Guillain–Barré Syndrome After Zika Virus Infection in Brazil

Mateus Santana do Rosário Hospital Geral Roberto Santos, Secretaria Estadual da Saúde da Bahia, Salvador, Brazil.

Search for other papers by Mateus Santana do Rosário in
Current site
Google Scholar
PubMed
Close
,
Pedro Antonio Pereira de Jesus Hospital Geral Roberto Santos, Secretaria Estadual da Saúde da Bahia, Salvador, Brazil.

Search for other papers by Pedro Antonio Pereira de Jesus in
Current site
Google Scholar
PubMed
Close
,
Nikos Vasilakis Department of Pathology, Center for Biodefense and Emerging Infectious Diseases, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas.
Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas.

Search for other papers by Nikos Vasilakis in
Current site
Google Scholar
PubMed
Close
,
Daniel Santana Farias Hospital Geral Roberto Santos, Secretaria Estadual da Saúde da Bahia, Salvador, Brazil.

Search for other papers by Daniel Santana Farias in
Current site
Google Scholar
PubMed
Close
,
Marco Antônio Caires Novaes Hospital São Rafael, Fundação Monte Tabor, Salvador, Brazil.

Search for other papers by Marco Antônio Caires Novaes in
Current site
Google Scholar
PubMed
Close
,
Sueli Guerreiro Rodrigues Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas/SVS/MS, Ananindeua, Brazil.

Search for other papers by Sueli Guerreiro Rodrigues in
Current site
Google Scholar
PubMed
Close
,
Lívia Caricio Martins Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas/SVS/MS, Ananindeua, Brazil.

Search for other papers by Lívia Caricio Martins in
Current site
Google Scholar
PubMed
Close
,
Pedro Fernando da Costa Vasconcelos Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas/SVS/MS, Ananindeua, Brazil.

Search for other papers by Pedro Fernando da Costa Vasconcelos in
Current site
Google Scholar
PubMed
Close
,
Albert Icksang Ko Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut.

Search for other papers by Albert Icksang Ko in
Current site
Google Scholar
PubMed
Close
,
Luiz Carlos Junior Alcântara Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil.

Search for other papers by Luiz Carlos Junior Alcântara in
Current site
Google Scholar
PubMed
Close
, and
Isadora Cristina de Siqueira Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil.

Search for other papers by Isadora Cristina de Siqueira in
Current site
Google Scholar
PubMed
Close
Restricted access

Zika virus (ZIKV) is an emerging flavivirus, which has caused a widespread outbreak in the Americas. Shortly after its introduction in 2015, a cluster of cases with Guillain–Barré syndrome was detected in Brazil. Herein, we describe two cases from the city of Salvador, who developed ascending paresis after an acute exanthematous illness. The patients were admitted to the intensive care unit with tetraparesis and cranial nerve palsy, which resolved after intravenous administration of human immunoglobulin. Serological evaluation detected IgM-specific ZIKV antibodies. In regions of Zika virus transmission, health-care workers must be aware of the potential severe neurological complications associated with ZIKV infection and be prepared to provide prompt diagnosis, treatment, and supportive care.

Author Notes

* Address correspondence to Isadora Cristina de Siqueira, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, R. Waldemar Falcao, 121 Candeal, Salvador 40296-710, Brazil. E-mail: isadora.siqueira@bahia.fiocruz.br

Authors' addresses: Mateus Santana do Rosário, Centro de Pesquisas Gonçalo Moniz, Fundacao Oswaldo Cruz (FIOCRUZ), Salvador, Brazil, and Hospital Geral Roberto Santos, Secretaria de Saude do Estado da Bahia, Salvador, Brazil, E-mail: drmateusan@gmail.com. Pedro Antonio Pereira de Jesus and Daniel Santana Farias, Hospital Geral Roberto Santos, Secretaria de Saude do Estado da Bahia, Salvador, Brazil, E-mails: papj@terra.com.br and danielfarias1@hotmail.com. Nikos Vasilakis, Department of Pathology, Center for Biodefense and Emerging Infectious Diseases, University of Texas Medical Branch, Galveston, TX, E-mail: nivasila@utmb.edu. Marco Antônio Caires Novaes, Hospital São Rafael, Fundação Monte Tabor, Salvador, Bahia, Brazil, E-mail: macnovaes@yahoo.com.br. Sueli Guerreiro Rodrigues, Lívia Caricio Martins, and Pedro Fernando da Costa Vasconcelos, Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Belém, Brazil, E-mail: suelirodrigues@iec.pa.gov.br, liviamartins@iec.pa.gov.br, and pedrovasconcelos@iec.pa.gov.br. Albert Icksang Ko, Centro de Pesquisas Gonçalo Moniz, Fundacao Oswaldo Cruz (FIOCRUZ), Salvador, Brazil, and Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, E-mail: albert.ko@yale.edu. Luiz Carlos Junior Alcântara and Isadora Cristina de Siqueira, Centro de Pesquisas Gonçalo Moniz, Fundacao Oswaldo Cruz (FIOCRUZ), Salvador, Brazil, E-mails: lalcan@bahia.fiocruz.br and isadora.siqueira@bahia.fiocruz.br.

