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ジカ熱を知り、ジカ熱に備えよう!

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最近話題のジカ熱ってどんな病気なのでしょうか?また我々にできることは何でしょうか?

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ジカ熱を知り、ジカ熱に備えよう!

  1. 1. CID Disease Control & Prevention Center H C G H Nnlonal com: for Global Health and Modiclm
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  3. 3. Number of cases 1400 1200 I Pernambuco I Paraiba I Rio Grande do Norte I Sergipe I Alagoas I Bahia I Piaui I Ceara' I Maranhao 1000 I Tocantins I Rio de Janeiro I Goiés I Distrito Federal I Mato Grosso do Sul 800 600 400 200 0 2010 2011 2012 2013 2014 2015 Year reporting
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  6. 6. l ' "{-_ V. /’ L ’ /5 ~ ~"-' §' i /7 Culex Aedes Anopheles Jong Travel and Tropical Medicine Manual, 4th ed.
  7. 7. IN IN ON 19 IN 39 IN N IN 81 IN IN IN IN IN IN IN Japanese enoephalllls virus (R99-190) W Japanese encephal-tis urns (. laOArS982) Japanese encepnalxlis unis (CH2l95l. A) Uwlu mus Amy unis (subtype oIMuvray Valley one Muray Valley encephalitis um: (OM56) 1m Muray Valley encephalulis vlms (NGI56) Ill) Many Valley encephalitis llrus IMKOGB4) Wesl NIIO IIIUS (E9101) ‘N West Nile mus (WN laly 1998 eqline) I West Nile llrus (NV99) SI. Louis encepnal-Iis mus Begun um: Ineus llms Redo llvus Zkn Irus Oenwe lines type 4 Dengue llrus type 2 Dengue drus Iype 1 Dengue mus lype 3 Yellowfeser llms Yokose llrus Anal drus Powassan Irus Omsk hemorrhagic lavenlrus Loupino ill lims Tick-borne encephalitis llms
  8. 8. SYLVATIC CYCLE : ‘; Svuuwr CDC. PLOS. Rnnxn Cxrdnr David Fain. Launt Gaunt, Doug Hnlun-. Gabriella Mtlrur M It appears that Zika can be iransmilted ihrough sexual inlorcoursu, blood iransfusion, and in uievo. ‘ ‘.4 . . —’ I ‘t I | I' ( I COUNClLun. - FOREIGN RELATIONS
  9. 9. Up to 2005 Lancet. 2015 Jul 18;386(9990):243—4.
  10. 10. Lancet. 2015 Jul 18;386(9990):243—4. Emergence 2005515 OO
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  12. 12. Amerlwl 1817 C! :3 . Affemed areas in the past nine months . Eu/ E51 Memoersrares, lndudmg outermost legions other countries and hen-imories Maritime Exclusive Economic Zones for non-visible areas ECOC. Map produced on 3 Feb 2016 ‘ = cape Verde l . - coliunbu ’FI99di 506006 Eciudor Brazil aglma Pvranwv Maldives Thailand
  13. 13. How the Zika Virus Spread to the Americas 7* The lirst serious outbroalr oi ZiLa virus outsideolAlri(. i orzurrnd in Apnt 2007 on Vap, ono Mirronesian islands In 1978. a liandlul Since the A. rk. _n H DI! CIIOI VIOII Indotniu outbreak on Yap, Zilia 0 count. ‘ idontlhd In 1978 has spread eastward 1948 Indorrnlil. blltttli across the Pauli( to «Issue -our-db the Coolrlslancls. disappear vrlhout Taluti, and, last year‘ any public health Easter Island otl irrtorurrtioo. Clule Social: CDC. Now Yuri Tub! Cardin: David Fania. Louie Cure“. Doug Halley. Golrrielh Mehu Researchers have suggested the Zilra virus arrived in Braxil in 20l4 lrorn French Polynesia during mayor global sporting Froncli Polynesia 201 4 The introduction cl nonnative mosquitox, the El Nino climate event, and political and economic crises in Braxil created lhe conditions lor the spread ol Zika in the Americas in 2015-2016 In May 2015, Zilmvirus was (onliriru-d as tlw cause ol an outbreak oladengue-like disease in northern and eastern Brazil COUNCILo; .. FOREIGN RELATIONS
  14. 14. /-' ‘ 9; / A is . '. i 1 ’ . ;/ ’l, "' O F" K", @ e. ::—; ,», _v= .. .~ 4,; . N “ / ,,. : 1958 to present / ' ‘ ‘ " ' ' -“xx . A ‘ ~. ~" I 2oos—2o11 1952 to present 201 2013 to present " 2008 to present 1952 to present‘ I Areas infested with A. aegypti I Areas infested with A. a/ bopictus I Areas infested with A. aegypti and A. a/ bopictus C West African enzootic 2014 t° Pfesent O ECSA enzootic 0 Asian urban O IOL urban
