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ホームIMICライブラリMMWR抄訳2017年(Vol.66)最新情報:ジカウイルス曝露の可能性のある妊婦のケア・・・

MMWR抄訳

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2017/07/28Vol. 66 / No. 29

MMWR66(29):781-793
Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States (Including U.S. Territories), July 2017

最新情報:ジカウイルス曝露の可能性のある妊婦のケアに関する医療従事者のための暫定ガイドライン-アメリカ(海外領土を含む)、2017年7月

2017年7月、CDCはWHOアメリカ地域でのジカウイルス疾患の発症率の低下およびジカウイルス免疫グロブリンM(IgM)抗体が感染後12週間持続するとのエビデンスに基づき、ジカウイルス曝露の可能性のある妊婦のケアに関する医療従事者のための暫定ガイドラインを改訂した。以下にその主要な部分を示す。1)アメリカ本土および海外領土におけるすべての妊婦は、現在の妊娠前および妊娠中のジカウイルス曝露の可能性について、妊婦健診のたびに問われるべきである(CDCはすべての妊婦に対しジカウイルス流行地域への渡航を控え、また、これらの地域へ渡航したパートナーとの性行為の際は避妊具の使用を推奨している)、2)ジカウイルス曝露の可能性のある妊婦およびジカウイルス疾患の症状のある妊婦はその症状の原因を診断するための検査を実施する(発症から12週間までのできるだけ早い時期にジカウイルス核酸検査[NAT]および血清検査の実施が推奨されている)、3)ジカウイルス曝露の可能性が持続している無症候性の妊婦は妊娠中3回、ジカウイルスNAT検査を行う(IgM検査は感染後数カ月陽性が持続し、現在の妊娠中の感染か否か確定できないため、NAT検査が推奨される)、4)旅行または性的曝露によりジカウイルス曝露の可能性はあるが、現在は持続していない無症候性の妊婦に定期的な検査は推奨されない、5)ジカウイルス曝露の可能性があり、超音波検査にて胎児に先天性ジカウイルス症候群を認める場合、先天性欠損の原因を確立するためジカウイルス検査を受けるべきである(NATおよびIgM検査)、6)胎盤および胎児組織検査の包括的アプローチが更新された(研究室レベルでジカウイルス感染が確診されていない女性、および胎児または乳児がジカウイルス関連先天性欠損の可能性がある女性に対して行われる)、7)ジカウイルス曝露の可能性が持続していない非妊娠女性の場合、受胎前カウンセリングの一部としてのIgM検査は推奨されない。

