#Chikungunya, a #risk #factor for #GBS (Clin Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Clin Infect Dis. 2019 Jul 9. pii: ciz625. doi: 10.1093/cid/ciz625. [Epub ahead of print]

Chikungunya, a risk factor for Guillain-Barré syndrome.

Stegmann-Planchard S1,2, Gallian P3,4, Tressières B2, Leparc-Goffart I5, Lannuzel A6, Signaté A7, Laouénan C8, Cabié A9, Hoen B10.

Author information: 1 Unité de Maladies Infectieuses, Centre Hospitalier Louis-Constant Fleming, Saint Martin, France. 2 Centre d’Investigation Clinique Antilles Guyane, Inserm CIC 1424, Pointe-à-Pitre, Guadeloupe, France. 3 Etablissement Français du Sang, Saint Denis-La Plaine Stade de France, France. 4 Unité des Virus Emergents (UVE: Aix-Marseille Univ – IRD 190 – Inserm 1207 – IHU Méditerranée Infection), Marseille, France. 5 Centre national de référence des arbovirus, Errit-IRBA HIA Laveran, Marseille, France. 6 Service de Neurologie, Centre Hospitalier Universitaire de Pointe-à-Pitre, Guadeloupe, France. 7 Service de Neurologie, Centre Hospitalier Universitaire de Martinique, Fort de France, Martinique, France. 8 IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité ; Centre d’Investigation Clinique Inserm CIC-EC 1425 and Département d’Epidémiologie, Biostatistiques et recherche Clinique, Hôpital Bichat-Claude Bernard, AP-HP, all in Paris, France. 9 Centre d’Investigation Clinique Antilles Guyane, Inserm CIC 1424 and Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de la Martinique and Université des Antilles, EA 4537, all in Fort-de-France, France. 10 Centre d’Investigation Clinique Antilles Guyane, Inserm CIC 1424 and Service de Maladies Infectieuses et Tropicales, Dermatologie, Médecine Interne, Centre Hospitalier Universitaire de la Guadeloupe and Université des Antilles, EA 4537, all in Pointe-à-Pitre, France.

 

Abstract

In a matched case-control study where 24 cases developed Guillain-Barré syndrome (GBS) during the 2014 chikungunya outbreak in the French West Indies and 72 controls were blood donors who donated their blood at the same period, Chikungunya infection was a risk factor for GBS (OR 8.3, 95% CI 2.3-29.7, p=0.001).

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

KEYWORDS: Chikungunya virus; Guillain-Barré syndrome; case-control study; chikungunya infection

PMID: 31290540 DOI: 10.1093/cid/ciz625

Keywords: Chikungunya fever; GBS.

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#Zika virus #infection and #risk of #GBS: A meta-analysis (J Neurol Sci., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Neurol Sci. 2019 Jun 21;403:99-105. doi: 10.1016/j.jns.2019.06.019. [Epub ahead of print]

Zika virus infection and risk of Guillain-Barré syndrome: A meta-analysis.

Bautista LE1.

Author information: 1 Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, 610 Walnut Street, WARF 703, Madison, WI 53726-2397, United States. Electronic address: lebautista@wisc.edu.

 

Abstract

OBJECTIVE:

Findings from studies of the association between Zika virus (ZIKV) infection and Guillain-Barré syndrome (GBS) are inconsistent. I conducted a systematic review and meta-analysis to clarify the nature of this association.

METHODS:

I searched PubMed, Scopus, Cochrane, CINAHL, Web of Science, Scielo, and DOAJ for case report, ecological, and analytic studies with “Zika” and “Guillain-Barré syndrome” as keywords, published up to July 1stth 2018. I evaluated if ZIKV infection status influenced the diagnosis of GBS (detection bias) in case-report and analytic studies; assessed if changes in weekly number of cases of ZIKV infection during outbreaks were followed by changes in number of GBS cases 1-8 weeks later; gauged the likelihood of selection, confounding, information, sparse data, and time-dependent bias (i.e. when ZIKV infection was ascertained after GBS onset) in analytic studies; and calculated the average ZIKV-GBS odds ratio (OR) in studies without time-dependent bias.