  15. 15. Zika virus: following the path of dengue and chikungunya? On May 7, 2015, the Pan American Health Organization issued an alert about potential Zika virus (ZIKV) transmission in northeast Brazil.1This has now been confirmed with wide spread of the disease, underscoring the potential for ZIKV to spread globally, similar to dengue (DENV) and chikungunya (CHIKV) viruses. ZIKV is an emerging arthropod- borne virus (arbovirus) that was first isolated from a Rhesus monkey in Uganda, in 1947. This arbovirus is related to DENV and they have similar epidemiology and transmission cycle in urban environments. Until recently, only sporadic human ZIKV infections were reported. In 2007, ZIKV emerged outside of Asia and Africa for the first Correspondence time and caused an epidemic on Yap Island in the Federated States of Micronesia} which was followed by a large epidemic in French Polynesia in 2013-14} Subsequently, ZIKV spread to several countries in Oceania (figure). ‘ The clinical presentation of ZIKV infection is not specific (mild fever, rash, arthralgia, and conjunctivitis) and can be confused with other diseases, especially dengue and
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  17. 17. 10.C 9‘ 3 Countries or areas where dengue nas been renoned The contour Irios ollho January and Jury -somorms ll‘1dlCIlO areas at risk. doilnod by CM geographical limits oilho northern and southern Mmisphoros lot your-round survival olAooos uqypli. Inc principal mosquito voclor oi oonguo viruses WHO
  18. 18. 4 Current or previous local transmission of chikmfngunya virus http: / / www. cdc. gov/ chikungunVa/ pdfs / chikungunVawor1dmap_1O—20—2015.pdf
  19. 19. HOME > ASIA TIMES NEWS & FEATURES I THAILAND CONFIRMS FIRST DOMESTIC CASE OF ZIKA VIRUS Thailand confinns first domestic case of Zika virus av AT EDITOR on rcsnumv 2. 2016 In ASIA TIMES NEWS .2 FEATURES. SOUTHEAST ASIA (From AI-‘P) A man has contracted the Zika virus in Thailand, officials said Tuesday, as a global alert intensifies over the mosquito—bome infection blamed for a surge in serious birth defects in South America. Authorities said the 22-year-old Thai man is likely to have caught the same strain of the virus that has caused panic in countries such as Brazil and Colombia. The virus “was confirmed by blood tests”, Air Vice , — Marshall Santi Srisermpoke, director of Bangkok's / /ft ‘ ’ Bhumibol Adulyadej Hospital, told reporters. I - “His symptoms were a fever, a rash and redness of the eyes, ” he said, adding he had not travelled abroad. The man has recovered and been discharged from hospital, he added, without giving further details of how The zika , ,,', -us is transmitted by the Aedes long he was in hospital, or where he contracted the Aegypfi mosquito and cannot spread Sickness" between humans Amnuay Gajeena, director—general of the disease control department of the public health ministry, said: “There is no need to panic. .. we have never had an epidemic of the Zika virus in Thailand. All of the cases were one—offs. " Read More
  20. 20. _ _ : :: Home | Sitemap | Bilingual Glossary | Director- Centers for Disease Control , R. O.C. (Toiwon) mail I 4,3-an fi$i*‘l§5§fii5I' Textsize; |_ u 5 About CDC l NEWS l Health Topics l Programs & Campaigns l Iniemationel Cooperation l Statistics & Analysis l Publication l During this Chinese Lunar New Year holiday, public advised to pay attent. .. :3 .3 : ::Q Home > News > Press Releases News I Press Releases > Press Releases > Current Topics As first Imported case of Zika virus Infection Identified in Taiwan, Taiwan CDC to list Zika virus Infection as category II Notifiable Infectious Disease and raises travel notice level for > Events central and South America and six countries In Southeast AsIa( 2016-01-19 ) E G010
  21. 21. EH 0 sigiiiii News span Weather Shop Emii More NEWS Home Vlmo world Asia UK Businea World Aln Australia Europe LaiinArnonca Middlciiast Usacanada Zika virus pregnancy case confirmed in Spain - first in Europe :1 hours ago Luropa Zika ~ a mosqunc-come vlrus ~ has been linked in babies being born wl1h underdevsioood brains Spain has confirmed that a pregnant woman has boon diagnosed with the Zllu virus - the first Elm vlrus auch can In Europa. Zika outbreak: What you The health ministry said the woman had rooonlly “'9” ‘° ""°" roturnod irom Colombia. whom it is believed she was Wound ZIluoutbroak: Travai advioa Zika. which is spreading through the Americas. has 2"“ ombmur Tn. boon linked to babies being born with "ma momnno underdeveloped brains. I How mums-to-be are The World Hoaith Organization (WHO) has declared tackling Zika tho microoophaly condition. linked to the mosquito- borne virus. a global public health emergency.
