zika grossesse france

Territories, January 1, 2016–April 25, 2017. Mais dans 70% des cas, l’infection est asymptomatique. Virus peu connu jusqu’à la récente épidémie, les premières études ont rapidement fait apparaitre la possibilité de malformations cérébrales fœtales notamment à type de microcéphalies. Halai UA, Nielsen-Saines K, Moreira ML, et al. On 9 October 2019, the French authorities reported an autochthonous Zika virus (ZIKV) case in Hyeres, Var department, France. ), French Guiana; and Unité de Maladies Infectieuses, Centre Hospitalier Louis Constant Fleming, St. Martin (S.S.-P.) — all in France. Second, although birth defects could be observed as a consequence of ZIKV infection in any trimester of pregnancy, our data showed that the risk of birth defects and the risk of the congenital Zika syndrome were higher when ZIKV infection occurred early in pregnancy — a finding consistent with previous reports.5,15 The risk of birth defects was 12.7% when ZIKV infection occurred in the first trimester, 3.6% when it occurred in the second trimester, and 5.3% when it occurred in the third trimester, and the risk of the congenital Zika syndrome was 6.9%, 1.2%, and 0.9%, respectively. First, we found a 7.0% overall risk of neurologic and ocular defects possibly associated with ZIKV infection that were evident at birth in the offspring of women in French territories in the Americas who had acute, symptomatic, PCR-confirmed ZIKV infection during pregnancy. † The body-mass index (BMI) is the weight in kilograms divided by the square of the height in meters. Le traitement va consister à atténuer les symptômes douloureux, par la prise d’antalgiques. The Zika (ZIKV) epidemic has spread into the three French Overseas Departments in the Caribbean (DFAs). Bouthry E(1), Hervé A(2), Brichler S(3), Poveda JD(4), Roque-Afonso AM(5), Vauloup-Fellous C(6). We thank the women who participated in this study; all the physicians, midwives, clinical research assistants, health officers, and epidemiologists who helped conduct this study in each of the French territories in the Americas: Myriam Atine, Lyderic Aubert, Marie Barrau, Kebe Beavogui, Christelle Celeste, Joelle Colat-Peyron, Elvire Couchy, Véronique Davidas, Lucetta Delver, Jacqueline Dubois, Stanie Gaete, Dorothée Harrois, Marie-Laure Lalanne-Mistrih, Mathilde Melin, Marie-France Mirane, Francelise Nadessein, Marie-Josée Pelczar, Véronique Plantier, Céline Rocquet, Magdalena Saint-Marc, Patrick Saint-Martin, Valérie Soter, Ingrid Soubdhan, Jennifer Taillefond, Lambo Velonasy, and Véronique Walter (Guadeloupe); Nicole Ambroisine, Gilda Belrose, Alain Blateau, Patricia Blondel, Isabelle Calmont, Valérie Decatrelle, Michèle Gueneret, Eugénie Jolivet, Isabelle Komla-Soukha, Corinne Plavonil, Marie-andrée Pyram, and Jean-Luc Voluménie (Martinique); Antoine Adenis, Audrey Andrieu, Luisiane Carvalho, Sandy Dabrowski, Céline Delorme, Maryvonne Dueymes, Aniza Fahrasmane, Arthur Felix, Hélène Hilderal, Anne Jolivet, Justine Krajewsky, Véronique Lambert, Thomas Lemaitre, Myriam Livain, Jérémie Pasquier, Marion Petit-Sinturel, Céline Pomar, Léo Pomar, and Stéphanie Rogier (French Guiana); and David Baud (University of Lausanne, Switzerland) and Rebecca Grant (Institut Pasteur de Paris, France) for their critical review of an earlier version of the manuscript. Microcephaly was detected in 32 fetuses and infants (5.8%): 9 cases (1.6%) were severe, 9 (1.6%) were moderate-disproportionate, and 14 (2.5%) were moderate-proportionate. Zika virus infection in pregnant women in Rio de Janeiro. We were therefore able to describe outcomes in 555 fetuses and infants (Figure 1). The centralized antenatal and maternal care facilities enabled enhanced surveillance of all pregnancies during the ZIKV epidemic. Nouvelle maladie infectieuse potentiellement grave pour les fœtus dont l’éventail géographique va s’étendre en raison de la diffusion du moustique vecteur par le réchauffement climatique. Clinical information — including the number of previous pregnancies and live births, history of adverse pregnancy outcomes, pertinent medical history, body-mass index, symptoms of ZIKV infection, gestational age of fetuses, and any clinically relevant medical event during pregnancy — was recorded during this baseline visit, and blood and urine specimens were obtained. le 23 octobre 2019 à 16h17 Rechercher. 