Follow-up Clinic, Neonatal Intensive Care Unit, Hospital Universtário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, Department of Pediatrics and Neonatology (UNIRIO), Rio de Janeiro, Brazil.
Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
J Pediatric Infect Dis Soc. 2024 Nov 27;13(11):576-584. doi: 10.1093/jpids/piae102.
Large-scale epidemics in countries with high birth rates can create a concerning scenario where pregnant people are more likely to transmit the virus. In addition, increased international mobility has made arboviruses a growing problem for travelers. The increased risk of vertical transmission has been related to maternal viremia near delivery. Such transmission leads to severe infection of newborns and may be associated with subsequent neurological impairment including cerebral palsy. This case series provides an overview of clinical and laboratory findings in pregnant individuals with confirmed chikungunya virus (CHIKV) infection as well as the clinical effects on their newborn emphasizing the severity of neonatal chikungunya.
An ambispective case series enrolled newborns with confirmed exposure to CHIKV in utero or in the neonatal period.
During the delivery period, the transmission rate among viremic individuals was approximately 62% (18/29). Fever, irritability, rash, and poor feeding in the first week of life were critical signs of neonatal chikungunya, highlighting its severity.
Close monitoring of healthy newborns during the first week of life is essential in areas affected by CHIKV epidemics, and in offspring of pregnant travelers who visited the outbreaks zones. This case series is intended to increase neonatologists' awareness of the possibility of mother-to-child transmission of CHIKV among newborns with a sepsis-like presentation. Prioritizing CHIKV vaccination for women of childbearing age should also be considered.
出生率较高的国家发生大规模疫情时，孕妇更有可能传播病毒，这令人担忧。此外，国际间的人员流动增加，使虫媒病毒成为旅行者日益严重的问题。垂直传播的风险增加与接近分娩时母体病毒血症有关。这种传播会导致新生儿严重感染，并且可能与随后的神经损伤包括脑瘫有关。本病例系列提供了确诊感染基孔肯雅病毒（CHIKV）的孕妇的临床和实验室发现概述，以及对其新生儿的临床影响，强调了新生儿基孔肯雅病的严重性。
前瞻性病例系列纳入了在子宫内或新生儿期确认为 CHIKV 暴露的新生儿。
在分娩期间，病毒血症个体的传播率约为 62%（18/29）。发热、烦躁、皮疹和新生儿出生后第一周喂养不良是新生儿基孔肯雅病的关键体征，突出了其严重性。
在受 CHIKV 流行影响的地区，以及孕妇旅行者在疫区旅行后的新生儿中，在出生后的第一周内应密切监测健康新生儿。本病例系列旨在提高新生儿科医生对在出现脓毒症样表现的新生儿中存在 CHIKV 母婴传播可能性的认识。还应考虑为育龄妇女优先接种 CHIKV 疫苗。
