Laboratory of Paediatric Infectology, Jundiaí School of Medicine.
Department of Paediatric, Jundiaí School of Medicine.
Medicine (Baltimore). 2021 Apr 30;100(17):e25695. doi: 10.1097/MD.0000000000025695.
The chikungunya virus (CHIKV) was first isolated in a Tanzanian epidemic area between 1952 and 1953. The best description of the CHIKV transmission during pregnancy can be found in a well-documented epidemic in 2005, in the "La Reunion" island, a French territory located in the Indian Ocean, in which about one-third of the population was infected. Reports of arbovirus infections in pregnancy are increasing over time, but the spectrum of clinical findings remains an incognita among researchers, including CHIKV.
In this report, it was possible to verify 2 cases exposed to CHIKV during foetal period and the possible implications of the infection on gestational structures and exposed children after the birth.
In both cases, the mothers were positive by laboratory tests in serologic analysis for CHIKV, as ezyme-linked immunossorbent assay (ELISA), plaque reduction neutralisation testing (PRNT) and immunofluorescence (IF); but there were no positive tests in quantitative polymerase chain reaction (qPCR) for mothers or children.
The exposed children were followed up in a paediatrics clinic in order not only to provide the medical assistance, but also to verify child development and the possible implications and neurocognitive changes caused by gestational infection.
There were neurological and developmental changes in one of the children followed up on an outpatient basis. There was an improvement in the neurological situation and symptoms only 3 years and 1 month after birth.
Based on the cases presented, we can conclude that clinical symptoms of CHIKV maternal infection may occur late in new-borns and can affect their development.
基孔肯雅病毒（CHIKV）于 1952 年至 1953 年期间首次在坦桑尼亚疫区分离。在 2005 年一次记录详实的疫情中，可以最好地描述妊娠期间 CHIKV 的传播情况，该疫情发生在法属留尼汪岛，这是一个位于印度洋的法国领土，当时岛上约三分之一的人口受到感染。随着时间的推移，有关妊娠期间虫媒病毒感染的报告越来越多，但包括 CHIKV 在内的研究人员对其临床表现仍知之甚少。
在本报告中，我们能够证实 2 例在胎儿期暴露于 CHIKV 的病例，以及感染对妊娠结构和出生后暴露儿童的可能影响。
在这两种情况下，母亲的实验室检测结果均为 CHIKV 血清学分析阳性，包括酶联免疫吸附试验（ELISA）、蚀斑减少中和试验（PRNT）和免疫荧光（IF）；但母亲或儿童的定量聚合酶链反应（qPCR）检测均为阴性。
对暴露的儿童在儿科诊所进行随访，不仅提供医疗援助，还对儿童发育以及妊娠感染引起的可能影响和神经认知变化进行评估。
在接受门诊随访的儿童中，有 1 人出现神经和发育变化。仅在出生后 3 年 1 个月时，神经状况和症状才有所改善。
根据所提出的病例，我们可以得出结论，母体 CHIKV 感染的临床症状可能在新生儿晚期出现，并可能影响其发育。