1. (Funded by the French Ministry of Health and others; ClinicalTrials.gov number, NCT02916732. A key component of the ZIKA-DFA-FE study was the prospective follow-up, until the end of pregnancy, of women who had clinical symptoms of ZIKV infection during pregnancy. The risk of birth defects possibly associated with ZIKV infection was similar in Guadeloupe and Martinique (7.2% and 7.5%, respectively). and Center for Global Health (A.F. Longer-term follow-up of infants is required to assess for late-onset manifestations not detected at birth. Microcephaly was considered moderate when the head circumference was between 3 SD and 2 SD below the mean and severe when the head circumference was more than 3 SD below the mean. March 15, 2018N Engl J Med 2018; 378:985-994 The study received ethics approval from Comité de Protection des Personnes Sud-Ouest et Outre Mer III. Of the 546 women with known outcomes, 185 (33.9%) were infected with ZIKV in the first trimester of pregnancy, 249 (45.6%) in the second trimester, and 112 (20.5%) in the third trimester. Characterizing the pattern of anomalies in congenital Zika syndrome for pediatric clinicians. In addition, results of TORCH serologic testing12,13 (toxoplasmosis, other [syphilis, varicella, parvovirus infection, human immunodeficiency virus infection], rubella, cytomegalovirus infection, and herpes simplex virus infection), which is routinely performed during pregnancy in French territories in the Americas, were recorded. Zika virus (ZIKV) (pronounced / ˈ z iː k ə / or / ˈ z ɪ k ə /) is a member of the virus family Flaviviridae. † Results from tests on urine specimens were negative or unknown, or tests were not performed. Détecté pour la 1ère fois en 1947 en Ouganda, responsable de petites épidémies en Afrique, il va se déployer dans les années 70 en Asie puis dans les années 2010 dans le Pacifique pour atteindre le Brésil en 2015 où il sera responsable d’une importante épidémie, pour ensuite se répandre dans les Caraïbes et en Amérique centrale. It was estimated to be higher than 40% in a prospective observational study in Brazil involving women who had symptomatic ZIKV infection during pregnancy.3 In the U.S. Zika Pregnancy Registry, the estimate was 6% overall and 11% when ZIKV exposure occurred during the first trimester.5 The latter estimate has been updated recently to 15%.6. Defects were more common among fetuses and infants whose mothers had been infected early in pregnancy. L’évolution est le plus souvent rapidement favorable avec une guérison spontanée en 2 à 7 jours. Shapiro-Mendoza CK, Rice ME, Galang RR, et al. Women were included in this analysis if they met all of the following criteria: ongoing pregnancy at any gestational stage; clinical symptoms consistent with acute ZIKV infection, with at least one symptom of pruritic rash, fever, conjunctival hyperemia, arthralgia, or myalgia; and laboratory confirmation of recent ZIKV infection, on the basis of a positive result on a reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay performed on a specimen of blood, urine, or both. Pregnancy outcomes after maternal Zika virus infection during pregnancy — U.S. When ultrasonographic findings were used instead of autopsy data, microcephaly was defined as a head circumference more than 3 SD below the mean. Microcephaly (defined as head circumference more than 2 SD below the mean for sex and gestational age) was detected in 32 fetuses and infants (5.8%), of whom 9 (1.6%) had severe microcephaly (more than 3 SD below the mean). 8. No fetal abnormality or birth defect was observed in any of the women who had coinfection with syphilis (4 women), human immunodeficiency virus (2), toxoplasmosis (3), or cytomegalovirus (1). Ultrasound Obstet Gynecol 2017;49:729-736. La transmission par le lait maternel est exceptionnelle. Pour répondre aux interrogations des femmes et des couples, des modules interactifs personnalisés sont proposés, afin que chacun puisse, en fonction de sa propre situation, évaluer son risque et trouver des réponses pratiques. Virus Zika : toute l'actualité en direct, soyez informé de toute l'info en continu, en images et en vidéos. 