  22. 22. Age Sex Country of residence Country of likely acquisition Early—60s M Italy Salvador de Bahi Brazil 45 F Germany 30, 1: 0 LA. .. . . _-, , Early—30a M Italy - Early—30s F Italy Frech Pol nesia NA F Canada Phuket, . 505 M Germany -_ . Jum, Ko Lanta : Mid—20s M Japan French Polynesia 3 Early—30s M Japan French Polynesia 31 F Norway rhiti 52 F Australia Jakarta 40s M Japan Ko Samui, Shinohara etal. JTM 2016
  23. 23. Centers for Disease Control and Prevention CDC 24/7: Saving Lives. Protecting People” 5- MENU CDC A-Z Q SEARCH Morbidity and Mortality Weekly Report (MMWR) CDC > MMWR Travel-Associated Zika Virus Disease Cases Among U. S. Residents — United States, January 2015—February 2016 Early Release/ March 18, 2016/65
  24. 24. No. of cases Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 201 5 201 6 Month and year of symptom onset
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  26. 26. RAPID COMMUNICATIONS Two cases of Zika fever imported from French Polynesia to Japan, December 2013 to January 2014 S Kutsuna (sonare. since1192@gmail. com)‘, Y Kato‘, TTakasaki= , M L Moi’, A Kotakiz, H Uemura‘, T Matono‘, Y Fuiiya‘, M Mawatari‘, N Takeshita‘, K Hayakawa‘, S Kanagawa‘, N Ohmagari‘ 1. National Center for Global health and Medicine, Disease Control and Prevention Center, Tokyo, Japan 2. Department of Virology 1, National institute of infectious Diseases, Shinjukuku, Tokyo, Japan ‘ JQfiRNAL jw Kiiiiéiii Brief communication Journal of Travel Medicine, 2016, i—3 International Society of Travel Medicine doi: 10.1093/itm/ tavuii _ _ Eslabllshed 1991 Promoting healthy travel worldwide Brief communication Zika fever imported from Thailand to Japan, and diagnosed by PCR in the urines Koh Shinohara, MD‘, Satoshi Kutsuna, MD‘*, Tomohiko Takasaki, MD2, Meng Ling Moi, PhD2, Makiko lkeda, PhD2, Akira Kotaki, PhD2, Kei Yamamoto, MD‘, Yoshihiro Fuiiya, MD‘, Momoko Mawatari, MD‘, Nozomi Takeshita, MD‘, Kayoko Hayakawa, MD‘, Shuzo Kanagawa, MD‘, Yasuyuki Kato, MD‘, and Norio Ohmagari, MD‘
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  30. 30. Freedman, et al. N Engl J Med 2006;354:119-30.
  31. 31. CDC Home i W, Centers for Disease Control and Prevention , lI/ /// //, ,_‘' ; coc 24/7: Saving Lives. Protecting People. " 5 . -r. Ii~I: _ ' '. . I . . , ‘. . ‘ . '. TRAVELERS’ HEALTH )( TRAVEL SAFE. TRAVEL SMART. Film‘! . Home > Travel Notices . __. : Email page link Destinations , _3 print page Travel Notices ’~F']P‘e'I'p‘mend fl Twee‘ 5 ' Share ; :1 Our Twitter ’1"‘= Fm’ '" F'= ""' Zika Fever in French Polynesia (Tahiti) G our racebook page Polynesia (Tahiti) G I d . . , et emai up ates Find a Clinic “ Disease Directory , Get email updates l_*. ’_4 I"f°""‘a[l°" C9"‘e"5 . , , .; _ . . , . : ~. To receive email : .°; ’:‘: ::: ::; :r': ... .. For Clinicians address: Released: November 21, 2013 Travel Industry - - Submit Yellow Book M What is the current situation? The French Polvnesia Department of Health has confirmed an outbreak of Zika fever in Tahiti and the c°"""' U’: other islands that make up the country (Tahaa, Uturoa, Bora-Bora, Taiohae, and Arutua). Several fr centers for Disease Disease Directory hundred casesare suspected. No hospitalizations or deaths have been reported. The Department of control and Learn more abom "ave| _ Health is working to improve surveillance. iggtgegltilftizn Rd ’°"'"°“ ""°a‘°5' what is Zika fever? Atlanta. GA 30333 African Sleeping Sick“ : Zika fever is an illness caused by a virus that spread through mosquito bites. It is closely related to _, ,‘ B00—CDc-INFO dengue virus and causes a similar illness. Symptoms of Zika fever may include fever, headache, red (500-232-4636) 5,, eyes, rash, muscle aches, and joint pains. The illness is usually mild and lasts 4-7 days. WY‘ (553) 23263“ Contact CDC-INFO
  32. 32. X—2 X—7
  33. 33. Short (<10 days) Medium (11-21 days) Long (>30 days) ( P. falciparum) (A, B, C, E) Mellioidosis HIV Assessment of travellers who return home ill. Lancet 2003; 361:1459—69
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  43. 43. Table 1. Clinical Characteristics of 31 Patients with Confirmed Zika Virus Disease on Yap Island during the Period from April through July 2007. Sign or Symptom No. of Patients (%) Macular or papular rash 28 (90) Fever* Arthritis or arthralgia Non purulent conjunctivitis Myalgia Headache Retro-orbital pain Edema Vomiting * Cases of measured and subjective fever are included.
