#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.

——

Advertisements

#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.

——

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.

——

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.

——

Severe #bornavirus #encephalitis presenting as #GBS (Acta Neuropathol., summary)

[Source: Acta Neuropathologica, full page: (LINK). Summary, edited.]

Severe bornavirus-encephalitis presenting as Guillain–Barré-syndrome

Authors: Roland Coras, Klaus Korn, Stefanie Kuerten, Hagen B. Huttner, Armin Ensser

Correspondence / First Online: 05 April 2019

___

The underlying cause of encephalitis and other inflammatory diseases of the human central nervous system remains unclear in a substantial number of cases. Not infrequently, these cases are then assigned an “autoimmune” or “probably infectious” etiology. Two species of bornaviruses are currently unequivocally associated with encephalitis in mammals including humans. Mammalian 2 orthobornavirus (variegated squirrel bornavirus, VSBV) was identified as the cause of encephalitis in breeders of imported squirrels [2]; Mammalian 1 orthobornavirus (BoDV-1 and -2) is the agent of zoonotic borna disease, an encephalitic disease characterized by disturbances of behavior and movements in warm-blooded animals [4] that is most often diagnosed in horses and sheep. Recently, we detected BoDV-1 as the cause of fatal encephalitis in a previously healthy young man [3], and it was found in a cluster of encephalitic disease in organ recipients that received organs of a single donor from southern Bavaria [6…

(…)

___

Electronic supplementary material

The online version of this article ( https://doi.org/10.1007/s00401-019-02005-z) contains supplementary material, which is available to authorized users.

 

Notes

Acknowledgements

We like to thank Dr. Sybille M. Herzog, Gießen, Germany, for providing the Bo18 antibody and Doris Jungnickl, Brigitte Scholz, and Andrea Hilpert for excellent technical assistance. Research was done with internal funds, and in part by programme overhead financing related to Deutsche Forschungsgemeinschaft Grant EN423/5-1 to Dr. Ensser.

 

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Keywords: Orthobornavirus; Variegated Squirrel Bornavirus; Zoonoses; Encephalitis; GBS.

——

#GBS associated with #Zika virus #infection in #Brazil: a cost-of-illness study (Trans Roy Soc Trop Med Hyg., abstract)

[Source: Transactions of the Royal Society of Tropical Medicine and Hygiene, full page: (LINK). Abstract, edited.]

Guillain–Barré syndrome associated with Zika virus infection in Brazil: a cost-of-illness study

Henry Maia Peixoto, Gustavo Adolfo Sierra, Romero Wildo Navegantes de Araújo, Maria Regina Fernandes de Oliveira

Transactions of The Royal Society of Tropical Medicine and Hygiene, trz010,https://doi.org/10.1093/trstmh/trz010

Published: 20 March 2019

 

Abstract

Background

Guillain–Barré syndrome (GBS) is a serious, acute paralytic neuropathy of autoimmune aetiology, usually associated with a previous infection. The current study aims to estimate the costs of GBS associated with Zika virus (ZIKV) infection in Brazil.

Methods

A cost-of-illness study was conducted from the perspective of the Brazilian public health system (Sistema Único de Saúde [SUS]) and Brazilian society for the year 2016. Direct and indirect costs were estimated by a mixed macrocosting and microcosting approach.

Results

The total cost of ZIKV-associated GBS in Brazil was US$11 997 225.85, consisting of the costs of symptomatic ZIKV infection before onset of GBS (direct costs US$2011.51, indirect costs US$19 780.53) and the costs that followed development of GBS (direct costs US$4 722 980.89, indirect costs US$7 252 452.92). The cost of treatment with human immunoglobulin (US$3 263 210.50) and the cost of productivity losses associated with potential years of working life lost due to early mortality (US$4 398 551.72) were particularly noteworthy.

Conclusions

These findings suggest that ZIKV-associated GBS is costly to Brazil, especially due to productivity losses and hospitalization. This highlights the importance of investing in the prevention of ZIKV infection and in the care of patients with GBS.

cost of illness, economic analysis, Guillain–Barré syndrome, Zika virus

Topic: guillain-barre syndrome – brazil – cost of illness – health care costs – immunoglobulins – infection – mortality – public health medicine – facilities and administrative costs – zika virus – zika virus infections

Issue Section: Original Articles

© The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Zika Virus; GBS; Brazil.

—–

#Zika Virus-Associated Aseptic #Meningitis and #GBS in a #Traveler Returning from Latin America: a Case Report and Mini-Review (Curr Infect Dis Rep., abstract)

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

Curr Infect Dis Rep. 2019 Feb 15;21(1):3. doi: 10.1007/s11908-019-0661-1.

Zika Virus-Associated Aseptic Meningitis and Guillain-Barre Syndrome in a Traveler Returning from Latin America: a Case Report and Mini-Review.

Wright JK1, Castellani L2, Lecce C3, Khatib A3, Bonta M1, Boggild AK4,5,6.

Author information: 1 Department of Medicine, University of Toronto, Toronto, Canada. 2 Department of Medicine, Division of Clinical Sciences, Northern Ontario School of Medicine, Sudbury, Canada. 3 Tropical Disease Unit, Toronto General Hospital, 200 Elizabeth Street, Toronto, 13EN-218, Canada. 4 Department of Medicine, University of Toronto, Toronto, Canada. andrea.boggild@utoronto.ca. 5 Tropical Disease Unit, Toronto General Hospital, 200 Elizabeth Street, Toronto, 13EN-218, Canada. andrea.boggild@utoronto.ca. 6 Public Health Ontario Laboratories, Toronto, Canada. andrea.boggild@utoronto.ca.

 

Abstract

ZIKV-associated Guillain-Barré syndrome presents with an accelerated clinical course compared to classic post-infectious Guillain-Barré syndrome. Clinicians should anticipate and screen patients with ZIKV infection for neurologic complications bearing in mind that these may manifest during the acute viremic phase or during early convalescence.

KEYWORDS: Emerging infectious diseases; Flaviviruses; Guillain–Barre syndrome; Vector-borne infections; Zika virus

PMID: 30767073 DOI: 10.1007/s11908-019-0661-1

Keywords: Zika Virus; GBS; Meningitis.

—–