, Trenton (Ms Grazel); and Thomas Jefferson School of Nursing, Philadelphia, Pennsylvania, and Duke-Johnson & Johnson Nurse Leadership, Division of Community Health, Durham, North Carolina, and Geisinger Holy Spirit Hospital, Middletown, Pennsylvania (Dr Harris-Haman).

出版信息

Adv Neonatal Care. 2018 Oct;18(5):350-359. doi: 10.1097/ANC.0000000000000557.

Abstract

BACKGROUND

Zika virus (ZIKV) is an emergent flavivirus, transmitted predominately by Aedes genus mosquitos that recently reached the Americas and was soon implicated in an increase in microcephaly and other serious birth defects.

PURPOSE

This report provides updated information and recommendations on testing, screening, and care for pregnant women and infants affected by ZIKV.

METHODS

Current published recommendations from the Centers for Disease Control and Prevention, the World Health Organization, and the American Academy of Pediatrics were reviewed and included in this report.

RESULTS

Although largely a self-limiting disease usually without symptoms, pregnant women and their fetuses are at greatest risk. Maternal transmission of ZIKV to the fetus can lead to congenital Zika infection with potentially devastating sequelae to the infant. The available evidence suggests that infection during the first trimester of pregnancy, in which the fetus' central nervous system is being formed, is associated with higher risk of brain abnormalities and perinatal loss.

IMPLICATIONS FOR PRACTICE

Uncertainties remain about the course of the disease, and the full spectrum of effects of the virus on the developing infant is not yet understood. Infants with congenital Zika syndrome need coordinated follow-up and long-term specialty care, as well as support for the family.

IMPLICATIONS FOR RESEARCH

There is no known cure for ZIKV infection and no vaccine is currently available. The full spectrum of developmental disabilities and other adverse early childhood outcomes associated with congenital ZIKV infection needs to be studied.

摘要

背景

寨卡病毒(ZIKV)是一种新出现的黄病毒,主要通过伊蚊属蚊子传播,该病毒最近传播到美洲,并很快被认为与小头畸形及其他严重出生缺陷的增加有关。

目的

本报告提供了关于对受寨卡病毒影响的孕妇和婴儿进行检测、筛查及护理的最新信息和建议。

方法

对美国疾病控制与预防中心、世界卫生组织及美国儿科学会目前已发表的建议进行了审查,并纳入本报告。

结果

虽然寨卡病毒病在很大程度上是一种通常无症状的自限性疾病,但孕妇及其胎儿面临的风险最大。寨卡病毒的母婴传播可导致先天性寨卡病毒感染,对婴儿可能产生毁灭性后果。现有证据表明,在胎儿中枢神经系统正在形成的妊娠头三个月感染,与脑异常及围产期死亡的较高风险相关。

对实践的启示

该病的病程仍存在不确定性,病毒对发育中婴儿的全面影响尚不清楚。患有先天性寨卡综合征的婴儿需要协调的随访和长期专科护理,以及对家庭的支持。

对研究的启示

目前尚无已知的寨卡病毒感染治愈方法,也没有可用的疫苗。需要研究与先天性寨卡病毒感染相关的发育障碍及其他不良幼儿期结局的全貌。

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