RESULTS:

In case reports, ZIKV infection prevalence in GBS cases was 2.4 to 25 times higher than expected. Changes in the number of ZIKV-infection cases during outbreaks were not consequentially followed by changes in the number of GBS cases (OR: 1.01; 95% CI: 0.99-1.03). Major biases were likely in all but one analytic study, which showed a non-significant ZIKV-GBS association. The average ZIKV-GBS OR in studies without time-dependent bias was 1.57 (95% CI: 0.86-2.86).

INTERPRETATION:

These findings indicate the available evidence is insufficient to claim ZIKV infection causes GBS. Therefore, stakeholders may want to reconsider current ZIKV-GBS public health and patient care recommendations.

Copyright © 2019 Elsevier B.V. All rights reserved.

KEYWORDS: Disease outbreaks; Guillain-Barre syndrome; Systematic review; Zika virus

PMID: 31255970 DOI: 10.1016/j.jns.2019.06.019

Keywords: Zika Virus; GBS.

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#GBS and its correlation with #dengue, #Zika and #chikungunya viruses #infection based on a literature review of reported cases in #Brazil (Acta Trop., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Acta Trop. 2019 Jun 17:105064. doi: 10.1016/j.actatropica.2019.105064. [Epub ahead of print]

Guillain-Barre Syndrome and its correlation with dengue, Zika and chikungunya viruses infection based on a literature review of reported cases in Brazil.

de Sousa Lima ME1, Rodrigues Bachur TP2, Frota Aragão G3.

Author information: 1 Curso de Medicina, Universidade Estadual do Ceará, Campus Itaperi, Av. Dr. Silas Munguba, 1700 – Itaperi, Fortaleza, CE, CEP 60.714-903, Brazil. Electronic address: matheus.eugenio@aluno.uece.br. 2 Curso de Medicina, Universidade Estadual do Ceará, Campus Itaperi, Av. Dr. Silas Munguba, 1700 – Itaperi, Fortaleza, CE, CEP 60.714-903, Brazil. Electronic address: tatiana.bachur@uece.br. 3 Curso de Medicina, Universidade Estadual do Ceará, Campus Itaperi, Av. Dr. Silas Munguba, 1700 – Itaperi, Fortaleza, CE, CEP 60.714-903, Brazil; Núcleo de Pesquisa e Desenvolvimento de Medicamentos, Faculdade de Medicina, Universidade Federal do Ceará, Campus do Porangabuçu, Rua Cel. Nunes de Melo, 1000 – Rodolfo Teófilo, Fortaleza, CE, CEP 60.430-275, Brazil. Electronic address: gislei.frota@uece.br.

 

Abstract

Guillain-Barre syndrome (GBS) is one of the main neurologic manifestations of arboviruses, especially Zika virus infection. As known, the prevalence of these diseases is high, so the risk of having an increase on GBS is relevant. The study purposes making a comparative survey between the involvement of dengue, Zika and chikungunya infections in the development of the GBS in Brazil, as well as search in literature resemblances and distinctions between beforehand reported cases. It was performed an electronic search in online databases, with articles published between the years of 2004 to 2018. A total of 729 articles about the proposed search were found, and 10 were selected according to inclusion and exclusion criteria. The medium age found in Brazilian studies was 42,9. The time lapse for the neurological symptoms manifest was 6,5 to 11 days. Facial palsy, paresthesia and member weakness were the main symptoms related. Pediatric cases are rare. There are many studies that implicated the association of GBS and arboviruses and point it to one of the main neurological manifestation of these infections. More research and consistent data are needed to clarify unanswered questions and guide public health measures.

Copyright © 2019. Published by Elsevier B.V.

KEYWORDS: Guillain-Barre syndrome; Zika virus; chikungunya; dengue fever

PMID: 31220435 DOI: 10.1016/j.actatropica.2019.105064

Keywords: Arbovirus; GBS; Chikungunya fever, Zika Virus, Dengue fever, Brazil.

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#GBS Associated With #Zika Virus #Infection: A Prospective Case Series From #Mexico (Front Neurol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Front Neurol. 2019 Apr 30;10:435. doi: 10.3389/fneur.2019.00435. eCollection 2019.

