2012-2019 年旅行者在 GeoSentinel 站点就诊的 Zika 感染病例：对临床实践的影响。
Zika among international travellers presenting to GeoSentinel sites, 2012-2019: implications for clinical practice.
机构信息
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30329, USA.
Department of Medicine, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA.
出版信息
J Travel Med. 2020 Jul 14;27(4). doi: 10.1093/jtm/taaa061.
INTRODUCTION
International travellers contribute to the rapid spread of Zika virus (ZIKV) and its sentinel identification globally. We describe ZIKV infections among international travellers seen at GeoSentinel sites with a focus on ZIKV acquired in the Americas and the Caribbean, describe countries of exposure and traveller characteristics, and assess ZIKV diagnostic testing by site.
METHODS
Records with an international travel-related diagnosis of confirmed or probable ZIKV from January 2012 through December 2019 reported to GeoSentinel with a recorded illness onset date were included to show reported cases over time. Records from March 2016 through December 2019 with an exposure region of the Americas or the Caribbean were included in the descriptive analysis. A survey was conducted to assess the availability, accessibility and utilization of ZIKV diagnostic tests at GeoSentinel sites.
RESULTS
GeoSentinel sites reported 525 ZIKV cases from 2012 through 2019. Between 2012 and 2014, eight cases were reported, and all were acquired in Asia or Oceania. After 2014, most cases were acquired in the Americas or the Caribbean, a large decline in ZIKV cases occurred in 2018-19.Between March 2016 and December 2019, 423 patients acquired ZIKV in the Americas or the Caribbean, peak reporting to these regions occurred in 2016 [330 cases (78%)]. The median age was 36 years (range: 3-92); 63% were female. The most frequent region of exposure was the Caribbean (60%). Thirteen travellers were pregnant during or after travel; one had a sexually acquired ZIKV infection. There was one case of fetal anomaly and two travellers with Guillain-Barré syndrome. GeoSentinel sites reported various challenges to diagnose ZIKV effectively.
CONCLUSION
ZIKV should remain a consideration for travellers returning from areas with risk of ZIKV transmission. Travellers should discuss their travel plans with their healthcare providers to ensure ZIKV prevention measures are taken.
简介
国际旅行者促进了寨卡病毒（ZIKV）在全球范围内的快速传播及其哨点识别。我们描述了在 GeoSentinel 站点就诊的国际旅行者中寨卡病毒感染情况，重点介绍了在美洲和加勒比地区获得的寨卡病毒感染，描述了暴露国家和旅行者特征，并评估了各站点的寨卡病毒诊断检测情况。
方法
从 2012 年 1 月至 2019 年 12 月，向 GeoSentinel 报告了与国际旅行相关的确诊或疑似寨卡病毒感染病例记录，并记录了发病日期，以显示随时间推移的报告病例数。2016 年 3 月至 2019 年 12 月期间，暴露地区为美洲或加勒比地区的记录被纳入描述性分析。我们进行了一项调查，以评估 GeoSentinel 站点提供、获取和使用寨卡病毒诊断检测的情况。
结果
2012 年至 2019 年，GeoSentinel 站点共报告了 525 例寨卡病毒病例。2012 年至 2014 年期间，共报告了 8 例病例，均在亚洲或大洋洲获得。2014 年以后，大多数病例发生在美洲或加勒比地区，2018-19 年寨卡病毒病例数大幅下降。2016 年 3 月至 2019 年 12 月，423 例患者在美洲或加勒比地区感染寨卡病毒，这些地区报告病例的高峰期出现在 2016 年[330 例（78%）]。中位年龄为 36 岁（范围：3-92 岁）；63%为女性。最常见的暴露地区是加勒比地区（60%）。13 名旅行者在旅行期间或旅行后怀孕；1 人发生性传播寨卡病毒感染。有 1 例胎儿畸形和 2 例旅行者患有格林-巴利综合征。GeoSentinel 站点报告了在有效诊断寨卡病毒方面存在各种挑战。
结论
对于从有寨卡病毒传播风险的地区返回的旅行者，仍应考虑寨卡病毒。旅行者应与医疗保健提供者讨论旅行计划，以确保采取寨卡病毒预防措施。
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