Zika virus disease-associated Guillain-Barré syndrome—Barranquilla, Colombia 2015–2016
2017; Elsevier BV; Volume: 381; Linguagem: Inglês
10.1016/j.jns.2017.09.001
ISSN1878-5883
AutoresJorge Salinas, Diana Marcela Walteros Acero, Ashley Styczynski, Flavio Garzón, Hernán Quijada, Elsa Bravo, Pablo Chaparro, Javier Madero, Jorge Acosta‐Reyes, Jeremy P. Ledermann, Zuleima Arteta, Erin M. Borland, Paul Burns, Maritza González, Ann M. Powers, Marcela Mercado, Alma Solano, James J. Sejvar, Martha Ospina,
Tópico(s)Long-Term Effects of COVID-19
ResumoBackground An outbreak of Guillain-Barré syndrome (GBS), a disorder characterized by acute, symmetric limb weakness with decreased or absent deep-tendon reflexes, was reported in Barranquilla, Colombia, after the introduction of Zika virus in 2015. We reviewed clinical data for GBS cases in Barranquilla and performed a case-control investigation to assess the association of suspect and probable Zika virus disease with GBS. Methods We used the Brighton Collaboration Criteria to confirm reported GBS patients in Barranquilla during October 2015–April 2016. In April 2016, two neighborhood and age range-matched controls were selected for each confirmed GBS case-patient. We obtained demographics and antecedent symptoms in the 2-month period before GBS onset for case-patients and the same period for controls. Sera were collected for Zika virus antibody testing. Suspected Zika virus disease was defined as a history of rash and ≥2 other Zika-related symptoms (fever, arthralgia, myalgia, or conjunctivitis). Probable Zika virus disease was defined as suspected Zika virus disease with laboratory evidence of a recent Zika virus or flavivirus infection. Conditional logistic regression adjusted for sex and race/ethnicity was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results We confirmed 47 GBS cases. Incidence increased with age (10-fold higher in those ≥60 years versus those <20 years). We interviewed 40 case-patients and 79 controls. There was no significant difference in laboratory evidence of recent Zika virus or flavivirus infection between case-patients and controls (OR: 2.2; 95% CI: 0.9–5.1). GBS was associated with having suspected (OR: 3.0, 95% CI: 1.1–8.6) or probable Zika virus disease (OR: 4.6, CI: 1.1–19.0). Conclusions Older individuals and those with suspected and probable Zika virus disease had higher odds of developing GBS. Key points We confirmed a Guillain-Barré syndrome (GBS) outbreak in Barranquilla, Colombia, during October 2015–April 2016. A case-control investigation using neighborhood controls showed an association of suspected and probable Zika virus disease with GBS.
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