  44. 44. The NEW ENGLAND IOURNAL of MEDICINE ORIGINAL ARTICLE Zika Virus Infection in Pregnant Women in Rio de Janeiro — Preliminary Report Patricia Brasil, M. D., jose P. Pereira, jr. , M. D., Claudia Raja Gabaglia, M. D., Luana Damasceno, M. S., Mayumi Wa| <imoto, Ph. D., Rita M. Ribeiro Nogueira, M. D., Patricia Carvalho de Sequeira, Ph. D., André Machado Siqueira, M. D., Liege M. Abreu de Carvalho, M. D., Denise Cotrim da Cunha, M. D., Guilherme A. Calvet, M. D., Elizabeth S. Neves, M. D., Maria E. Moreira, M. D., Ana E. Rodrigues Baiao, M. D., Paulo R. Nassar de Carvalho, M. D., Carlajanzen, M. D., Stephanie G. Valderramos, M. D., james D. Cherry, M. D., Ana M. Bispo de Filippis, Ph. D., and Karin Nielsen-Saines, M. D.
  45. 45. Median (IQR) Range Distribution — no. (%) >4 to 513 wk >13 to 526 wk >26 to 539 wk Symptoms — no. /total no. (%) Rash) Any Median duration Range Macular Maculopapular Other Pruritus Arthralgia or arthritis Conjunctival injection Headache Fatigue or malaise Retro-orbital pain Myalgia Lymphadenopathy Localized Generalized Paresthesia Edema 20 (14-25) 5-38 4 2-14 37/72 (51.4) 32/72 (44.4) 3/72 (4.2) 59/72 (95.8 45/72 (53.9 42/72 (58.3 38/72 (52.8 35/72 (48.5 34/59 (49.3 30/72 (41.7 29/72 (40.3 15/29 (51.7 14/29 (48.3 27/58 (45.5 ) ) ) ) ) ) ) ) ) ) ) 23/54 (35.9) 17 (10-23) 7-39 5.5 2-50 8/15(50.0 2/15 (12.5 5/15 (37.5 14/15 (93.3 7/15 (43.8 2/15 (13.3 9/15 (55.3 7/15 (43.8 5/15 (31.3 8/15 (50.0 1/15 (5.7) 0/1 1/1 (100.0) 4/10 (40.0) 4/15 (25.0) ) ) ) ) ) ) ) ) ) ) 0.501 0.471- 1.00 0.02 0.001 0.54 0.16 0.002 1.00 0.79 0.27 0.59 0.015 1.00 1.00 0.75 0.56
  46. 46. Table 1. (Continued. ) Variable Fever Duration <24 hr Duration 224 to <72 hr Median temperature (range) — °C Photophobia Anorexia Diarrhea Nausea or vomiting Bleeding, petechia, or enanthema Abdominal pain Dizziness or light-headedness Respiratory symptoms: coryza, cough, or sore throat Dysuria ZIKV-Positive Women (N = 72) 20/72 (27.8) 12/20 50.0) 8/20 40.0) 37.5 (37.5-38.0) 17/72 (23.5) 15/72 (22.2 15/72 (22.2 15/72 (20.8 15/72 (20.8 ( ( ( ( ( ( ) ) ) ) 9/71 1 . ) 8/71 1 ) 5/72 7 3 ) 1/59 ) 2 1. 6.9 1.4 Zl KV- N egative Women (N=16) 2/15(12.5) 0/2 2/2(100.0) 38.2 (37.5-39.0) 5/15 31.2) 2/15 12.5 5/15 31.2 5/15 37.5 2/15 12.5 1/15 5.2) 1/15 5.2) 3/15 18.8) 0/15 ) ) ) ) ( ( ( ( ( ( ( (
  47. 47. Centers for Disease Control and Prevention CDC 24/7: Saving Lives. Prorecling People-W Morbidity and Mortality Weekly Report (MMWR) CDC > MMWR Travel-Associated Zika Virus Disease Cases Among U. S. Residents — United States, January 2015—February 2016 Ea"V’*'-”"“‘-" Mm“ 18‘ 2°1"’6-” Yes1' N 0 Unknown Sign/ symptom No. (%) No. (%) No. (%) Rash 113 (98) 1 (1) 1 (1) Fever 94 (82) 20 (17) 1 (1) Arthralgia 76 (66) 33 (29) 6 (5) Headache 65 (57) 37 (32) 13 (11) Myalgia 63 (55) 38 (33) 14 (12) Conjunctivitis 43 (37) 53 (46) 19 (17) Diarrhea 22 (19) 63 (55) 30 (26) Vomiting 6 (5) 79 (69) 30 (26)
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  49. 49. I . l ! _- I J ‘-_; »<‘‘ 1 '~~: ‘~~. ' ‘’ . » '
  50. 50. Am J Trop Med Hyg. 2014 N0v;91(5):1035—8.
