截至 2019 年 7 月,共有 87 个国家和地区报告了目前或以前的寨卡病毒传播病例,包括非洲、美洲、东南亚和西太平洋地区。[17]World Health Organization. Zika epidemiology update. July 2019 [internet publication].
https://www.who.int/emergencies/diseases/zika/epidemiology-update/en/
寨卡病毒最早于 1947 年在乌干达寨卡丛林的恒河猴中发现,但直到 1952 年在坦桑尼亚才第一次在人类身上发现。[18]Smithburn KC. Neutralizing antibodies against certain recently isolated viruses in the sera of human beings residing in East Africa. J Immunol. 1952 Aug;69(2):223-34.
http://www.ncbi.nlm.nih.gov/pubmed/14946416?tool=bestpractice.com
[19]Dick GW, Kitchen SF, Haddow AJ. Zika virus. I. Isolations and serological specificity. Trans R Soc Trop Med Hyg. 1952 Sep;46(5):509-20.
http://www.ncbi.nlm.nih.gov/pubmed/12995440?tool=bestpractice.com
此后,在非洲、美洲、亚洲和太平洋地区开始散在暴发。直至 2007 年,全球仅有 14 例病例记录在案。[20]Filipe AR, Martins CM, Rocha H. Laboratory infection with Zika virus after vaccination against yellow fever. Arch Gesamte Virusforsch. 1973;43(4):315-9.
http://www.ncbi.nlm.nih.gov/pubmed/4799154?tool=bestpractice.com
2007 年,在雅浦岛(密克罗尼西亚联邦)发生了第一次大暴发。[21]Oehler E, Watrin L, Larre P, et al. Zika virus infection complicated by Guillain-Barre syndrome - case report, French Polynesia, December 2013. Euro Surveill. 2014 Mar 6;19(9). pii: 20720.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20720
http://www.ncbi.nlm.nih.gov/pubmed/24626205?tool=bestpractice.com
[22]Duffy MR, Chen TH, Hancock WT, et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med. 2009 Jun 11;360(24):2536-43.
http://www.nejm.org/doi/full/10.1056/NEJMoa0805715#t=article
http://www.ncbi.nlm.nih.gov/pubmed/19516034?tool=bestpractice.com
这次暴发最可能的原因是由于旅游或贸易使已感染的人或蚊子将病毒带入此地。[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
另一次较大的暴发发生于 2013 至 2014 年,在太平洋岛屿(法属波利尼西亚、复活节岛、库克群岛、新喀里多尼亚)。此次暴发首次出现与感染相关联的先天性畸形(如,小头畸形)以及神经系统并发症(包括格林-巴利综合征,GBS),尽管这种关联是靠疫情回顾分析得出。[21]Oehler E, Watrin L, Larre P, et al. Zika virus infection complicated by Guillain-Barre syndrome - case report, French Polynesia, December 2013. Euro Surveill. 2014 Mar 6;19(9). pii: 20720.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20720
http://www.ncbi.nlm.nih.gov/pubmed/24626205?tool=bestpractice.com
[23]Cauchemez S, Besnard M, Bompard P, et al. Association between Zika virus and microcephaly in French Polynesia, 2013-15: a retrospective study. Lancet. 2016 May 21;387(10033):2125-32.
http://www.ncbi.nlm.nih.gov/pubmed/26993883?tool=bestpractice.com
[24]Cao-Lormeau VM, Blake A, Mons S, et al. Guillain-Barré syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study. Lancet. 2016 Apr 9;387(10027):1531-39.
http://www.ncbi.nlm.nih.gov/pubmed/26948433?tool=bestpractice.com
2015-2016 年,美国发生大规模暴发,引发了公共卫生紧急事件。在 2016 年暴发高峰时,巴西(疾病暴发的重点疫区)报告了超过 200,000 例病例,其中 8000 多名婴儿出生时患有寨卡病毒感染相关性畸形。发病率在 2016 年达到顶峰,此后大幅下降,目前认为疫情已经结束。[25]World Health Organization. Zika: the continuing threat. Bull World Health Organ. 2019 Jan 1;97(1):6-7.
