4.5 Article

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

Journal

PLOS NEGLECTED TROPICAL DISEASES
Volume 11, Issue 8, Pages -

Publisher

PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pntd.0005869

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Funding

  1. Global Disease Detection Operations Center of the Centers for Disease Control and Prevention
  2. Municipal Secretary of Health of Bahia and Salvador

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In mid-2015, Salvador, Brazil, reported an outbreak of Guillain-Barre A 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.

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