220.2 📚 國考版

220.2.0.1 必背 — Zika

  • ssRNA flavivirus
  • 2015-2016 Americas epidemic
  • Aedes aegypti primary vector
  • Sexual transmission unique (semen 6+ months)
  • Congenital Zika Syndrome: microcephaly + brain calcifications + arthrogryposis + ocular
  • GBS post-Zika documented association

220.2.0.2 必背 — Zika Diagnosis

  • PCR blood (first 5d) + urine (up to 14d)
  • IgM (cross-reacts with dengue)
  • PRNT for confirmation

220.2.0.3 必背 — Zika Pregnancy

  • Avoid travel to endemic
  • Condoms ≥ 3 mo post-Zika exposure
  • Defer pregnancy 3-6 mo

220.2.0.4 必背 — Chikungunya

  • ssRNA alphavirus
  • Aedes aegypti / albopictus
  • “To walk bent over” — severe polyarthralgia
  • Chronic arthralgia 30-60% persists weeks-years
  • 2024 Brazil + Paraguay severe epidemic

220.2.0.5 必背 — Chikungunya vs Dengue vs Zika

Feature Dengue Chikungunya Zika
Joint pain Moderate Severe + prolonged Mild
Hemorrhage Severe Rare Rare
Microcephaly No No YES
GBS Rare Rare Documented
Vaccine Dengvaxia, Qdenga Ixchiq (2023) None licensed

220.2.0.6 必背 — Ixchiq Vaccine (FDA 2023)

  • First chikungunya vaccine
  • Live attenuated single dose
  • 99% neutralizing Ab
  • Caution immunocompromise + pregnancy

220.2.0.7 必背 — Chronic Chikungunya Arthritis Treatment

  • NSAIDs + DMARDs (methotrexate, HCQ, sulfasalazine)
  • Anti-TNF refractory