醫學專欄~蔡季君-新興蟲媒暨性交傳染病

1. 2015
1947
(Flaviviridae)
2016 1
2016 9 15
8
( 2
1 )
流行病學
Zika virus
RNA 10,794
vector borne disease 1947
1954
1978
2007
2007

2. 2013
10
2015 5
(WHO)
2016 1
/ 2016 8 27
2016 9 14
333

3. 臨床症狀
25%
3–12
2–7
(
GuillainBarré
Syndrome, GBS)
(
Idiopathic
Thrombocytopenic Purpura, ITP)
鑑別診斷
38
1-2
38
4-7
2-3 90% -
100% 3
5 3
5-7 3
茲卡病毒感染症病例定義

4. 1.
arthralgia arthritis
non-purulent /
hyperemic conjunctivitis
2. *
*
3 3rd percentile
1.
2.
傳染方式
1.
3 7
12
1
11
15
1–2
2–3
62
2016 7
8
2016 7 13 CDC USA
1306 ( 1
) 14
5 GuillainBarré
Syndrome 2
6

5. 3.
2
2
4.
75%-80%
28
24
24
實驗室診斷
RT-PCR
RT-PCR
IgM
IgG
(Flavivirus)
( 14 40 )
(
)
( 20 )
RT-PCR
RT-PCR
IgM
neutralizing antibody
治療
acetaminophen
aspirin nonsteroidal anti-

6. 預防方法
1.
2.
(1)
DEET
(3)
( )
(permethrin)
(4)
(5)
認識防蚊蟲產品
WHO
1. DEET(
) ;2.IR3535(
) 3. Picaridin(
)
: 50
DEET
DEET
DEET
DEET
10% 1 2
30 35%
6

7. 6
DEET
DEET
10%
6
6 24
DEET 10% 1
2 12 3
: Picaridin,
icaridin, KBR 3023, Bayrepel) 1998
DEET
CDC DEET
(
): BAAPE
BAAPE
DEET
6 8
99%
DEET IR3535
(
)
: PMD (p-menthane
3,8-diol) ( )
(EPA)
PMD
DEET

8. 2
塗抹驅蚊劑時應注意的事項
1. 15~20
2. ( )
15
未來展望
(NIH)
1. Plourde AR, Bloch EM. A Literature
Review of Zika Virus Emerg Infect Dis.
2016 Jul;22(7):1185-92. doi: 10.3201/
eid2207.151990. Epub 2016 Jul 15.
2. Petersen LR, Jamieson DJ, Powers AM,
Honein MA. Zika Virus. N Engl J Med.
2016 Apr 21;374(16):1552-63. doi: 10.1056/
NEJMra1602113. Epub 2016 Mar 30.
3. Davidson A, Slavinski S, Komoto K, Rakeman
J, Weiss D. Suspected Female-to-Male Sexual
Transmission of Zika Virus — New York City,
2016. MMWR July 15, 2016 / 65(28);716–
717.
4.
. http://www.cdc.gov.tw/professional/kno-
wdisease.aspx?treeid=53fde358da8186dd&no
wtreeid=53fde358da8186dd&id=B6454E90E
B0C2618&did=7445
5. Zika virus disease in the United States, 2015–
2016. CDC, USA. http://www.cdc.gov/zika/
geo/united-states.html
6. Mosquito Bite Prevention (CDC,USA).
CS259867. February 18, 2016.
https://www.cdc.gov/chikungunya/pdfs/fs_
mosquito_bite_prevention_travelers.pdf
7.
(Consumer Council). https://www.
consumer.org.hk/ws_chi/news/press/p46404.
html