Guillain-Barré Syndrome Associated With Zika Virus Infection: A Prospective Case Series From Mexico.

Soto-Hernández JL1, Ponce de León Rosales S2, Vargas Cañas ES3, Cárdenas G1, Carrillo Loza K4, Díaz-Quiñonez JA5,6, López-Martínez I5, Jiménez-Corona ME7, Ruiz-Matus C7, Kuri Morales P6.

Author information: 1 Department of Infectious Diseases National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico. 2 Programa Universitario de Investigación en Salud UNAM, Mexico City, Mexico. 3 Neuromuscular Clinic, Department of Neurology, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico. 4 Department of Neurology, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico. 5 Instituto de Diagnóstico y Referencia Epidemiológicos “Dr. Manuel Martínez Báez”, Mexico City, Mexico. 6 División de Estudios de Postgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico. 7 Dirección General de Epidemiología, Mexico City, Mexico.

 

Abstract

Background:

On May 2016, anticipating the rainy season from June to October in Mexico, we expected an increase in cases of Zika virus (ZIKV) infections. With the goal of identifying cases of GBS associated with ZIKV infection, a prospective joint study was conducted by a reference center for neurological patients and the Secretary of Health in Mexico City from July 2016 to November 2016.

Methods:

Serum, cerebrospinal fluid, urine, and saliva were tested by RT-PCR for ZIKV, dengue virus, and chikungunya virus in patients referred from states with reported transmissions of ZIKV infection, and with clinical symptoms of GBS according to the Brighton Collaboration criteria. Clinical, electrophysiological, and long-term disability data were collected.

Results:

In the year 2016 twenty-eight patients with GBS were diagnosed at our institute. In five hospitalized patients with GBS, RT-PCR was positive to ZIKV in any collected specimen. Dengue and chikungunya RT-PCR results were negative. All five patients had areflexic flaccid weakness, and cranial nerves affected in three. Electrophysiological patterns were demyelinating in two patients and axonal in three. Three patients were discharged improved in 10 days or less, and two patients required intensive care unit admission, and completely recovered during follow-up.

Conclusion:

Our results are similar to those reported from the state of Veracruz, Mexico, in which out of 33 samples of urine of patients with GBS two had a positive RT-PCR for ZIKV. Simultaneous processing of serum, CSF, urine, and saliva by RT-PCR may increase the success of diagnosis of GBS associated to ZIKV.

KEYWORDS: Guillain–Barré Syndrome; RT-PCR; Zika virus; cranial neuropathies multiple; flavivirus infection

PMID: 31114537 PMCID: PMC6502985 DOI: 10.3389/fneur.2019.00435

Keywords: Zika Virus; GBS; Neurology; Mexico.

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#Zika virus #outbreak in 19 #English- and #Dutch-speaking #Caribbean #countries and territories, 2015-2016 (Rev Panam Salud Publica, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Rev Panam Salud Publica. 2018 Sep 7;42:e120. doi: 10.26633/RPSP.2018.120. eCollection 2018.

Zika virus outbreak in 19 English- and Dutch-speaking Caribbean countries and territories, 2015-2016.

Francis L1, Hunte SA2, Valadere AM3, Polson-Edwards K1, Asin-Oostburg V1, Hospedales CJ1.

Author information: 1 Division of Surveillance, Disease Prevention and Control, Communicable Diseases and Emergency Response Department, Caribbean Public Health Agency, Port-of-Spain, Trinidad. 2 Division of Policy, Planning and Research, Caribbean Public Health Agency, Port-of-Spain, Trinidad. 3 Division of Surveillance, Disease Prevention and Control, Laboratory Services and Networks Department, Caribbean Public Health Agency, Port-of-Spain, Trinidad.