  51. 51. RAPID COMMUNICATIONS Zika Virus detection in urine from patients with Guillain-Barré syndrome on Martinique, January 2016 B Rozé ' . F Naiioullah =3 . J Fergé 4 . K Apetse 5 . Y Brouste 6 . R Cesaire =3 . C Fagour 7 . L Fagour = . P Hochedez '3 . S Jeannin 3 , J Joux 3 . H Mehdaoui 4 . R Valentino 4, A Signate 3 . A Cabié '39 . on behalf of the GBS Zika Working Group '° 1. Infectious and Tropical diseases Unit, Universitary Hospital ofMartinique, Fort de France, France Laboratory ofvirology, Universitary Hospital of Martinique, Fort de France, France Université des Antilles, EA4537, Fort de France, France . Intensive Care Unit, Universitary Hospital of Martinique, Fort de France, France Electrophysiological Departement, Universitary Hospital of Martinique, Fort de France, France . Emergency Departement, Universitary Hospital of Martinique, Fort de France, France Diabetology Departement, Universitary Hospital of Martinique, Fort de France, France . Neurology Departement, Universitary Hospital of Martinique, Fort de France, France . INSERM C| C1428, Fort de France, France 10. The members of the group are listed at the end of the article Correspondence: Benoit Rozé (benoit. roze@chu-fortdefrance. fr) o 0031 ou_n. i.>, u go
  52. 52. Eurosurvelllance, Volume 21, Issue 10, 10 March 2016 Rapid communication ISOLATION OF INFECTIOUS ZIKA VIRUS FROM SALIVA AND PROLONGED VIRAL RNA SHEDDING IN A TRAVELLER RETURNING FROM THE DOMINICAN REPUBLIC TO ITALY, JANUARY 2016 L Barzon ‘ 2, M Pacenti 2 . A Berto l . A Sinigaglia 3 . E Franchin ' 2 . E Lavezzo ‘ , P Brugnaro " . G Pall] 1 2 + Author affiliations 1. Department of Molecular Medicine, University of Padova. Padova. Italy 2. Microbiology and Virology Unit. Padova University Hospital. Padova. Italy 3. Veneto Institute of Oncology IOV lRCCS_ Padova. Italy 4. Infectious Disease Department. Venice City Hospital ‘SS. Giovanni e Paolo’. Venice. Italy Correspondence: Luisa Barzon (Iuisa. barzon@unipd. it)
  53. 53. 10,000,000 -- ZIKV RNA plasma -o- ZIKV RNA urine "' ZIKV RNA saliva 1,000,000 100.000 10.000 1,000 100 ZIKV RNA (copies/ mL) . ... .~ u. ‘ u. ‘ 10 Time (days after symptom onset)
  54. 54. Articles Guillain-Barré Syndrome outbreak associated with Zika virus E}-@+i‘. © infection in French Polynesia: a case-control study Van—Mai Cao—Lormeau*, Alexandre Blake*, Sandrine Mons, Stéphane Lastere, Claudine Roche, Jessica Vanhomwegen, Timothée Dub, Laure Baudouin, Anita Teissier, Philippe Larre, Anne—La ure Vial, Christophe Decam, Valérie Choumet, Susan K Halstead, H ugh J Willison, Lucile Musset, Jean—Claude Manug uerra, Philippe Despres, Emmanuel Fournier, Henri—Pierre Mallet, Didier Musso, Arnaud Fontanet*, Jean Neil *, Frédéric Ghawche'*
  55. 55. n (%) or median (IQR) Age (years) 42 (36-56) Men 31 (74%) Obese 11 (26%) Smoking (n=40) A I I if I I I 12 (30%) High blood pressure 7 (17%) Heart disease 3 (7%) Previous viral syndrome 37 (88%) Conjunctivitis (n=31) 15 (48%) Rash (n=36) 29 (81%) Fever (n=31) 18 (58%) Arthralgia (n=31) 23 (74%) Oedema ofthe limbs (n=29) 9 (31%) Time between reported viral syndrome and onset of neurological symptoms (days) 6 (4-10) (n=37) Time between onset of neurological symptoms and admission (days) 4-5 (2-8) Symptoms at admission Muscle weakness 31 (74%) Symmetric muscle weakness 27 (64%) Muscle weakness limited to lower limbs 18 (43%) Incapacity to walk (n=41) 18 (44%)