  • 1.

    Musso D, Cao-Lormeau VM, Gubler DJ, 2015. Zika virus: following the path of dengue and chikungunya? Lancet 386: 243244.

  • 2.

    Macnamara FN, 1954. Zika virus: a report on three cases of human infection during an epidemic of jaundice in Nigeria. Trans R Soc Trop Med Hyg 48: 139145.

  • 3.

    Hayes EB, 2009. Zika virus outside Africa. Emerg Infect Dis 15: 13471350.

  • 4.

    Duffy MR, Chen T-H, Hancock WT, Powers AM, Kool JL, Lanciotti RS, Pretrick M, Marfel M, Holzbauer S, Dubray C, Guillaumot L, Griggs A, Bel M, Lambert AJ, Laven J, Kosoy O, Panella A, Biggerstaff BJ, Fischer M, Hayes EB, 2009. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med 360: 25362543.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Ioos S, Mallet HP, Leparc Goffart I, Gauthier V, Cardoso T, Herida M, 2014. Current Zika virus epidemiology and recent epidemics. Med Mal Infect 44: 302307.

  • 6.

    Cao-Lormeau VM, Roche C, Teissier A, Robin E, Berry AL, Mallet HP, Sall AA, Musso D, 2014. Zika virus, French Polynesia, South Pacific, 2013. Emerg Infect Dis 20: 10851086.

  • 7.

    Roth A, Mercier A, Lepers C, Hoy D, Duituturaga S, Benyon E, Guillaumot L, Souares Y, 2014. Concurrent outbreaks of dengue, chikungunya and Zika virus infections: an unprecedented epidemic wave of mosquito-borne viruses in the Pacific 2012–2014. Euro Surveill 19: 18.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Zanluca C, De Melo VCA, Mosimann ALP, Santos GI, Santos CN, Luz K, 2015. First report of autochthonous transmission of Zika virus in Brazil. Mem Inst Oswaldo Cruz 110: 569572.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Campos GS, Bandeira AC, Sardi SI, 2015. Zika virus outbreak, Bahia, Brazil. Emerg Infect Dis 21: 18851886.

  • 10.

    Pan American Health Organization (PAHO)/World Health Organization (WHO), 2016. Epidemiological Update: Neurological Syndrome, Congenital Anomalies, and Zika Virus Infection. Washington, DC: PAHO/WHO.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Cao-Lormeau V-M, Blake A, Mons S, Lastère S, Roche C, Vanhomwegen J, Dub T, Baudouin L, Teissier A, Larre P, Vial AL, Decam C, Choumet V, Halstead SK, Willison HJ, Musset L, Manuguerra JC, Despres P, Fournier E, Mallet HP, Musso D, Fontanet A, Neil J, Ghawché F, 2016. Guillain-Barré Syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study. Lancet 387: 15311539.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Wakerley BR, Uncini A, Yuki N, GBS Classification Group, 2014. Guillain–Barré and Miller Fisher syndromes: new diagnostic classification. Nat Rev Neurol 10: 537544.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Hughes RAC, Newsom-Davis JM, Perkin GD, Pierce JM, 1978. Controlled trial prednisolone in acute polyneuropathy. Lancet 312: 750753.

  • 14.

    Rodriguez-Morales AJ, 2015. Zika: the new arbovirus threat for Latin America. J Infect Dev Ctries 9: 684685.

  • 15.

    Garg R, Malhotra H, Jain A, Malhotra K, 2015. Dengue-associated neuromuscular complications. Neurol India 63: 497516.

  • 16.

    El Amrani M, De Monredon J, Wielanek AC, Roger JC, Serveaux JP, 2007. Guillain-Barré syndrome complicating a chikungunya virus infection. Neurology 69: 21052106.

  • 17.

    DVIS/CIEVS, 2015. Informe Epidemiológico Doença Exantemática/Zika Vírus. Salvador-Ba. n 9. Available at: http://www.cievs.saude.salvador.ba.gov.br/boletins-epidemiologicos/boletimsindrexant_n.9agostorev. Accessed August 5, 2016.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Oehler E, Watrin L, Larre P, Leparc-Goffart I, Lastere S, Valour F, Baudouin L, Mallet H, Musso D, Ghawche F, 2014. Zika virus infection complicated by Guillain-Barre syndrome: case report, French Polynesia, December 2013. Euro Surveill 19: 79.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Campos GS, Pinho ACO, Brandao CJDF, Bandeira AC, Sardi SI, 2015. Dengue virus 4 (DENV-4) re-emerges after 30 years in Brazil: cocirculation of DENV-2, DENV-3, and DENV-4 in Bahia. Jpn J Infect Dis 68: 4549.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Chio A, Cocito D, Leone M, Giordana MT, Mora G, Mutani R, 2003. Guillain-Barre syndrome: a prospective, population-based incidence and outcome survey. Neurology 60: 11461150.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 2392 2103 61
Full Text Views 738 20 0
PDF Downloads 268 18 0
 

 

 

 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save