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ホームIMICライブラリMMWR抄訳2016年(Vol.65)最新情報:ジカウイルス曝露の可能性がある出産可能年・・・

MMWR抄訳

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2016/04/01Vol. 65 / No. 12

MMWR65(12):315-322
Update: Interim Guidance for Health Care Providers Caring for Women of Reproductive Age with Possible Zika Virus Exposure — United States, 2016

最新情報:ジカウイルス曝露の可能性がある出産可能年齢女性をケアする医療関係者に対する暫定ガイダンス ― アメリカ、2016年

現在のジカウイルスのアウトブレイクは2015年5月、ブラジルにて発生、2016年3月23日の時点で39の国とアメリカ管轄地域にてジカウイルス感染が報告されている。これまでのアウトブレイクのデータから、ジカウイルスに感染した患者は初期の段階では無症状であり、発症時の症候や症状は一般的に軽度であり、発熱、黄斑または丘疹性発疹、関節痛、結膜炎などが認められる。妊娠初期での感染は有害転帰との関連性が示唆され、妊娠7週未満で感染した2名の女性は流産し、妊娠7~8週で感染した女性は重度の小頭症の子供を出産しているが、データは少ない。ジカウイルスに曝露した可能性がある場合、妊娠前のカウンセリングが行われており、また、症状を認める場合はカウンセリングにて、女性に対しては妊娠は症状の消失から少なくとも8週間、男性は発症から少なくとも6カ月経過した後とすることが推奨されている。ジカウイルス感染を認める地域に居住する場合は、医療関係者と相談し、妊娠した場合のリスクを認識した上で判断するが、できれば適切な避妊を行うことが望まれる。現時点では曝露のリスクがある場合、妊娠前の検査は推奨されておらず、妊娠している場合はCDCの検査アルゴリズムに従って検査を行うことが推奨される。なお、羊水がジカウイルス感染症のRT-PCR検査に陽性を示す場合、胎児の先天性異常を予測するものではない可能性があるため、最新のガイダンスから羊水穿刺は除外されている。

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