Sampieri Clara Luz, Montero Hilda
Instituto de Salud Pública, Universidad Veracruzana, Xalapa, Veracruz, México.
PeerJ. 2019 Feb 19;7:e6452. doi: 10.7717/peerj.6452. eCollection 2019.
The disease Zika is considered as emergent. The infection can be acquired through different routes: a bite from the mosquito, sexual contact, from mother to child during pregnancy and by blood transfusion. The possibility of Zika transmission through human lactation has been considered. Zika is a disease of great concern for public health because it has been associated with neonatal and postnatal microcephaly, among other birth defects.
To review published evidence of the probable transmission of Zika through human lactation.
Electronic databases: Cochrane Central Register of Controlled Trials, EBSCO, Gale, Science Direct, Scopus, US National Library of Medicine (PubMed) and Web of Science. World Health Organization and Centers for Disease Control and Prevention web pages.
To be eligible, studies of any design had to provide primary data of human breast milk as a potential fluid for the transmission of Zika, or primary or secondary follow-up data of infants with at least one previous published study that complied with the first criterion of eligibility.
Studies about women with suspected, probable or confirmed Zika during pregnancy, or the postnatal period and beyond. Studies about infants who breastfeed directly from the breast or where fed with the expressed breast milk of the suspected, probable or confirmed women with Zika.
This study only chose data from research papers; no patients were taken directly by the authors. A total of 1,146 were screened and nine studies were included in the qualitative synthesis, from which a total of 10 cases were identified, with documented follow-up in three of these cases. Through the timing of maternal Zika infection, five cases were classified as prenatal (time before delivery), one as immediate postnatal (period from 0 to 4 days after birth); no cases were classified as medium postnatal (period from 5 days to 8 weeks after birth); two were classified as long postnatal (period from 8 weeks to 6 months after birth) and two as beyond six months after birth.
Human milk may be considered as a potentially infectious fluid, but we found no currently documented studies of the long-term complications in infants up to 32 months of age, with suspected, probable or confirmed Zika through human lactation, or evidence with respect to the human pathophysiology of the infection acquired through human lactation. In the light of the studies reviewed here, the World Health Organization recommendation of June 29th 2016, remains valid: "the benefits of breastfeeding for the infant and mother outweigh any potential risk of Zika virus transmission through breast milk."
寨卡病毒病被视为一种新发疾病。该感染可通过不同途径获得：蚊虫叮咬、性接触、孕期母婴传播以及输血传播。人们已考虑过寨卡病毒通过人乳传播的可能性。寨卡病毒病是一个备受公共卫生关注的疾病，因为它与新生儿及产后小头畸形等其他出生缺陷有关。
综述已发表的关于寨卡病毒可能通过人乳传播的证据。
电子数据库：考克兰系统评价数据库、EBSCO、Gale、科学Direct、Scopus、美国国立医学图书馆（PubMed）及科学引文索引。世界卫生组织和疾病控制与预防中心网页。
符合条件的研究，任何设计的研究都必须提供人母乳作为寨卡病毒传播潜在载体的原始数据，或至少有一项先前发表的符合首个入选标准的研究中的婴儿的原始或二次随访数据。
关于孕期、产后及产后更长时间疑似、可能或确诊感染寨卡病毒的女性的研究。关于直接母乳喂养或食用疑似、可能或确诊感染寨卡病毒的女性挤出的母乳的婴儿的研究。
本研究仅选取了研究论文中的数据；作者未直接纳入任何患者。共筛选了1146篇文献，9项研究被纳入定性综合分析，从中共确定了10例病例，其中3例有记录在案的随访情况。根据母亲寨卡病毒感染时间，5例被归类为产前（分娩前），1例为出生后即刻（出生后0至4天）；无病例被归类为出生后中期（出生后5天至8周）；2例被归类为出生后长期（出生后8周 至6个月），2例为出生后6个月以上。
人乳可能被视为一种潜在的感染性液体，但我们未发现目前有关于通过人乳疑似、可能或确诊感染寨卡病毒的32个月龄以下婴儿长期并发症的文献记载，也未发现关于通过人乳感染的人体病理生理学的证据。根据此处综述的研究，世界卫生组织2016年6月29日的建议仍然有效：“母乳喂养对婴儿和母亲的益处超过了寨卡病毒通过母乳传播的任何潜在风险。”
