ジカ熱の広がり2005 2014 Zika virus: following the path of dengue and chikungunya? globally, similar to dengue (DENV) time and caused an epidemic on Yap Island in the Federated States of and chikungunya (CHIKV) viruses. ZIKV is an emerging arthropod- Micronesia,2 which was followed by borne virus (arbovirus) that was first a large epidemic in French Polynesia isolated from a Rhesus monkey in in 2013 14. 3 Subsequently, ZIKV On May 7, 2015, the Pan American Uganda, in 1947. This arbovirus is spread to several countries in Oceania 2007年のミクロネシア連邦のヤップ島でのアウトブレイクがあり約 Health Organization issued an alert related to DENV and they have similar (figure).4 about potential Zika virus (ZIKV) epidemiology and transmission cycle The clinical presentation of ZIKV 300名の感染者が出た transmission in northeast Brazil.1 This in urban environments. Until recently, infection is not specific (mild fever, has now been confirmed with wide only sporadic human ZIKV infections rash, arthralgia, and conjunctivitis) また2013年9月よりフランス領ポリネシアで始まったジカ熱の大流行 spread of the disease, underscoring were reported. In 2007, ZIKV emerged and can be confused with other the potential for ZIKV to spread outside of Asia and Africa for the first diseases, especially dengue and は ニューカレドニア クック諸島にも波及し感染者は3万人以上に も上ると推計されている Emergence 2005 15 Up to 2005 Lancet. 2015 Jul 18;386(9990):243-4. Northern Mariana Isl Guam Palau Oceania Hawaii ジカ熱の広がり 2015 Marshall Isl Federated States of Micronesia Kiribati Nauru Papua New Guinea Solomon Isl Vanuatu Australia Up to 2005 Tuvalu Tokelau Wallis and Futuna Samoa American Samoa Niue 2015年5月にブラジルで渡 Tonga New Caledonia 航歴のないジカ熱症例が Norfolk Isl 報告 French Polynesia Fiji Isl その後 中南米で急速に 拡大 Cook Isl Pitcairn Isl 2005 15 Easter Isl Key: Zika virus Chikungunya virus PAHO Zika Epidemiological Update - 31 March 2016 Figure: Distribution of Zika and chikungunya viruses before 2005 and their expansion worldwide and in Oceania between 2005 and 2015 sl=island. Circles represent the occurrence of an outbreak. Data are from Weaver and colleagues (2015),5 Cao-Lormeau and colleagues (2014),3 Nhan and Musso and data for New Caledonia are from The Network of (2015)6, and Musso and colleagues (2014).7 Data for Vanuatu are from ProMED (http://promedmail.org), 15 Sentinel Physicians in New Caledonia (http://www.gouv.nc/portal/page/portal/dass/librairie/fichiers/29228252.pdf). Other data are available from the European Centre for Disease Prevention and Control (http://ecdc.europa.eu/en/publications/_layouts/forms/publication_dispform.aspx?list=4f55ad51-4aed-4d32-b960af70113dbb90&id=1309). Submissions shou made via our elect submission system http://ees.elsevie thelancet/

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1 Culex Aedes Anopheles / Jong Travel and Tropical Medicine Manual, 4th ed. 21

50 25 22 Freedman, et al. N Engl J Med 2006;354:119-30.

日本におけるマラリア 年間60 80例前後 全て海外感染例 現在でも年間1~2人程度死亡例がみられる 診断 治療の 遅れが主な原因と考えられる 23

12 35 15-20% Plasmodium falciparum P. vivax P. malariae P. ovale P. knowlesi 24

http://www.dcc-ncgm.info/resource/ マラリアの治療 マラリアと診断されたら速やかに抗マラリア薬で治療を行う 熱帯熱マラリアという種類のマラリアは 治療せずに放っておくと命 に関わる 25