婴儿是否要测试寨卡病毒的指南（多图+视屏）

2015年10月8日和10月16日之间，巴西和哥伦比亚《国际卫生条例》国家归口单位向世卫组织/泛美卫生组织通报了寨卡病毒感染病例。

巴西

2015年5月，巴西公共卫生当局确认该国东北部地区发生寨卡病毒本土传播。截至10月8日，在14个州已经发现寨卡病毒本土病例：阿拉戈阿斯、巴伊亚、塞阿拉、马拉尼昂、马托格罗索、帕拉、巴拉那、帕拉伊巴、伯南布哥、皮奥伊、里约热内卢、北里奥格兰德、罗赖马和圣保罗。

由国家和州行政部门采取的公共卫生措施包括：制定并分发寨卡病毒哨点监测操作规程，制定并验证神经综合征监测和媒介控制活动的操作规程。

哥伦比亚

截至2015年10月16日，从玻利瓦尔省获得的98个标本中（13个来自卡塔赫纳，85个来自图尔瓦科），有9个标本经实验室确认存在寨卡病毒感染。这是在该国首次发现的寨卡病毒感染病例。

背景

寨卡热是由寨卡病毒引起的一种蚊媒病毒病，包括轻微发热、红疹（多数为斑丘疹）、头痛、关节痛、肌肉痛、无力以及非化脓性结膜炎，这些症状在受到蚊子叮咬后三至十二天出现。四分之一的病人可能不会出现症状，但受到感染的人员中通常出现的轻微疾病症状可能会持续二至七天。其临床表现往往与同为蚊媒传播疾病的登革热类似。

 

自2014年以来，已经发现寨卡病毒在美洲存在本土流行。2014年2月，智利公共卫生当局确认在复活节岛发现了寨卡病毒感染首位本土传播病例，病例报告一直持续到2014年6月。最近在世界上不同地区出现寨卡病毒热的疫情表明，虫媒病毒能够通过伊蚊所在的领土传播。

世卫组织建议

由于寨卡病毒在美洲区域的传播出现上升，世卫组织/泛美卫生组织建议其会员国建设并且保持用以发现和确认寨卡病毒感染病例的能力，卫生服务部门要做出准备，应对卫生保健所有层面可能出现的负担加重情况，并采取有效的公众交流策略，减少引起该病传播的蚊虫数量，尤其是在该虫媒已经出现的地区。

寨卡病毒是一种ＳＳ ＲＮＡ病毒。在疫区，有少数感染的母亲生出的孩子有小头畸形(microcephaly)，因此孕妇要格外小心，预防感染，尽量避免进入疫区。

 

婴儿在下列情况需要做寨卡病毒的测试检验:
１）婴儿有小头畸形;
２）母亲可能感染寨卡病毒。

关于寨卡病毒:
Zika is ssRNA containing virus primarily spread by mosquito and human serves as natural host. It causes Zika fever in human characterized by fever, rashes, joint pain and conjunctivitis. In May 2015 Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infections in Brazil. WHO is expecting 4 million cases of Zika virus alone in America by the end of 2016. Unborn children are biggest threat to this virus and babies were born with deformed heads to virus infected mothers. New born babies with shrunken skull called microcephaly a congenital deformation of the skull that compresses the infants' brain. Thus pregnant women should be more cautious in travelling to Zika infected area.

ＣＤＣ的通告:
Interim guidelines for testing infants with Zika virus

CDC has developed interim guidelines for health care providers in the U.S. who are caring for infants born to mothers who traveled to or resided in an area with Zika virus transmission during pregnancy. These guidelines include recommendations for the testing and management of these infants.

Pediatric health care providers should work closely with obstetric providers to identify infants whose mothers were potentially infected with Zika virus during pregnancy (based on travel to or residence in an area with Zika virus transmission) and review fetal ultrasounds and maternal testing for Zika virus infection.

Zika virus testing is recommended for 1) infants with microcephaly or intracranial calcifications born to women who traveled to or resided in an area with Zika virus transmission while pregnant; or 2) infants born to mothers with positive or inconclusive test results for Zika virus infection. For infants with laboratory evidence of a possible congenital Zika virus infection, additional clinical evaluation and follow-up is recommended. Health care providers should contact their state or territorial health department to facilitate testing.

The only way to prevent congenital Zika virus infection is to prevent maternal infection, either by avoiding areas where Zika virus transmission is ongoing or strictly following steps to avoid mosquito bites. Mosquito-bite prevention includes using air conditioning or window and door screens when indoors, wearing long sleeves and pants, using permethrin-treated clothing and gear, and using insect repellents.

