茲卡病毒的性行為傳染與相關防治建議

The Possibility of Sexual Transmission and Recommendation for Infection Control of the Zika Virus

茲卡病毒（Zika virus）感染疫情自2015年5月以來在國際間持續蔓延，且懷孕期間感染茲卡病毒與胎兒的先天性腦部異常相關，為國際公共衛生緊急關注事件。傳統認為茲卡病毒是經由斑蚊（Aedes spp.）叮咬傳播，近來的個案報告與研究顯示「性行為」是可能的傳染途徑，包含陰道性交、肛交與口交；從發病的男性感染者傳染給性伴侶，於症狀發生前、發病中、症狀緩解後都可能傳染。茲卡病毒感染者的血液、尿液、唾液與精液可偵測到病毒，在精液中有較高的病毒量且持續存在時間比病毒血症期長，可作為茲卡病毒感染症的診斷工具與傳染防治措施的介入點。因此，世界衛生組織依現有的證據提出預防茲卡病毒經性行為傳染之防治建議，美國疾病管制與預防中心針對育齡婦女也有詳細的防治建議。對於無症狀者、有接觸風險的孕婦或計畫懷孕之婦女，能否提供檢測之服務，籲請疾病管制署研擬對策。

The Zika virus disease outbreak has continued to spread internationally since May 2015. Infection during pregnancy contributes to fetal congenital brain abnormalities, making the disease a public health emergency of international concern. Traditionally, the Zika virus is transmitted through the bite of infected Aedes mosquitoes. However, recent case reports and studies have shown that sexual transmission is a possible route, including vaginal intercourse, anal intercourse, and fellatio. Transmission from a person with symptomatic Zika virus infection to a sexual partner, which occurred before, during or after the onset of Zika symptoms is likely. Zika virus was detected in the blood, urine, saliva, and semen of infected patients. It had a higher viral load and longer persistence in semen than viremia. Thus, these could be used as diagnostic tools and intervention strategies for the control of the Zika virus infection. The World Health Organization issued and updated an interim guideline for the prevention of sexual transmission of the Zika virus, and the US Centers for Disease Control and Prevention (CDC) provided a recommendation for women of reproductive age with possible Zika virus exposure. The Taiwan Centers for Disease Control may develop a policy on whether asymptomatic persons, pregnant women, or women attempting contraception with possible Zika virus exposure should undergo Zika virus testing.