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哥伦比亚寨卡病毒病的初步报告
作者:小柯机器人 发布时间:2020/8/7 22:13:27
本期文章:《新英格兰医学杂志》:Vol.383 No.6
美国疾病控制和预防中心Margaret A. Honein团队对哥伦比亚的寨卡病毒病进行了初步报告。2020年8月6日,该研究发表在《新英格兰医学杂志》上。
哥伦比亚于2015年8月开始对寨卡病毒病(ZVD)进行正式检测。2015年10月,在9名患者经实验室确诊后,宣布ZVD爆发。
研究组使用全国人群监测系统,评估了2015年8月9日至2016年4月2日患有ZVD临床症状的患者,评估了孕妇亚组的化验结果和妊娠结局。同时,还调查了小头畸形的报道,以寻找先天性ZVD的证据。
截至2016年4月2日,哥伦比亚共报告了65726例ZVD病例,其中2485例(4%)通过逆转录酶-聚合酶链反应(RT-PCR)检测确诊。女性患者中ZVD的总体报告发病率是男性患者的两倍。哥伦比亚共报告了11944例ZVD孕妇,其中1484例(12%)通过RT-PCR检测确诊。
在一个包含1850名孕妇的亚组中,据报道90%的孕妇在妊娠晚期分娩,未发现有明显异常(包括小头畸形)的婴儿。该试验结束时,大多数在孕早期或孕中期感染ZVD的妇女仍在妊娠。2016年1月至4月调查的小头畸形病例中,其中4例有先天性ZVD的实验室证据。这些都是无症状母亲分娩的,因此没被纳入ZVD监测系统。
哥伦比亚的初步监测数据表明,孕妇在孕晚期感染寨卡病毒与胎儿结构异常无关。
附:英文原文
Title: Zika Virus Disease in Colombia — Preliminary Report
Author: Oscar Pacheco, M.D.,, Mauricio Beltrán, M.S.,, Christina A. Nelson, M.D.,, Diana Valencia, M.S.,, Natalia Tolosa, M.D.,, Sherry L. Farr, Ph.D.,, Ana V. Padilla, M.D.,, Van T. Tong, M.P.H.,, Esther L. Cuevas, M.S.,, Andrés Espinosa-Bode, M.D.,, Lissethe Pardo, B.S.,, Angélica Rico, B.S.,, Jennita Reefhuis, Ph.D.,, Maritza González, M.D.,, Marcela Mercado, M.S.,, Pablo Chaparro, M.D.,, Mancel Martínez Duran, M.D.,, Carol Y. Rao, Sc.D.,, María M. Muoz, M.D.,, Ann M. Powers, Ph.D.,, Claudia Cuéllar, M.D.,, Rita Helfand, M.D.,, Claudia Huguett, M.S.,, Denise J. Jamieson, M.D.,, Margaret A. Honein, Ph.D.,, and Martha L. Ospina Martínez, M.D.
Issue&Volume: 2016-06-15
Abstract: BACKGROUND
Colombia began official surveillance for Zika virus disease (ZVD) in August 2015. In October 2015, an outbreak of ZVD was declared after laboratory-confirmed disease was identified in nine patients.
METHODS
Using the national population-based surveillance system, we assessed patients with clinical symptoms of ZVD from August 9, 2015, to April 2, 2016. Laboratory test results and pregnancy outcomes were evaluated for a subgroup of pregnant women. Concurrently, we investigated reports of microcephaly for evidence of congenital ZVD.
RESULTS
By April 2, 2016, there were 65,726 cases of ZVD reported in Colombia, of which 2485 (4%) were confirmed by means of reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay. The overall reported incidence of ZVD among female patients was twice that in male patients. A total of 11,944 pregnant women with ZVD were reported in Colombia, with 1484 (12%) of these cases confirmed on RT-PCR assay. In a subgroup of 1850 pregnant women, more than 90% of women who were reportedly infected during the third trimester had given birth, and no infants with apparent abnormalities, including microcephaly, have been identified. A majority of the women who contracted ZVD in the first or second trimester were still pregnant at the time of this report. Among the cases of microcephaly investigated from January 2016 through April 2016, four patients had laboratory evidence of congenital ZVD; all were born to asymptomatic mothers who were not included in the ZVD surveillance system.
CONCLUSIONS
Preliminary surveillance data in Colombia suggest that maternal infection with the Zika virus during the third trimester of pregnancy is not linked to structural abnormalities in the fetus. However, the monitoring of the effect of ZVD on pregnant women in Colombia is ongoing.
DOI: 10.1056/NEJMoa1604037
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1604037 |
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