2. Once women were enrolled, they underwent monthly clinical and ultrasonographic examinations until they had a pregnancy outcome. USA : 442 grossesses, 6% d’anomalies congénitales, Guadeloupe : 662 cas, 1,2% de microcéphalies, 2,1% d’anomalies cérébrales, Martinique : 669 cas, 1% de microcéphalies, 3,1% d’anomalies cérébrales, Guyane : 1650 cas, 0,24% de microcéphalies, 1% d’anomalies cérébrales. ), Pointe-à-Pitre, Guadeloupe; Centre Pluridisciplinaire de Diagnostic Prénatal, Maison de la Femme de la Mère et de l’Enfant (B.S. ZIKA-DFA-FE was a cohort study that used four different recruitment methods in an attempt to capture all women whose pregnancies overlapped with the period of the ZIKV epidemic in French territories in the Americas (details are provided in the Supplementary Appendix, available with the full text of this article at NEJM.org). Results of ZIKV and TORCH Testing in the 546 Women with Symptomatic, PCR-Confirmed ZIKV Infection. In French Guiana, where the number of participants (24) was small, no birth defects possibly associated with ZIKV infection were observed. ‡ Results from tests on blood specimens were negative or unknown, or tests were not performed. Neurologic and ocular abnormalities were more common when ZIKV infection had occurred during the first trimester (24 of 189 fetuses and infants [12.7%]) than when it had occurred during the second trimester (9 of 252 [3.6%]) or third trimester (6 of 114 [5.3%]) (P=0.001). 3. ), CHU Martinique, Fort-de-France, Martinique; the Emerging Diseases Epidemiology Unit (A.L.F., Y.M., A.F.) Santé publique France pilote et coordonne sa surveillance et participe à sa prévention. Fetuses or infants may have had more than one neurologic or ocular defect. ), and Pôle Parent-Enfant (E.J. PCR denotes polymerase chain reaction, RT-PCR, reverse-transcriptase–PCR, and ZIKV Zika virus. In 3 of the 527 live births (0.6%), clinical abnormalities other than microcephaly were detected at birth. Information, resources, and support needed to approach rotations - and life as a resident. 12. Zika virus shares a genus with the dengue, yellow fever, Japanese encephalitis, and West Nile viruses. 13. de Jong EP, Vossen AC, Walther FJ, Lopriore E. How to use … neonatal TORCH testing. First, the 2013–14 French Polynesian outbreak was the initial report of neurological and congenital complications in people infected by Zika virus, with an increase in incidence of Guillain-Barré syndrome and eight reported cases of neurological congenital malformations. Dans une très grande majorité des cas, la maladie provoque peu de symptômes ou même l’absence de symptôme. 11. Birth Outcomes and Abnormalities Observed in the Fetuses and Infants. Le dépistage échographique pendant la grossesse peut retrouver : calcifications, ventriculomégalies, anomalies de développement du cortex, du corps calleux ou du cervelet, anomalies ophtalmiques, l’infection peut être évolutive après la naissance. Neurologic and ocular defects were more common when ZIKV infection occurred during the first trimester (24 of 189 fetuses and infants [12.7%]) than when it occurred during the second trimester (9 of 252 [3.6%]) or third trimester (6 of 114 [5.3%]) (P=0.001). Brasil P, Pereira JP Jr, Moreira ME, et al. Schaub B, Gueneret Ml, Jolivet En, et al. The percentage of fetuses and infants with birth defects possibly associated with ZIKV infection was estimated according to the trimester in which pregnant women were infected, and we compared these values across the three groups using Fisher’s exact test. Zika outbreaks have probably occurred in many locations. Pregnancy Outcomes after Zika Virus Infection Zika virus was recently linked to birth defects, especially microcephaly. 10. Neurologic and ocular abnormalities possibly associated with ZIKV infection were observed in 39 fetuses and infants (7.0%; 95% confidence interval [CI], 5.0 to 9.5): 28 live-born infants, 10 fetuses that were not carried to term because of termination of pregnancy for medical reasons, and 1 stillborn baby. Additional defects were observed in only 1 of the 23 infants with moderate microcephaly — a case involving medical termination of pregnancy in which the fetus had moderate-disproportionate microcephaly. Consequences of central nervous system dysfunction included conditions such as arthrogryposis, clubfoot, congenital hip dysplasia, and congenital deafness. ), Institut Pasteur, INSERM, IAME (Infection, Antimicrobials, Modeling, Evolution), Paris Diderot University (C.L. Information and tools for librarians about site license offerings. The virus was first isolated in 1947 from rhesus monkeys of the Zika forests of Uganda. The termination of 10 pregnancies for medical reasons in the French territories (as compared with none in Brazil) may have resulted in fewer neurologic abnormalities being detected at birth in the French territories than in Brazil, but this cannot explain the entire difference between the two cohorts. We acknowledge that our study has limitations. Issues de grossesse et anomalies congénitales dans une cohorte de 546 femmes ayant présenté une infection symptomatique à virus Zika (ZIKV) au cours de l'épidémie de Zika dans les TFA B. Hoen, A. Cabié, A. Funk, C. Herrmann-Storck, F. Najioullah, K. Schepers, M. Douine, S. Stegmann-Planchard, D. Rousset, A. Fontanet Atteintes congénitales liéesau virus Zika Comparison de trois études internationales Brasil (n=126) Honein (n=442) Hoen (n=555) Issuesdegrossesses Fausses couches / morts-nés/ interruptions de grossesse 9 (7.1) 47 (10.6) 28 (5.0) Naissances vivantes 117 (92.9) 395 (89.6) 527 (95.0) Anomalies congénitales Microcéphalie 4 (3.2) 18 (4.1) 32(5.8) Data on BMI are missing for 90 women (16.5%). Compte tenu de la gravité de latteinte du fœtus, les recommandations sadressent essentiellement aux femmes enceintes et aux couples qui ont un projet de grossesse. Pregnancy outcomes are shown in Table 4 and in Table S2 in the Supplementary Appendix. Valuable tools for building a rewarding career in health care. PCR denotes polymerase chain reaction, and ZIKV Zika virus. MMWR Morb Mortal Wkly Rep 2016;65:1343-1348. Optimism for Interstitial Lung Disease–Associated Pulmonary Hypertension? Chez les nouveau-nés de mamans atteintes de la maladie, les malformations fœtales retrouvées durant les dernières années comptent notamment parmi elles la microcéphalie . Thus, 561 women with symptomatic, PCR-confirmed, ZIKV infection were included in the analysis in this study. Of the 267 tests performed, 1 was positive. 14. von der Hagen M, Pivarcsi M, Liebe J, et al. Declaration of Zika virus infection is now mandatory in France. If a fetal abnormality was identified during a follow-up ultrasonographic examination, magnetic resonance imaging (MRI) of the fetus was performed, and the woman was followed up monthly with laboratory testing and ultrasonography, as reported elsewhere.9-11 The end point for each woman enrolled in the study was the pregnancy outcome: delivery of a live-born infant with or without birth defects, miscarriage, termination of pregnancy for medical reasons, or stillbirth. Women were included in this analysis if they met all of the following criteria: ongoing pregnancy at any gestational stage; clinical symptoms consistent with acute ZIKV infection, with at least one symptom of pruritic rash, fever, conjunctival hyperemia, arthralgia, or myalgia; and laboratory confirmation of recent ZIKV infection, on the basis of a positive result on a reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay performed on a specimen of blood, urine, or both. ), QUICK TAKEPregnancy Outcomes after Zika 01:57, It has been recognized recently that Zika virus (ZIKV) infection during pregnancy can cause severe birth defects,1 including microcephaly,2 other brain defects,3 and the congenital Zika syndrome.4 However, the magnitude of this risk is not clearly defined. Mes favoris. Arch Dis Child Educ Pract Ed 2013;98:93-98. Site de l'ECDC avec les dernières données : https://ecdc.europa.eu/en/zika-virus-infection. The risk of congenital neurologic defects related to Zika virus (ZIKV) infection has ranged from 6 to 42% in various reports. ¶ Toxoplasmosis, rubella, and cytomegalovirus tests were for IgM antibodies. Pregnant women with suspected ZIKV infection were referred to the prenatal diagnosis center in each territory, where they underwent testing for ZIKV infection and were invited to participate in the study. It is spread by daytime-active Aedes mosquitoes, such as A. aegypti and A. albopictus. We believe that this aspect of the study design had a limited effect on the rate of birth defects that could have been identified if all neonates had undergone brain imaging soon after birth. In addition, the results were consistent across the two territories in which the largest numbers of women were recruited (Martinique and Guadeloupe). The overall risk of evident birth defects included in the current definition of the congenital Zika syndrome was 3.1%, and the overall risk of severe microcephaly was 1.6%. In accordance with the guidelines of the French High Council for Public Health7 and the French National College of Gynecologists and Obstetricians8 that were released on July 28, 2015, and February 5, 2016, respectively, whenever a pregnant woman presented to the outpatient clinic or emergency department of a participating center with symptoms consistent with acute ZIKV infection, she underwent a clinical examination, and blood and urine specimens were obtained for confirmation of recent ZIKV infection. Le virus zika est transmis à l’homme par la piqûre d’un moustique du genre Aedes (A.aegypti et A.albopictus) largement réparti dans le monde et dont la période d’activité est surtout diurne. ), Service de Maladies Infectieuses et Tropicales, Dermatologie, Médecine Interne (B.H., K.S. The percentage of infants who were small for gestational age was similar in French territories in the Americas and in the Brazilian cohort (13.1% and 9%, respectively), but differences between those two cohorts are apparent when we examine the percentage of infants who were admitted to neonatal intensive care immediately after birth (1.3% in the French territories and 21% in Brazil) and the percentage of infants with abnormal neurologic findings from the clinical examination at birth (0.6% and 26.5%, respectively). De la mère au fœtus, elle est possible tout au long de la grossesse et les conséquences fœtales seront d’autant plus grave que l’infection survient tôt durant la grossesse. Stay connected to what's important in medical research and clinical practice, Subscribe to the most trusted and influential source ofmedical knowledge. Neurologic and ocular abnormalities were more common when ZIKV infection had occurred during the first trimester (24 of 189 fetuses and infants [12.7%]) than when it had occurred during the second trimester (9 of 252 [3.6%]) or third trimester (6 of 114 [5.3%]) (P=0.001). JAMA 2017;317:59-68. Lancet Child Adolesc Health 2017;1:45-55. Among the 527 live births, 69 infants (13.1%) were small for gestational age, and 75 infants (14.2%) were delivered through emergency cesarean section. Ms. Funk reports receiving salary from Institut Carnot-Pasteur Maladies Infectieuses (ANR 11-CARN 017-01) through the Pasteur-Paris University International Ph.D. program. We present here the pregnancy outcomes in a cohort of women living in French territories in the Americas (French Guiana, Guadeloupe, and Martinique) who had symptomatic, laboratory-confirmed ZIKV infection during pregnancy. Baud D, Gubler DJ, Schaub B, Lanteri MC, Musso D. An update on Zika virus infection. Pomar L, Malinger G, Benoist G, et al. virus Zika au cours de la grossesse Bruno Hoen, Anna L Funk, Benoit Tressières, Ingrid Vingadassalom, Eustase Janky, Philippe Kadhel, Catherine Ryan, Kinda Schepers, Stanie Gaete, Arnaud Fontanet These data included age, ethnic group, residence, level of education, professional activity, and lifestyle factors. Celle-ci possède un neurotropisme dont il nous faut connaitre les signes échographiques. † Among the 527 live births, 96 infants (18.2%) did not undergo prenatal ultrasonography after the mother had been infected with ZIKV (7.9% when ZIKV infection occurred in the first trimester, 11.3% when infection occurred in the second trimester, and 48.3% when infection occurred in the third trimester). Lorsque des symptômes apparaissent, ils sont le plus souvent de type grippal (fièvre, maux de tête, courbatures) avec des éruptions cutanées et se manifestent dans les 3 à 12 jours qui suivent la piqûre par le moustique. Si vous envisagez une grossesse après un voyage : Les femmes devraient attendre 2 mois après leur retour de voyage ou l’apparition des symptômes d’une infection à virus Zika (selon la période la plus longue) avant d’essayer de tomber enceintes pour que toute infection possible à virus Zika … Actuellement il n’existe pas de vaccin pour prévenir l'infection par le virus Zika, ni de médicament spécifique pour soigner la maladie. Although the rate of complications would be expected to be higher among women with symptomatic infection than among those who were asymptomatic, an observational