Zika Virus Disease in Colombia - Preliminary Report
Zika Virus Disease in Colombia - Preliminary Report
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DOI：
10.1056/nejmoa1604037
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发表时间：
2020-08-06
影响因子：
158.5
通讯作者：
Ospina Martinez, Martha L.
中科院分区：
文献类型：
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作者：
Pacheco, Oscar;Beltran, Mauricio;Ospina Martinez, Martha L.
哥伦比亚于2015年8月开始对寨卡病毒病（ZVD）进行官方监测。2015年10月，在9名患者中发现经实验室确认的疾病后，宣布爆发了ZVD。方法采用全国人群监测系统，对2015年8月9日至2016年4月2日出现ZVD临床症状的患者进行评估。对一组孕妇的实验室检查结果和妊娠结局进行了评估。同时，我们调查了小头畸形的报告，以寻找先天性ZVD的证据。结果截至2016年4月2日，哥伦比亚共报告ZVD病例65,726例，其中2485例（4%）通过逆转录-聚合酶链反应（RT-PCR）法确诊。总的报道，女性患者的ZVD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%）经RT-PCR检测确诊。在一个由1850名孕妇组成的亚组中，90%以上在妊娠晚期感染的妇女已经分娩，没有发现有明显异常的婴儿，包括小头畸形。大多数在妊娠早期或中期感染ZVD的妇女在本报告发表时仍在怀孕。在2016年1月至2016年4月调查的小头症病例中，有4例患者有先天性ZVD的实验室证据；所有病例均为无症状母亲所生，未纳入ZVD监测系统。结论哥伦比亚的初步监测数据表明，孕妇在妊娠晚期感染寨卡病毒与胎儿结构异常无关。然而，目前正在监测寨卡病毒对哥伦比亚孕妇的影响。
BACKGROUNDColombia 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.METHODSUsing 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.RESULTSBy 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.CONCLUSIONSPreliminary 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.