References

  • Lanciotti RS, Kosoy OL, Laven JJ, et al. Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect Dis 2008;14:1232–9. <https://doi.org/10.3201/eid1408.080287>
  • Pan American Health Organization. Regional Zika epidemiological update (Americas) May 25, 2017. Washington, DC: Pan American Health Organization. <http://www.paho.org/hq/index.php?option=com_content&view=article&id=11599&Itemid=41691&lang=en>
  • Hancock WT, Soeters HM, Hills SL, et al. Establishing a timeline to discontinue routine testing of asymptomatic pregnant women for Zika virus infection—American Samoa, 2016–2017. MMWR Morb Mortal Wkly Rep 2017;66:299–301. <https://doi.org/10.15585/mmwr.mm6611a5>
  • World Health Organization. Zika virus country classification scheme: interim guidance. Geneva, Switzerland: World Health Organization, 2017. <http://www.who.int/csr/resources/publications/zika/classification/en/>
  • Rabe IB, Staples JE, Villanueva J, et al.; MTS. MTS. Interim guidance for interpretation of Zika virus antibody test results. MMWR Morb Mortal Wkly Rep 2016;65:543–6. <https://doi.org/10.15585/mmwr.mm6521e1>
  • Woods CR. False-positive results for immunoglobulin M serologic results: explanations and examples. J Pediatric Infect Dis Soc 2013;2:87–90. <https://doi.org/10.1093/jpids/pis133>
  • Musso D, Nhan T, Robin E, et al. Potential for Zika virus transmission through blood transfusion demonstrated during an outbreak in French Polynesia, November 2013 to February 2014. Euro Surveill 2014;19:20761. <https://doi.org/10.2807/1560-7917.ES2014.19.14.20761>
  • Paz-Bailey G, Rosenberg ES, Doyle K, et al. Persistence of Zika virus in body fluids —preliminary report. N Engl J Med 2017;NEJMoa1613108. <https://doi.org/10.1056/NEJMoa1613108>
  • Bocanegra C, Sulleiro E, Soriano-Arandes A, et al. Zika virus infection in pregnant women in Barcelona, Spain. Clin Microbiol Infect 2016;22:648–50. <https://doi.org/10.1016/j.cmi.2016.03.025>
  • Driggers RW, Ho CY, Korhonen EM, et al. Zika virus infection with prolonged maternal viremia and fetal brain abnormalities. N Engl J Med 2016;374:2142–51. <https://doi.org/10.1056/NEJMoa1601824>
  • Meaney-Delman D, Oduyebo T, Polen KN, et al.; U.S. Zika Pregnancy Registry Prolonged Viremia Working Group. Prolonged detection of Zika virus RNA in pregnant women. Obstet Gynecol 2016;128:724–30. <https://doi.org/10.1097/AOG.0000000000001625>
  • Pacheco O, Beltrán M, Nelson CA, et al. Zika Virus disease in Colombia—preliminary report. N Engl J Med 2016;NEJMoa1604037. <https://doi.org/10.1056/NEJMoa1604037>
  • Schaub B, Vouga M, Najioullah F, et al. Analysis of blood from Zika virus-infected fetuses: a prospective case series. Lancet Infect Dis 2017;17:520–7. <https://doi.org/10.1016/S1473-3099(17)30102-0>
  • St George K, Sohi IS, Dufort EM, et al. Zika virus testing considerations: lessons learned from the first 80 real-time reverse transcription-PCR-positive cases diagnosed in New York State. J Clin Microbiol 2017;55:535–44. <https://doi.org/10.1128/JCM.01232-16>
  • Suy A, Sulleiro E, Rodó C, et al. Prolonged Zika virus viremia during pregnancy. N Engl J Med 2016;375:2611–3. <https://doi.org/10.1056/NEJMc1607580>
  • Bingham AM, Cone M, Mock V, et al. Comparison of test results for Zika virus RNA in urine, serum, and saliva specimens from persons with travel-associated Zika virus disease—Florida, 2016. MMWR Morb Mortal Wkly Rep 2016;65:475–8. <https://doi.org/10.15585/mmwr.mm6518e2>
  • Roehrig JT, Nash D, Maldin B, et al. Persistence of virus-reactive serum immunoglobulin m antibody in confirmed West Nile virus encephalitis cases. Emerg Infect Dis 2003;9:376–9. <https://doi.org/10.3201/eid0903.020531>
  • CDC. Prolonged IgM antibody response in people infected with Zika virus: implications for interpreting serologic testing results for pregnant women. Atlanta, GA: US Department of Health and Human Services, CDC; 2017.