study involving U.S. women did not show any significant difference in the rate of birth defects between the offspring of women who had symptomatic ZIKV infection and the offspring of women who had asymptomatic ZIKV infection during pregnancy.5 A recent study also showed no significant association between disease severity or viral load and adverse outcomes.16 Second, we were not able to fully assess the presence of birth defects possibly associated with ZIKV infection in the case of the 11 miscarriages, 2 of the 6 stillbirths, and the 1 voluntary abortion, as well as in the 96 live-born infants (18.2% of the 527 live-born infants) who did not undergo prenatal ultrasonography after ZIKV infection. Prevent mosquito bites when traveling:. During the enrollment visit, sociodemographic data were collected for each woman. Les études en cours vont préciser les conséquences fœtales réelles, l’évolutivité possible après la naissance et les facteurs de risques. Premiers cas de Zika en France métropolitaine : ce qu'il faut savoir pour se protéger du virus. ), and Conservatoire National des Arts et Métiers, Unité Pasteur-Cnam Risques Infectieux et Émergents (A.F. Neurologic and ocular abnormalities possibly associated with ZIKV infection were observed in 39 fetuses and infants (7.0%; 95% confidence interval [CI], 5.0 to 9.5): 28 live-born infants, 10 fetuses that were not carried to term because of termination of pregnancy for medical reasons, and 1 stillborn baby. All other live-born babies with ZIKV-related defects had at least one abnormality that would have been detected during the clinical examination at birth (e.g., microcephaly, clubfoot, or a neural-tube defect such as spina bifida). All karyotypes were normal except for one pericentric inversion of chromosome 2, and RT-PCR for ZIKV in an amniotic-fluid specimen was positive in 7 cases. ), Paris; CIRE de Guyane, Santé Publique France (V.A. Il en va sans doute de même pour Zika. Disease outbreak news. Moderate microcephaly was further defined as proportionate or disproportionate — proportionate if the neonate was small for gestational age (a weight more than 1.28 SD below the mean for sex and gestational age) and disproportionate if the neonate was not small for gestational age. The main findings of this cohort study are twofold. Evaluation and optimisation of commercial Zika IgG avidity assay. Characteristics of Infection in the Women with Symptomatic, PCR-Confirmed ZIKV Infection. The authors vouch for the completeness and accuracy of the data and analyses and for the fidelity of the study to the protocol. When the mother is symptomatic, the infection is confirmed by a positive reverse transcription polymerase chain reaction (RT‐PCR) test of the blood or urine 15 and/or by detection of anti‐ZIKV antibodies. éruption maculo-papuleuse peu visible sur peau noire, autres : arthralgies, céphalées, asthénie, œdèmes, diarrhée…. In addition, 6 nonneurologic birth defects (in 1.1% of the fetuses or infants) were detected in this cohort (see Table S3 in the Supplementary Appendix for a detailed description of all birth defects). Zika virus is a disease that is found in warm, tropical climates, particularly tropical Africa, Southeast Asia, and the Pacific Islands. A total of 31 infants (5.9%) were hospitalized immediately after birth, and 7 of these infants (1.3%) were admitted to the neonatal intensive care unit. Il se trouve à de fortes concentrations dans le sperme et la transmission par voie sexuelle, surtout dans le sens homme-femme, est une voie non négligeable de contamination. Schaub B, Vouga M, Najioullah F, et al. 4. The ZIKV epidemic in French territories in the Americas began in early 2016 and presented another opportunity to assess the risk of ZIKV-related congenital neurologic defects in a population of pregnant women living in a region in which a ZIKV outbreak occurred. 15. Moore CA, Staples JE, Dobyns WB, et al. In 1952, the first human cases of Zika were detected and since then, outbreaks of Zika have been reported in tropical Africa, Southeast Asia, and the Pacific Islands.

Onomatopée Signifiant Que L'on Boit, Insecte Mangeur De Patate, Grandental - Centre Dentaire Colombes - Gare Colombes, Liane Foly Et Sa Fille, Chanson Déjeuner Du Matin, Revue Technique Renault 11 Pdf, Laboratoire Lieusaint Test Pcr, Super 8 Camera Prix,