Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Aug 30;11(8):e0005869.
doi: 10.1371/journal.pntd.0005869. eCollection 2017 Aug.

Increased rates of Guillain-Barré syndrome associated with Zika virus outbreak in the Salvador metropolitan area, Brazil

Ashley R Styczynski  1 , Juliane M A S Malta  2 , Elisabeth R Krow-Lucal  3 , Jadher Percio  4 , Martha E Nóbrega  4 , Alexander Vargas  4 , Tatiana M Lanzieri  5 , Priscila L Leite  2 , J Erin Staples  3 , Marc X Fischer  3 , Ann M Powers  3 , Gwong-Jen J Chang  3 , P L Burns  3 , Erin M Borland  3 , Jeremy P Ledermann  3 , Eric C Mossel  3 , Lawrence B Schonberger  1 , Ermias B Belay  1 , Jorge L Salinas  6 , Roberto D Badaro  7 , James J Sejvar  1 , Giovanini E Coelho  4
Affiliations

Increased rates of Guillain-Barré syndrome associated with Zika virus outbreak in the Salvador metropolitan area, Brazil

Ashley R Styczynski et al. PLoS Negl Trop Dis. .

Abstract

In mid-2015, Salvador, Brazil, reported an outbreak of Guillain-Barré syndrome (GBS), coinciding with the introduction and spread of Zika virus (ZIKV). We found that GBS incidence during April-July 2015 among those ≥12 years of age was 5.6 cases/100,000 population/year and increased markedly with increasing age to 14.7 among those ≥60 years of age. We conducted interviews with 41 case-patients and 85 neighborhood controls and found no differences in demographics or exposures prior to GBS-symptom onset. A higher proportion of case-patients (83%) compared to controls (21%) reported an antecedent illness (OR 18.1, CI 6.9-47.5), most commonly characterized by rash, headache, fever, and myalgias, within a median of 8 days prior to GBS onset. Our investigation confirmed an outbreak of GBS, particularly in older adults, that was strongly associated with Zika-like illness and geo-temporally associated with ZIKV transmission, suggesting that ZIKV may result in severe neurologic complications.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Confirmed GBS and reported Zika, dengue, and chikungunya Cases–Salvador metropolitan area, Brazil 2015.
Epidemiologic curve of incident Guillain-Barré syndrome (GBS) cases was juxtaposed with reported symptomatic ZIKV, dengue, and chikungunya infections in the Salvador metropolitan area, Brazil, during January 1–August 31, 2015.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. van den Berg B, Walgaard C, Drenthen J, Fokke C, Jacobs BC, van Doorn PA. Guillain-Barre syndrome: pathogenesis, diagnosis, treatment and prognosis. Nat Rev Neurol. 2014;10(8):469–82. doi: 10.1038/nrneurol.2014.121 - DOI - PubMed
    1. Wakerley BR, Yuki N. Infectious and noninfectious triggers in Guillain-Barre syndrome. Expert Rev Clin Immunol. 2013;9(7):627–39. doi: 10.1586/1744666X.2013.811119 . - DOI - PubMed
    1. Leis AA, Stokic DS. Neuromuscular manifestations of west nile virus infection. Front Neurol. 2012;3:37 doi: 10.3389/fneur.2012.00037 . - DOI - PMC - PubMed
    1. Lebrun G, Chadda K, Reboux AH, Martinet O, Gauzere BA. Guillain-Barre syndrome after chikungunya infection. Emerg Infect Dis. 2009;15(3):495–6. doi: 10.3201/eid1503.071482 . - DOI - PMC - PubMed
    1. Suryapranata FS, Ang CW, Chong LL, Murk JL, Falconi J, Huits RM. Epidemiology of Guillain-Barre syndrome in Aruba. Am J Trop Med Hyg. 2016;94(6):1380–4. doi: 10.4269/ajtmh.15-0070 . - DOI - PMC - PubMed

Grants and funding

Funding for this investigation was provided by the Global Disease Detection Operations Center of the Centers for Disease Control and Prevention. All authors from the Centers for Disease Control and Prevention had direct involvement in the investigational design, data collection, analysis, interpretation, and writing of the report. No payment has been received from a pharmaceutical or other commercial company. ARS had full access to all the data in the study and had final responsibility for the decision to submit the report for publication. The funders provided input regarding study design but had no role in data collection and analysis, decision to publish, or preparation of the manuscript.
-