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. 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.

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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

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