大部分患者无症状;然而,约有 20% 的感染会导致轻度和自限性的发热、皮疹和结膜炎。
有很强的科学共识认为,寨卡病毒是引起小头畸形和一些其他先天性畸形的病因。所观察到的异常程度与病毒间可能的因果关系表明可能存在一种新的先天性综合征。不建议孕妇前往寨卡病毒疫区,且应仔细考虑前往有寨卡病毒传播风险地区的风险。
格林-巴利综合征以及其他神经系统疾病与寨卡病毒相关性很高,且疑似由寨卡病毒引起,但其中的关联尚未证实,关于此的研究正在进行中,包括阐明其中可能的机制。
症状性感染的治疗主要为支持性治疗,且在这个阶段还没有特异性抗病毒疗法。通过个人和公共卫生手段预防蚊子叮咬是预防感染的重要方式。
由寨卡病毒(又称 ZIKV)引起的感染,当有症状时(发生于约 20% 的感染)表现为轻度且通常为自限性。寨卡病毒属于黄病毒科(黄病毒属),且为虫媒病毒(由节肢动物传播的病毒)。该病毒以 1947 年首次发现它的乌干达寨卡丛林命名。[1]Kindhauser MK, Allen T, Frank V, et al. Zika: the origin and spread of a mosquito-borne virus. Bull World Health Organ. 2016 Sep 1;94(9):675–86C.
https://www.who.int/bulletin/volumes/94/9/16-171082-ab/en/
http://www.ncbi.nlm.nih.gov/pubmed/27708473?tool=bestpractice.com
寨卡病毒最初由伊蚊传播给人类,伊蚊同时也是登革热、基孔肯雅热和西尼罗河病毒的传播媒介。也有可能在人类之间经性传播。
发现先天性寨卡综合征是一种由孕期感染寨卡病毒所致的婴儿先天性异常(即,小头畸形、颅内钙化或其他脑部异常、或眼部异常等)。[2]Adebanjo T, Godfred-Cato S, Viens L, et al. Update: interim guidance for the diagnosis, evaluation, and management of infants with possible congenital Zika virus infection - United States, October 2017. MMWR Morb Mortal Wkly Rep. 2017 Oct 20;66(41):1089-99.
https://www.cdc.gov/mmwr/volumes/66/wr/mm6641a1.htm?s_cid=mm6641a1_w
http://www.ncbi.nlm.nih.gov/pubmed/29049277?tool=bestpractice.com
[3]França GV, Schuler-Faccini L, Oliveira WK, et al. Congenital Zika virus syndrome in Brazil: a case series of the first 1501 livebirths with complete investigation. Lancet. 2016 Aug 27;388(10047):891-7.
http://www.ncbi.nlm.nih.gov/pubmed/27372398?tool=bestpractice.com
[4]Melo AS, Aguiar RS, Amorim MM, et al. Congenital Zika virus infection: beyond neonatal microcephaly. JAMA Neurol. 2016 Dec 1;73(12):1407-16.
http://jamanetwork.com/journals/jamaneurology/fullarticle/2557231
http://www.ncbi.nlm.nih.gov/pubmed/27695855?tool=bestpractice.com
[5]Moore CA, Staples JE, Dobyns WB, et al. Characterizing the pattern of anomalies in congenital Zika syndrome for pediatric clinicians. JAMA Pediatr. 2017 Mar 1;171(3):288-95.
http://www.ncbi.nlm.nih.gov/pubmed/27812690?tool=bestpractice.com
[6]Lucey D, Cummins H, Sholts S. Congenital Zika syndrome in 2017. JAMA. 2017 Apr 4;317(13):1368-9.
http://www.ncbi.nlm.nih.gov/pubmed/28384812?tool=bestpractice.com
据世界卫生组织 (WHO) 表示,有很强的科学共识认为,寨卡病毒是引起小头畸形和其他一些先天性畸形的病因。[7]Costello A, Dua T, Duran P, et al. Defining the syndrome associated with congenital Zika virus infection. Bull World Health Organ. 2016 Jun 1;94(6):406-406A.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890216/
http://www.ncbi.nlm.nih.gov/pubmed/27274588?tool=bestpractice.com
美国疾病预防控制中心 (CDC) 也提出,产前寨卡病毒感染和小头畸形/其他脑部异常间存在因果关系。[8]Rasmussen SA, Jamieson DJ, Honein MA, Petersen LR. Zika virus and birth defects - reviewing the evidence for causality. N Engl J Med. 2016 May 19;374(20):1981-7.
http://www.nejm.org/doi/full/10.1056/NEJMsr1604338
http://www.ncbi.nlm.nih.gov/pubmed/27074377?tool=bestpractice.com
格林-巴利综合征以及其他神经系统疾病与寨卡病毒相关性很高,且疑似由寨卡病毒感染引起,但其中的关联尚未证实,关于此的研究正在进行中,包括阐明其中可能的机制。[9]Dos Santos T, Rodriguez A, Almiron M, et al. Zika virus and the Guillain-Barré syndrome - case series from seven countries. N Engl J Med. 2016 Oct 20;375(16):1598-601.
http://www.nejm.org/doi/full/10.1056/NEJMc1609015?query=featured_zika
http://www.ncbi.nlm.nih.gov/pubmed/27579558?tool=bestpractice.com
[10]Parra B, Lizarazo J, Jiménez-Arango JA, et al. Guillain-Barré syndrome associated with Zika virus infection in Colombia. N Engl J Med. 2016 Oct 20;375(16):1513-23.
http://www.nejm.org/doi/full/10.1056/NEJMoa1605564#t=article
http://www.ncbi.nlm.nih.gov/pubmed/27705091?tool=bestpractice.com
[11]Frontera JA, da Silva IR. Zika getting on your nerves? The association with the Guillain-Barré syndrome. N Engl J Med. 2016 Oct 20;375(16):1581-82.
http://www.nejm.org/doi/full/10.1056/NEJMe1611840
http://www.ncbi.nlm.nih.gov/pubmed/27705077?tool=bestpractice.com
[12]Leis AA, Stokic DS. Zika virus and Guillain–Barre syndrome: is there sufficient evidence for causality? Front Neurol. 2016 Sep 30;7:170.
http://journal.frontiersin.org/article/10.3389/fneur.2016.00170/full
http://www.ncbi.nlm.nih.gov/pubmed/27746763?tool=bestpractice.com
CDC: Zika virus
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WHO: Zika virus disease
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Pan American Health Organization: Zika virus infection
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