 

Abstract in English, Portuguese, Spanish

Surveillance for Zika virus was enhanced in the English- and Dutch-speaking Caribbean following emergence of the virus in Brazil in May 2015. The first autochthonous case of Zika in the Caribbean was reported by Suriname in November 2015, and the virus subsequently spread rapidly throughout the region. Caribbean Public Health Agency (CARPHA) member states (CMS) reported clinically suspected cases of Zika and submitted serum specimens to the agency for laboratory investigation. A patient was considered a confirmed case if Zika virus was detected by real-time reverse transcription-polymerase chain reaction (RT-PCR) assay or serological test. Due to the documented link between 1) Zika virus and congenital syndrome, and 2) Zika virus and Guillain-Barré syndrome (GBS), data on both of these disease outcomes were extracted from country and regional reports. This special report describes the epidemiology of laboratory-confirmed Zika cases reported to CARPHA, including links with both congenital syndrome and GBS, for 19 English- and Dutch-speaking Caribbean countries during the epidemic period (1 October 2015-29 December 2016).

KEYWORDS: Caribbean region; Communicable diseases; Zika virus; emerging; epidemics

PMID: 31093148 PMCID: PMC6386109 DOI: 10.26633/RPSP.2018.120

Keywords: Zika Virus; Zika Congenital Syndrome; GBS; Caribbean.

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Long-term #outcome in #neuroZika: When #biological #diagnosis matters (Neurology, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Neurology. 2019 Apr 26. pii: 10.1212/WNL.0000000000007536. doi: 10.1212/WNL.0000000000007536. [Epub ahead of print]

Long-term outcome in neuroZika: When biological diagnosis matters.

Lannuzel A1, Fergé JL2, Lobjois Q2, Signate A2, Rozé B2, Tressières B2, Madec Y2, Poullain P2, Herrmann C2, Najioullah F2, McGovern E2, Savidan AC2, Valentino R2, Breurec S2, Césaire R2, Hirsch E2, Lledo PM2, Thiery G2, Cabié A2, Lazarini F2, Roze E2.

Author information: 1 From the Service de Neurologie (A.L., Q.L.), Service de Radiologie (P.P.), Laboratoire de Microbiologie Clinique et Environnementale (C.H., S.B.), and Service de Réanimation (G.T.), Centre Hospitalier Universitaire de la Guadeloupe, Institut Pasteur de Guadeloupe (S.B.), Faculté de Médecine (A.L., Q.L., R.C., G.T., S.B., A.C.), Equipe d’accueil 4537 (F.N., R.C., A.C.), Université des Antilles; Faculté de Médecine de Sorbonne Université (A.L., E.H., E.R.), Institut National de la Santé et de la Recherche Médicale, U 1127, CNRS, Unité Mixte de Recherche 7225, Institut du Cerveau et de la Moelle Épinière, ICM, Paris; Service de Réanimation (J.-L.F., A.-C.S., R.V.), Service de Neurologie (A.S.), Service de Maladies Infectieuses et Tropicales (A.C., B.R.), and Laboratoire de Virologie (R.C., F.N.), Centre Hospitalier Universitaire de la Martinique (A.C.); Inserm CIC 1424 (B.T., A.C.), Centre d’Investigation Clinique Antilles Guyane; Emerging Diseases Epidemiology Unit (Y.M.), Institut Pasteur; Département de Neurologie (E.M., E.R.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Institut Pasteur, Perception and Memory Unit (P.-M.L., F.L.), Centre National de la Recherche Scientifique, Unité Mixte de Recherche 3571, Paris, France. annie.lannuzel@chu-guadeloupe.fr. 2 From the Service de Neurologie (A.L., Q.L.), Service de Radiologie (P.P.), Laboratoire de Microbiologie Clinique et Environnementale (C.H., S.B.), and Service de Réanimation (G.T.), Centre Hospitalier Universitaire de la Guadeloupe, Institut Pasteur de Guadeloupe (S.B.), Faculté de Médecine (A.L., Q.L., R.C., G.T., S.B., A.C.), Equipe d’accueil 4537 (F.N., R.C., A.C.), Université des Antilles; Faculté de Médecine de Sorbonne Université (A.L., E.H., E.R.), Institut National de la Santé et de la Recherche Médicale, U 1127, CNRS, Unité Mixte de Recherche 7225, Institut du Cerveau et de la Moelle Épinière, ICM, Paris; Service de Réanimation (J.-L.F., A.-C.S., R.V.), Service de Neurologie (A.S.), Service de Maladies Infectieuses et Tropicales (A.C., B.R.), and Laboratoire de Virologie (R.C., F.N.), Centre Hospitalier Universitaire de la Martinique (A.C.); Inserm CIC 1424 (B.T., A.C.), Centre d’Investigation Clinique Antilles Guyane; Emerging Diseases Epidemiology Unit (Y.M.), Institut Pasteur; Département de Neurologie (E.M., E.R.), AP-HP, Hôpital de la Pitié-Salpêtrière; and Institut Pasteur, Perception and Memory Unit (P.-M.L., F.L.), Centre National de la Recherche Scientifique, Unité Mixte de Recherche 3571, Paris, France.