STATE OF CALIFORNIA
HEALTH AND HUMAN SERVICES AGENCY
California Department of Public Health
Division of Communicable Disease Control

What is Zika?
Zika is an infectious disease caused by the Zika virus, which is transmitted to people by Aedes mosquitoes. Symptoms of Zika typically include fever, rash, joint pain, and/or red eyes.

Where does Zika occur?
Zika occurs in many tropical and sub-tropical areas of the world, particularly in Africa, Southeast Asia, and islands in the Pacific Ocean. Recent outbreaks have occurred in Latin America and the Caribbean.

How do people get Zika?
Zika virus is transmitted by Aedes aegypti mosquitoes (also known as yellow fever mosquitoes) and by Aedes albopictus mosquitoes (also known as Asian tiger mosquitoes). These mosquitoes are not native to California. However, since 2011 they have been detected in several California counties. An Aedes mosquito can only transmit Zika virus after it bites a person who has this virus in their blood. Thus far in California, Zika virus infections have been documented only in a few people who were infected while travelling outside the United States. A person with Zika is not contagious. Zika is not spread through casual contact such as touching or kissing a person with the virus, or by breathing in the virus.

What are the symptoms of Zika?
Most people infected with Zika virus have no symptoms. If symptoms develop, the most common are fever, rash, joint pain, and/or red eyes. Symptoms usually begin 3-7 days after being bitten by an infected mosquito and last several days to a week. There are other causes of fever and painful joints. Your healthcare provider can order different tests to help determine the cause.

What's the relationship between Zika virus and microcephaly in newborns?
There is a possible association between Zika and microcephaly (abnormally small head) in newborns. It is suspected that pregnant women who contract Zika virus through the bite of an infected mosquito are at risk of the fetal birth defect. However, there are many causes of microcephaly in babies, and whether Zika virus infection causes fetal microcephaly has not been confirmed. Studies are needed to understand this possible relationship.

Until more is known, and out of an abundance of caution, the California Department of Public Health recommends special travel precautions for pregnant women and women trying to become pregnant:
• Pregnant women in any trimester should consider postponing travel to areas where Zika virus transmission is ongoing. Pregnant women who must travel to one of these areas should talk to their healthcare provider first and strictly follow steps to avoid mosquito bites during the trip.
• Women trying to become pregnant should consult with their healthcare provider before traveling to these areas and strictly follow steps to avoid mosquito bites during the trip.
• Pregnant women who traveled to an area with ongoing Zika virus transmission during pregnancy should be evaluated for Zika virus infection if they had any symptoms suggestive of Zika or if their baby has evidence of microcephaly. Other mosquito-borne virus infections, such as dengue and chikungunya, should be ruled out in these patients.

What's the relationship between Zika virus and Guillain-Barré Syndrome?
Guillain-Barré syndrome (GBS) is a rare autoimmune disease affecting the nervous system leading to muscle weakness. Cases of GBS were reported among some persons with Zika in the French Polynesia Zika outbreak in 2013-2014, and an increase of GBS cases has recently been noted in Brazil and El Salvador where Zika outbreaks are ongoing. Whether Zika virus infection causes GBS is still not clear and awaits additional studies.

How is Zika treated?
There is no specific treatment for Zika. Talk with your health care provider about medications to help reduce fever and pain; rest and fluids are also helpful. Most people will feel better in about a week.

What can people do to keep from getting Zika?
There is no vaccine to prevent Zika. In areas where Zika is present, everyone, including pregnant women and women of childbearing age, should protect themselves from mosquito bites.
• Mosquito repellents containing DEET, picaridin, IR3535, and oil of lemon eucalyptus should be applied to exposed skin and clothing.
• Using insect repellent is safe and effective. Pregnant women and women who are breastfeeding can and should choose an EPA-registered insect repellent and use it according to the product label.
• When weather permits, wear long-sleeved shirts and long pants.
• Use air conditioning or window/door screens to keep mosquitoes outside. If you are not able to protect yourself from mosquitoes inside your home or hotel, sleep under a mosquito bed net.

What can people do to help prevent Zika from becoming established in California?
• If you are sick with fever and joint pain after returning from an area where Zika occurs, contact your healthcare provider and avoid mosquito bites to help prevent possible spread of the virus.
• To reduce mosquito breeding, check your yard often for water-filled containers. Clean and scrub bird baths and pet-watering dishes weekly and dump the water from overflow dishes under potted plants and flower pots. Check that gutters are not holding water.
• Contact your local vector control agency if you detect unusual numbers of mosquitoes or you are being bitten during the day.

Where can I find more information about Zika?
U.S. Centers for Disease Control and Prevention:
http://www.cdc.gov/zika/index.html

California Department of Public Health:
http://www.cdph.ca.gov/HealthInfo/discond/Pages/Aedes-albopictus-and-Aedes-aegypti-Mosquitoes.aspx