Musso Didier, Gubler Duane J
Unit of Emerging Infectious Diseases, Institut Louis Malardé, Tahiti, French Polynesia
Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore Partnership for Dengue Control, Lyon, France
Clin Microbiol Rev. 2016 Jul;29(3):487-524. doi: 10.1128/CMR.00072-15.
Zika virus (ZIKV) is an arthropod-borne virus (arbovirus) in the genus Flavivirus and the family Flaviviridae. ZIKV was first isolated from a nonhuman primate in 1947 and from mosquitoes in 1948 in Africa, and ZIKV infections in humans were sporadic for half a century before emerging in the Pacific and the Americas. ZIKV is usually transmitted by the bite of infected mosquitoes. The clinical presentation of Zika fever is nonspecific and can be misdiagnosed as other infectious diseases, especially those due to arboviruses such as dengue and chikungunya. ZIKV infection was associated with only mild illness prior to the large French Polynesian outbreak in 2013 and 2014, when severe neurological complications were reported, and the emergence in Brazil of a dramatic increase in severe congenital malformations (microcephaly) suspected to be associated with ZIKV. Laboratory diagnosis of Zika fever relies on virus isolation or detection of ZIKV-specific RNA. Serological diagnosis is complicated by cross-reactivity among members of the Flavivirus genus. The adaptation of ZIKV to an urban cycle involving humans and domestic mosquito vectors in tropical areas where dengue is endemic suggests that the incidence of ZIKV infections may be underestimated. There is a high potential for ZIKV emergence in urban centers in the tropics that are infested with competent mosquito vectors such as Aedes aegypti and Aedes albopictus.
寨卡病毒(ZIKV)是黄病毒属、黄病毒科的一种节肢动物传播病毒(虫媒病毒)。1947年寨卡病毒首次从非人类灵长类动物中分离出来,1948年在非洲从蚊子中分离出来,在其于太平洋地区和美洲出现之前的半个世纪里,人类感染寨卡病毒的情况一直较为零星。寨卡病毒通常通过受感染蚊子的叮咬传播。寨卡热的临床表现不具特异性,可能会被误诊为其他传染病,尤其是由登革热和基孔肯雅热等虫媒病毒引起的疾病。在2013年和2014年法属波利尼西亚大规模疫情爆发之前,寨卡病毒感染仅与轻微疾病相关,当时有严重神经并发症的报告,并且在巴西出现了疑似与寨卡病毒有关的严重先天性畸形(小头畸形)急剧增加的情况。寨卡热的实验室诊断依赖于病毒分离或寨卡病毒特异性RNA的检测。血清学诊断因黄病毒属成员之间的交叉反应而变得复杂。寨卡病毒适应了涉及人类和家蚊媒介的城市传播循环,在登革热流行的热带地区,这表明寨卡病毒感染的发生率可能被低估。在热带地区的城市中心,有大量埃及伊蚊和白纹伊蚊等易感蚊媒滋生,寨卡病毒在这些地区出现的可能性很高。