 

Abstract

OBJECTIVE:

To characterize the full spectrum, relative frequency, and prognosis of the neurologic manifestations in Zika virus (ZIKV) postnatal infection.

METHODS:

We conducted an observational study in consecutive ZIKV-infected patients presenting with neurologic manifestations during the French West Indies 2016 outbreak.

RESULTS:

Eighty-seven patients, including 6 children, were enrolled. Ninety-five percent of all cases required hospitalization. Guillain-Barré syndrome was the most frequent manifestation (46.0%) followed by encephalitis or encephalomyelitis (20.7%), isolated single or multiple cranial nerve palsies (9.2%), other peripheral manifestations (6.9%), and stroke (1.1%). Fourteen patients (16.1%), including one child, developed a mixed disorder involving both the central and peripheral nervous system. Mechanical ventilation was required in 21 cases, all of whom had ZIKV RNA in at least one biological fluid. Two adult patients died due to neuroZika. Clinical follow-up (median 14 months; interquartile range, 13-17 months) was available for 76 patients. Residual disability (modified Rankin Scale score ≥2) was identified in 19 (25.0%) patients; in 6 cases (7.9%), disability was severe (modified Rankin Scale score ≥4). Among patients with ZIKV RNA detected in one biological fluid, the risk of residual disability or death was higher (odds ratio 9.19; confidence interval 1.12-75.22; p = 0.039).

CONCLUSIONS:

NeuroZika spectrum represents a heterogeneous group of clinical neurologic manifestations. During an outbreak, clinicians should consider neuroZika in patients presenting with cranial nerve palsies and a mixed neurologic disorder. Long-term sequelae are frequent in NeuroZika. ZIKV reverse-transcription PCR status at admission can inform prognosis and should therefore be taken into consideration in the management of hospitalized patients.

© 2019 American Academy of Neurology.

PMID: 31028126 DOI: 10.1212/WNL.0000000000007536

Keywords: Zika Virus; Neuroinvasion; Encephalitis; Meningoencephalitis; GBS; Neurology.

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Rare #variant of #GBS after #chikungunya viral fever (BMJ Case Rep., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

BMJ Case Rep. 2019 Apr 23;12(4). pii: e228845. doi: 10.1136/bcr-2018-228845.

Rare variant of Guillain-Barré syndrome after chikungunya viral fever.

Hameed S1, Khan S1.

Author information: 1 Neurology, Aga Khan University Hospital, Karachi, Pakistan.

 

Abstract

Chikungunya (CHIK) viral fever is a self-limiting illness that presents with severe debilitating arthralgia, myalgia, fever and rash. Neurological complications are rare. We present a case of a 36-year-old woman who presented with acute onset progressive difficulty swallowing and left arm weakness. She was diagnosed with CHIK viral fever 4 weeks prior to admission. After investigations, she was diagnosed with a pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. In hospital, she required ventilator support. Her condition improved after five sessions of intravenous immunoglobulin with almost complete resolution within 6 months of symptom onset. With frequent CHIK outbreaks, the neurological complications are increasingly seen in the emergency department. The knowledge of these associations will result in early diagnosis and treatment.

© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.

KEYWORDS: clinical neurophysiology; neurology; peripheral nerve disease

PMID: 31015248 DOI: 10.1136/bcr-2018-228845

Keywords: Chikungunya fever; GBS.

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