  56. 56. Time between onset of neurological symptoms and admission (days) 4-5 (2-8) Symptoms at admission Muscle weakness 31 (74%) Symmetric muscle weakness 27 (64%) Muscle weakness limited to lower limbs 18 (43%) Incapacity to walk (n=41) 18 (44%) Areflexia or decreased reflexes 26 (62%) Facial palsy 27 (64%) Bilateral facial palsy 14 (33%) Unilateral facial palsy 13 (31%) Trouble swallowing 10 (24%) Paraesthesia 35 (83%) Time between onset of neurological symptoms and peak of illness (days) 6 (4-9) Time between admission and peak of illness (days) 1 (0-2) Symptoms at nadir Muscle weakness 36 (86%) Symmetric muscle weakness 33 (79%) Muscle weakness limited to lower limbs 17 (40%) Incapacity to walk 26 (62%) Areflexia or decreased reflexes 20 (48%) Facial palsy 33 (79%) Bilateral facial palsy 25 (60%) I ln: |—. +m»—. | Ln-I-‘I r*lt-I: Q /1 roz
  57. 57. The NEW ENGLAND JOURNAL of MEDICINE CORRESPONDENCE Zika Virus Associated with Meningoencephalitis
  58. 58. . I.
  59. 59. Case Report Acute myelitis due to Zika virus infection @+i, » ® CrossMarl< Sylvie Mecharles, Cecile Herrmann, Pascale Po ullain, Tuan—H uy Tran, Nathalie Deschamps, Gregory Mathon, Anne Landais, Sebastien Breurec, Annie Lann uzel
  60. 60. Roraima Amazonas Acre , Rondonla 'l some EDICIa". b<. ‘¥Ggl: oi reoeri or :52; er "I: roceVa y w Brut: Para Amopé Mararlhéio C9015 Rio Grande . Do Norte P>aui -L: ’l ' " Paraiba ‘l l Pernambuco Mom I V H N Grosso Tocqmins Bahia R agocis _ Sergrpe Golds i, 3 Distrito MIME Federal 09705 Mato Grosso Q Do Sui , Espirito 2, Sonic 360 ’ V Paulo Rio De’ Pgmnd Janelro Santa Catarina Rio Grande Do Sul mm ct Hen sier- Mi crocephaiy case count States/ Federal Districts with confirmed axes of Microoephaiy This cumulative confirmed data includes both microbiological confirmation of Zika AND radiological criteria of congenital infection. The latter probably includes other infection than Zika World _Hea_| th Organization
  61. 61. Brazil 944 Brazil Caboverde Caboverde M French Polvnesia M French Polvnesia — M M
  62. 62. n (%) 1 7 (49) 1 st trimester 21 (57) / 13 (37) 2nd trimester 504 M H20) 926) M 7<2o> 4(11) 21 (60) 3(9) 1 4 (40) 27 (1 O0) 31 (91) 20 (74) 3(9) M124» 9 (as) < -3 SD 25 (71) -2 SD -3 SD 10 (29) 22,5009 26 (74) 11 (31) <2,500g 9 (26) 5 (14) 4(11) 1 (3) M 2 (18)
  63. 63. The NEW ENGLAND JOURNAL of MEDICINE ORIGINAL ARTICLE Zika Virus Infection in Pregnant Women in Rio de Janeiro — Preliminary Report Patricia Brasil, M. D., Jose P. Pereira, Jr. , M. D., Claudia Raja Gabaglia, M. D., Luana Damasceno, M. S., Mayumi Wakimoto, Ph. D., Rita M. Ribeiro Nogueira, M. D., Patricia Carvalho de Sequeira, Ph. D., André Machado Siqueira, M. D., Liege M. Abreu de Carvalho, M. D., Denise Cotrim da Cunha, M. D., Guilherme A. Calvet, M. D., Elizabeth S. Neves, M. D., Maria E. Moreira, M. D., Ana E. Rodrigues Baiéo, M. D., Paulo R. Nassar de Carvalho, M. D., Carlajanzen, M. D., Stephanie G. Valderramos, M. D., James D. Cherry, M. D., Ana M. Bispo de Filippis, Ph. D., and Karin Nielsen-Saines, M. D.
