寨卡病毒与性传播

Zika virus and sexual transmission

寨卡病毒是蚊源性虫媒病毒,归属于黄病毒科黄病毒属。1947年在乌干达寨卡森林的一头哨猴(恒河猴)中首次分离到。上世纪60年代在亚洲和非洲报告有散发性病例。2007年,在密克罗尼西亚雅浦岛发生以发热与皮疹为特征的第一次大流行;2013年10月在法属波利尼西亚发生了南太平洋最大的寨卡病毒爆发流行;在2015年引入巴西的寨卡病毒引起爆发。迄今,巴西已有150万人感染,并扩展到世界上30多个国家,大多数在南美洲。由于在巴西不正常地密集出现新生儿小头畸形,而母亲在孕期曾感染过寨卡病毒,因此世界卫生组织宣布世界范围内流行的寨卡病毒是国际关注的突发公共卫生事件。寨卡病毒感染是酷似登革热的、自限性的发热、皮疹、关节痛综合征,我国称寨卡病毒病。大多数病例是轻症,主要症状是皮疹、发热、关节痛、肌痛、头痛和结膜炎。寨卡病毒自然传播中的媒介为伊蚊,但也存在非生物媒介传播的危险。曾从血清中分离到寨卡病毒,并证实性交传播。最近有更多的由性传播的病例报告。寨卡病毒由病毒携带的男性经性行为传染给女方。如果最近刚从寨卡病毒流行区来的男性,在性生活中应使用安全套;如果女方已经怀孕,最好是放弃性接触,以保护胎儿。

Zika virus is a mosquito borne arbovirus in family Flaviviridae, genus Flavivirus. It was first isolated in 1947 from a sentinel monkey （Macaca mulatta） in the Zika forest of Uganda. Sporadic human cases were reported from 1960s in Asia and Africa. The first large epidemic of fever and rash occurred in June, 2007 on Yap Island, Micronesia. The largest Zika outbreak in south Pacific started in October 2013 in French Polynesia. Zika introduction in Brazil cause outbreak in 2015. So far, there are l. 5 million people infected Zika virus in Brazil and the epidemic has extended to more than 30 countries in the world, especially m south America. Due to abnormal intensive appearance of cases of small head malformation of newborn babies whose mothers infected Zika virus during pregnancy in Brazil, WHO announced that Zika virus epidemic m the world is an internationally-concerned emergent public health event. Zika virus infection is a selblimiting fever and exanthematic arthralgia syndrome closely resembling dengue fever. It is called Zika virus disease m China. Most of the cases are mild disease, and the most often seen signs and symptoms are macula papular rash, fever, arthralgia, myalgia, headache and conjunctivitis. The natural transmission cycle of Zika virus involves Aedes mosquitoes, but there also exists risk of non-vector-borne transmission. Zika virus was once isolated from the serum of a patient, and transmission by sexual intercourse has been demonstrated. Recently, more cases of Zika virus infected by sexual transmission were reported. Zika virus may be transmitted from man carrying the virus to woman by sex behavior. If a man has just come back from Zika virus epidemic area, he should use condom when having sex, and if his sexual partner has been pregnant, it is better to avoid sexual contact in order to protect fetus.