  • Poland JD, Calisher CH, Monath TP, Downs WG, Murphy K. Persistence of neutralizing antibody 30-35 years after immunization with 17D yellow fever vaccine. Bull World Health Organ 1981;59:895–900.
  • Okuno Y, Fukunaga T, Tadano M, et al. Serological studies on volunteers inoculated experimentally with a dengue virus strain in 1943. Biken J 1983;26:161–3.
  • Calisher CH, Karabatsos N, Dalrymple JM, et al. Antigenic relationships between flaviviruses as determined by cross-neutralization tests with polyclonal antisera. J Gen Virol 1989;70:37–43. <https://doi.org/10.1099/0022-1317-70-1-37>
  • Halstead SB, Rojanasuphot S, Sangkawibha N. Original antigenic sin in dengue. Am J Trop Med Hyg 1983;32:154–6. <https://doi.org/10.4269/ajtmh.1983.32.154>
  • Johnson BW, Kosoy O, Martin DA, et al. West Nile virus infection and serologic response among persons previously vaccinated against yellow fever and Japanese encephalitis viruses. Vector Borne Zoonotic Dis 2005;5:137–45. <https://doi.org/10.1089/vbz.2005.5.137>
  • Ikejezie J, Shapiro CN, Kim J, et al. Zika virus transmission—Region of the Americas, May 15, 2015–December 15, 2016.. MMWR Morb Mortal Wkly Rep 2017;66:329–34. <https://doi.org/10.15585/mmwr.mm6612a4>
  • Massad E, Behrens BC, Coutinho FA, Behrens RH. Cost risk benefit analysis to support chemoprophylaxis policy for travellers to malaria endemic countries. Malar J 2011;10:130. <https://doi.org/10.1186/1475-2875-10-130>
  • Pinsent A, Read JM, Griffin JT, et al. Risk factors for UK Plasmodium falciparum cases. Malar J 2014;13:298. <https://doi.org/10.1186/1475-2875-13-298>
  • Williamson PC, Linnen JM, Kessler DA, et al. First cases of Zika virus-infected US blood donors outside states with areas of active transmission. Transfusion 2017;57:770–8. <https://doi.org/10.1111/trf.14041>
  • 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—U.S. territories, January 1, 2016–April 25, 2017. MMWR Morb Mortal Wkly Rep 2017;66:615–21. <https://doi.org/10.15585/mmwr.mm6623e1>
  • Reynolds MR, Jones AM, Petersen EE, et al.; U.S. Zika Pregnancy Registry Collaboration. Vital signs: update on Zika virus-associated birth defects and evaluation of all U.S. infants with congenital Zika virus exposure—U.S. Zika Pregnancy Registry, 2016. MMWR Morb Mortal Wkly Rep 2017;66:366–73. <https://doi.org/10.15585/mmwr.mm6613e1>
  • Petersen EE, Meaney-Delman D, Neblett-Fanfair R, et al. Update: interim guidance for preconception counseling and prevention of sexual transmission of Zika virus for persons with possible Zika virus exposure—United States, September 2016. MMWR Morb Mortal Wkly Rep 2016;65:1077–81. <https://doi.org/10.15585/mmwr.mm6539e1>
  • Parra-Saavedra M, Reefhuis J, Piraquive JP, et al. Serial head and brain imaging of 17 fetuses with confirmed Zika virus infection in Colombia, South America. Obstet Gynecol 2017;130:207–12. <https://doi.org/10.1097/AOG.0000000000002105>
  • Bhatnagar J, Rabeneck DB, Martines RB, et al. Zika virus RNA replication and persistence in brain and placental tissue. Emerg Infect Dis 2017;23:405–14. <https://doi.org/10.3201/eid2303.161499>
  • Reagan-Steiner S, Simeone R, Simon E, et al.; Zika Virus Response Epidemiology and Surveillance Task Force Pathology Team. Evaluation of placental and fetal tissue specimens for Zika virus infection—50 states and District of Columbia, January–December, 2016. MMWR Morb Mortal Wkly Rep 2017;66:636–43. <https://doi.org/10.15585/mmwr.mm6624a3>
  • Russell K, Oliver SE, Lewis L, et al.; Contributors. Contributors. Update: interim guidance for the evaluation and management of infants with possible congenital Zika virus infection—United States, August 2016. MMWR Morb Mortal Wkly Rep 2016;65:870–8. <https://doi.org/10.15585/mmwr.mm6533e2>
  • Oduyebo T, Igbinosa I, Petersen EE, et al. Update: interim guidance for health care providers caring for pregnant women with possible Zika virus exposure—United States, July 2016. MMWR Morb Mortal Wkly Rep 2016;65:739–44. <https://doi.org/10.15585/mmwr.mm6529e1>

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