  64. 64. T Abnormal findings Normal findings U, in V) to U H- O 6 Z 12 13 14 16 18 19 20 21 22 23 25 26 27 31 32 35 Week of Gestation at the Time of Infection Figure 2. Week of Gestation at the Time ofZ| KV Infection and Abnormal Ultrasonographic and Doppler Findings. Twelve of42 women (29%) in whom fetal ultrasonography was performed had abnormal findings.
  65. 65. Table 2. Ultrasonographic Features of Fetuses and Findings at Birth. * Week of Week of Gestation Fetus Gestation at Ultrasound No. at Infection Examination ‘Abnormal Fi_rldings on Doppler Ultrasonography Findings at Birth 19 8 35 l'/ Iicrocephaly, cerebral calcifications, abnormal Microcephaly, cerebral calcifications on CT, middle cerebral artery, intrauterine growth global cerebral atrophy, macular lesions restriction 40 8 20 Choroid plexus cyst, cerebellar atrophy (trans- Still in utero . v,erse. .dja1m, eter <5th percentile) 24 12 29 Microcep_ha_| y, cerebral calcification, Blake's cyst, Still in utero agenesls vermis, club foot, intrauterine growth restriction 41 12 24 Mega cisterna magna (>95th percentile) Still in utero 39 21 30 Cerebellar and cerebral right periventricular Still in utero calcifications 17 22 26 I _-_- rrl artery flow <5th percentile ‘ _ Still in utero _ 12 22 27 icroel V~ placental insufficiency as as- ' Small for gestational age, head circumfer- ' sese - i ler study, oligohydramnios, i- ence proportional to body size, macular intrauterine . , h restriction eions , _ __ I _ V _ g 10 25 30 Normal first ultras ogram, fetal death detected Stillbirth at 36 weeks on r eat ultrasonogram 36 26 35 Microcephaly: abnorm umbilical artery flow agflle on e pulsatile index), ' mall for gestational age, head circumfer- ence proportional to body size intrauterine’ r r friction 38 27 35 Cerebral c: )|cificafions_i/ L clilomeqa| v77_. .._____, T7Sill. in. ufero_7__,7__7. brachy( 2 30 34 1 3 31 33 53 32 38 3 23 35 40 Anhydraml V V EEG Ebnormalities
  66. 66. Articles Association between Zika virus and microcephaly in French 3 »@'i'(‘, (D Polynesia, 2013-15: a retrospective study Simon Cauchemez, Marianne Besnard, Priscillia Bompard, Timothee Dub, Prisca Guillemette—Artur, Dominique Eyrolle—Guignot, Henrik Salje, Maria D Van Kerkhove, Veronique Abadie, Catherine Garel, Arnaud Fontanet*, Henri—Pierre Mallet*
  67. 67. 75 200 l O 150 O3 O 50 Overall attack rate (%) OW U‘| Number of microcephaly cases per 10 000 l— O O 55 0 ti! Baseline Zika virus infection in T1 Figure 2: Attack rate and strength of the association between infection with Zika virus and microcephaly in French Polynesia (A) (B) 10000 1 10000
  68. 68. Centers for Disease Control and Prevention in S<'.1r<' '1 Tm; coc CDC 24/7: Saving Lives. Protecting People” CDCA 7|NDFX V Morbidity and Mortality Weekly Report (MMWR) Q1 > MMWR Interim Guidelines for Pregnant Women During a Zika Virus Outbreak — United States, 2016 Weeklyl January 22. 2016/ 65(2):30-33 nnecommend Utweet Share F0,-mat seimone v On January 1 9. 2016. this report was posted as an MMWR Early Release on the MMWR website ( ). Emily E. Petersen. MD‘; J. Erin Staples. MD, PhD2; Dana Meaney-Delman, . MD3: Marc Fischer, MD2; Sascha R. Ellington, MSPH1; William M. Callaghan. MD‘: Denise J. Jamieson, MD‘ (View author affiliations)
  69. 69. Probable Non—Vector-borne Transmission of Zika Virus, Colorado, USA Brian D. Foy, Kevin C. Kobylinski, Joy L. Chilson Foy, Bradley J. Blitvich, Amelia Travassos da Rosa, Andrew D. Haddow, Robert S. Lanciotti, and Robert B. Tesh Emerg Infect Dis. 2011 May; 17(5): 880-882.