https://www.who.int/bulletin/volumes/97/1/19-020119/en/
http://www.ncbi.nlm.nih.gov/pubmed/30618459?tool=bestpractice.com
在美国,2016-2017 年,佛罗里达州和德克萨斯州报告了有限的局部传播,但此后没有病例报告。尽管疫情已经结束,但寨卡病毒感染在美洲乃至全世界许多国家/地区仍然是并将持续是一种风险。
2015-2016 年在美洲暴发的疫情导致全球旅行相关病例增加,包括英国、欧洲、美国、澳大利亚、新西兰、以色列、日本和中国。[26]Craig AT, Butler MT, Pastore R, et al. Acute flaccid paralysis incidence and Zika virus surveillance, Pacific Islands. Bull World Health Organ. 2017 Jan 1;95(1):69-75.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5180343/
http://www.ncbi.nlm.nih.gov/pubmed/28053366?tool=bestpractice.com
[27]Gulland A. First case of Zika virus spread through sexual contact is detected in UK. BMJ. 2016 Dec 1;355:i6500.
http://www.bmj.com/content/355/bmj.i6500.long
http://www.ncbi.nlm.nih.gov/pubmed/27908879?tool=bestpractice.com
[28]Zammarchi L, Tappe D, Fortuna C, et al. Zika virus infection in a traveller returning to Europe from Brazil, March 2015. Euro Surveill. 2015 Jun 11;20(23):21153.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=21153
http://www.ncbi.nlm.nih.gov/pubmed/26084316?tool=bestpractice.com
[29]Public Health England. Zika virus (ZIKV): clinical and travel guidance. February 2019 [internet publication].
https://www.gov.uk/government/collections/zika-virus-zikv-clinical-and-travel-guidance
[30]O’Dowd A. UK records four cases of Zika virus in past six weeks. BMJ. 2016 Feb 11;352:i875.
http://www.bmj.com/content/352/bmj.i875
http://www.ncbi.nlm.nih.gov/pubmed/26868672?tool=bestpractice.com
[31]Centers for Disease Control and Prevention. Zika virus: case counts in the US. November 2019 [internet publication].
https://www.cdc.gov/zika/reporting/2019-case-counts.html
[32]Bachiller-Luque P, Domínguez-Gil González M, Álvarez-Manzanares J, et al. First case of imported Zika virus infection in Spain. Enferm Infecc Microbiol Clin. 2016 Apr;34(4):243-6.
http://www.ncbi.nlm.nih.gov/pubmed/26994814?tool=bestpractice.com
[33]Meltzer E, Lustig Y, Leshem E, et al. Zika virus disease in traveler returning from Vietnam to Israel. Emerg Infect Dis. 2016 Aug;22(8):1521-2.
http://wwwnc.cdc.gov/eid/article/22/8/16-0480_article
http://www.ncbi.nlm.nih.gov/pubmed/27331627?tool=bestpractice.com
[34]Taira M, Ogawa T, Nishijima H, et al. The first isolation of Zika virus from a Japanese patient who returned to Japan from Fiji in 2016. Jpn J Infect Dis. 2017 Sep 25;70(5):586-9.
https://www.jstage.jst.go.jp/article/yoken/advpub/0/advpub_JJID.2017.042/_article
http://www.ncbi.nlm.nih.gov/pubmed/28367888?tool=bestpractice.com
自 2017 年以来,美国各州的旅行相关病例一直在下降,2018 年报告了 72 例旅行归国输入病例,截至 2019 年 8 月 1 日,只有 5 例报告。[35]Centers for Disease Control and Prevention. Zika virus. Statistics and maps. November 2019 [internet publication].
https://www.cdc.gov/zika/reporting/index.html
在英国,2018 年报告了 4 例旅行相关病例,与 2016 年报告的 283 例相比大幅下降。2016 年,英国报告了 1 例疑似性传播病例。[36]Public Health England. Zika virus: epidemiology and cases diagnosed in the UK. February 2019 [internet publication].
https://www.gov.uk/government/publications/zika-virus-epidemiology-and-cases-diagnosed-in-the-uk/zika-virus-epidemiology-and-cases-diagnosed-in-the-uk
尽管大流行有所减弱,但亚洲、印度和非洲仍有疫情暴发的相关报告。[37]Musso D, Ko AI, Baud D. Zika virus infection - after the pandemic. N Engl J Med. 2019 Oct 10;381(15):1444-57.
