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Medline ® Abstract for Reference 128

of 'Zika virus infection: An overview'

Zika virus disease-associated Guillain-Barrésyndrome-Barranquilla, Colombia 2015-2016.
Salinas JL, Walteros DM, Styczynski A, Garzón F, Quijada H, Bravo E, Chaparro P, Madero J, Acosta-Reyes J, Ledermann J, Arteta Z, Borland E, Burns P, Gonzalez M, Powers AM, Mercado M, Solano A, Sejvar JJ, Ospina ML
J Neurol Sci. 2017;381:272. Epub 2017 Sep 4.
BACKGROUND: An outbreak of Guillain-Barrésyndrome (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≥60years versus those<20years). 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-Barrésyndrome (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.
Centers for Disease Control and Prevention, United States. Electronic address: jsalinas@cdc.gov.