  70. 70. RAPID COMMUNICATIONS An autochthonous case of Zika due to possible sexual transmission, Florence, Italy, 2014 G Venturi ' , L Zammarchi *3 , C Fortuna ' , ME Remoli ' , E Benedetti ' , C Fiorentini ' , M Trotta 3 , C Rizzo 4 , A Mantella ’ , G Rezza ' , A Bartoloni =3 1. Department of Infectious, Parasitic and Immune-Mediate Diseases, lstituto Superiore di Sanita, Rome, Italy 2. Clinica Malattie lnfettive, Dipartimento di Medicina Sperimentale e Clinica, Universita degli Studi di Firenze, Florence, Italy 3. SOD Malattie lnfettive e Tropicali, Azienda Ospedaliero-Universitaria Caeggi, Florence, Italy 4. National Center for Epidemiology and Health Promotion, lstituto Superiore di Sanita, Rome, Italy. Correspondence: Alessandro Bartoloni (alessandro. bartoloni@unifi. it)
  71. 71. Potential Sexual Transmission of Zika Virus Didier Musso, Claudine Roche, Emilie Robin, Tuxuan Nhan, Anita Teissier, Van—Mai Cao-Lormeau Emerg Infect Dis. 2015 Feb;21(2):359—61.
  72. 72. O Sign in News Sport Weather Shop Earth Mor J. I. l, :< gm} . '.. ., Lyll :9 I. . . ,. E| l~l'-l US & Canada us I: ccuon 2015 Zika virus infection ‘through sex‘ reported in US 3 I L‘Df. .£l", ‘ 2016 US & C€l'l£l: l£z A rare case of the Zika virus being transmitted through sex. not a mosquito bite. has been reported In the US. Zika virus Zika outbreak: What you
  73. 73. 33 BBC ID Menu ' N EWS Home Video wona Asia UK Business Tech Science Magazine Enl US & Canada us Election 2015 Zika virus: US investigating 14 possible sexually-transmitted cases 028 February/2016 USE-Canada 0 slgnln News Sport Weather shop Emh Mo NEWS Home Video World Asia UK Business Tech Science Magazine Enie Health Zika virus: Sexual transmission 'more common than thought’ 0 8 March 2016 Health
  74. 74. Centers for Disease Control and Prevention CDC 24/7: Saving Lives. Protecting People” 5- MENU coc A-Z Q SEARCH Morbidity and Mortality Weekly Report (MMWR) CDC > MMWR Travel-Associated Zika Virus Disease Cases Among U. S. Residents — United States, January 2015—February 2016 Early Release/ March 18, 2016/65
  75. 75. yflfie. !iilll'1'fl§§l€1J‘= 'I$bl: 0'—7~. l t — 759114 iI§$iBl§ 2E5EI(§) I 0lI§3I fiiiifi l#>R7Dfi¥lD49—fiEfi4B.75§w®#>K7DMHh>K—T zx#maty9—eam, zm5$wmmm; aynmo: aa%maokaa emmuttfiuk. lfilff-iCi: tt;5ii4l= . ! iim1lCJ: %>: >’Xi§§lé1J‘fit>n-': '>’I—Xb*&911:2:M5. eacgae,2#eu1neynaca%umAmmaeea. ewe. at y9—rmmeawnAmenenynmcaeurue: Ewwnun. 55leemeaeermmwaamaaeaeaann. ealeuaeeaw mrmeum. mmeawkeauanaa, fiaoseagscunmw. at iliiI3n'Ci§§%bf. -.ti; t%2‘ci: <i, tl. 5. me, emu. amm; avnmo: maee#ameu<. aamxmxae iEiEi: i;tf. s:5t; LttSii£§. 'Blifi’PRi; t. ! StE1&7't~e: '9*5—&B<Jt4tl§§é0)i£f: 'iI: $n‘ filC$‘l3?'6’‘3T5J t§§‘Jf: o
  76. 76. aecraaoe
  77. 77. aegypti albopictus 20l4 I lleallll O SEEM, §IE1( 2oo9~) NE —2o1o£Ii ’ ~ E$(2oo7) PER! . 7<lsE(2011~) ? Ea‘= (2oo7~) fiiillifi (| ASRVo| . 32 p. I67-|68:20| I 6 )
  78. 78. 5 DEET 20 ->DEET|2% l2% 2
  79. 79. I-D NI 3 § § § § '§ § Number of dengue cases In Brazil reported by MOH Number of III returned travelers from Brazll In Goosontlnol with dengue Ob - 3oo ooo 4 - zoo ooo 2 M » 1oo ooo O I Q — , . 0 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 2 Geosenttnei Cases of Dengue from Brazil (2008-2012) -C-3'31" M0" C356 Of 090809 (2003-2012I= TOW -I-Brazil MOH Cases of Dengue (2008~2012): World Cup dues only -I-Brazil MOH Cases oi Dengue (2008~2012): Rio de Janeiro only
  80. 80. Centers for Disease Control ond Prevention CDC 24/7: saving Lives, Protecting People” E = M L N U Morbidity and Mortality Weekly Report (MMWR) gm > MMWR Revision to CDC’s Zika Travel Notices: Minimal Likelihood for Mosquito- Borne Zika Virus Transmission at Elevations Above 2,000 Meters Early Releasel March 11.2016 / 65
  81. 81. to .1 » . .. . I J, . u. _ / n. .. . . . .

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