https://www.doi.org/10.1056/NEJMra1808246
http://www.ncbi.nlm.nih.gov/pubmed/31597021?tool=bestpractice.com
据报道,2018 年 11 月印度暴发疫情;但已阻断传播。[38]World Health Organization. Zika virus infection: India. November 2018 [internet publication].
https://www.who.int/emergencies/diseases/zika/india-november-2018/en/
据报道,2019 年 10 月法国发生了本土传播。这可能是在法国大城市和欧洲首次发现的本土病媒传播。[39]World Health Organization. Zika virus disease – France. Disease outbreak news. November 2019 [internet publication].
https://www.who.int/csr/don/01-november-2019-zika-virus-disease-france/en/
在 2015 年 10 月美洲暴发的疫情中,首次报道了寨卡病毒感染与胎儿小头畸形及其他出生缺陷的关联。[40]Kleber de Oliveira W, Cortez-Escalante J, De Oliveira WT, et al. Increase in reported prevalence of microcephaly in infants born to women living in areas with confirmed Zika virus transmission during the first trimester of pregnancy - Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016 Mar 11;65(9):242-7.
http://www.cdc.gov/mmwr/volumes/65/wr/mm6509e2.htm
http://www.ncbi.nlm.nih.gov/pubmed/26963593?tool=bestpractice.com
在 2016 年的一个有将近一百万新生儿的出生队列研究中,可能由寨卡病毒感染所致出生缺陷的患病率为 3 例/ 1000 活婴。[41]Delaney A, Mai C, Smoots A, et al. Population-based surveillance of birth defects potentially related to Zika virus infection - 15 states and U.S. territories, 2016. MMWR Morb Mortal Wkly Rep. 2018 Jan 26;67(3):91-96.
https://www.cdc.gov/mmwr/volumes/67/wr/mm6703a2.htm
http://www.ncbi.nlm.nih.gov/pubmed/29370151?tool=bestpractice.com
美国寨卡病毒妊娠登记处 (US Zika Pregnancy Registry) 的数据发现,10% 经实验室确诊的感染,导致了胎儿/婴儿的出生缺陷。当仅分析早期妊娠时,这一数据升高至 15%。[42]Reynolds MR, Jones AM, Petersen EE, et al; US Zika Pregnancy Registry Collaboration. Vital signs: update on Zika virus-associated birth defects and evaluation of all US infants with congenital Zika virus exposure - US Zika Pregnancy Registry, 2016. MMWR Morb Mortal Wkly Rep. 2017 Apr 7;66(13):366-373.
https://www.cdc.gov/mmwr/volumes/66/wr/mm6613e1.htm?s_cid=mm6613e1_w
http://www.ncbi.nlm.nih.gov/pubmed/28384133?tool=bestpractice.com
这份报告仅涵盖了美国所报道的病例。另一个更有力的研究是关于美国地区具有感染寨卡病毒实验室证据的已完成妊娠的女性,该研究发现每 20 例胎儿或婴儿中有约 1 例(5%)存在可能由寨卡病毒所致的出生缺陷。当仅分析在早期妊娠即确诊感染的病例时,这一数字升高至每 12 例中 1 例(8%)。[43]Shapiro-Mendoza CK, Rice ME, Galang RR, et al; Zika Pregnancy and Infant Registries Working Group. Pregnancy outcomes after maternal Zika virus infection during pregnancy - US territories, January 1, 2016-April 25, 2017. MMWR Morb Mortal Wkly Rep. 2017 Jun 16;66(23):615-621.
https://www.cdc.gov/mmwr/volumes/66/wr/mm6623e1.htm
http://www.ncbi.nlm.nih.gov/pubmed/28617773?tool=bestpractice.com
在 2015 年 7 月美洲暴发的疫情中,首次报道了寨卡病毒与 GBS 的关联。目前的证据估计 GBS 的发病率为 24/100,000 寨卡病毒感染者。[44]Uncini A, Shahrizaila N, Kuwabara S. Zika virus infection and Guillain-Barré syndrome: a review focused on clinical and electrophysiological subtypes. J Neurol Neurosurg Psychiatry. 2017 Mar;88(3):266-271.
http://www.ncbi.nlm.nih.gov/pubmed/27799296?tool=bestpractice.com
CDC: Zika virus case counts in the US
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European Centre for Disease Prevention and Control: threats and outbreaks of Zika virus disease
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PLISA health information platform for the Americas: Zika
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