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Multicenter Study
. 2025 Mar 5;19(3):e0012898.
doi: 10.1371/journal.pntd.0012898. eCollection 2025 Mar.

Guillain-Barré syndrome after the Zika epidemic in Colombia: A multicenter, matched case-control study

Lyda Osorio  1 , Beatriz Parra  2 , Martha Moyano  1 , Reydmar Lopez-Gonzalez  3 , Jorge A Jimenez-Arango  4 , José Vargas-Manotas  5   6 , Jairo Lizarazo  7 , Gustavo E Ramos-Burbano  8   9 , Mario Daniel Llanos  9 , Fernando Rosso  10   11 , Jonathan Urrego  8   12 , Juan P Rojas  13 , Christian A Rojas  8   12   14 , Julie Benavides-Melo  15 , Viviana A Martinez-Villota  16 , Karina A Luque-Burgos  17 , Adriana M Ruiz  17 , Liliana Soto  2 , Laura Quintero-Corzo  2 , Jaime A Quintero  2 , Daniela Zuluaga-Lotero  2 , David Acero-Garces  2 , Susana C Dominguez-Peñuela  1   18 , Susan Halstead  19 , Hugh J Willison  19 , Carlos A Pardo  18 ; Neuroinfections Emerging in the Americas Study (NEAS)
Affiliations
Multicenter Study

Guillain-Barré syndrome after the Zika epidemic in Colombia: A multicenter, matched case-control study

Lyda Osorio et al. PLoS Negl Trop Dis. .

Abstract

Background: Zika produced the highest increase in the incidence of Guillain-Barré syndrome (GBS) in Latin America in the last decade. The Neuroinfections Emerging in the Americas Study (NEAS) was established in 2016 to investigate the association of emerging infectious disorders with GBS in Colombia. The present study assessed the role of preceding infections, including arboviruses and other pathogens, as risk factors for GBS.

Methods: A case-control study was conducted prospectively between June 2016 and December 2019 in 5 Colombian cities. We recruited newly diagnosed patients with GBS and a house control plus an age and season-matched-hospital control per case. Clinical information, blood, CSF, and urine samples were used to diagnose bacterial and viral infections. Anti-glycolipid antibodies were identified in serum. Statistical analyses were performed using conditional logistic regression.

Findings: Fifty-seven patients with GBS, 66·7% male, 52 years of median age, were recruited along with 77 (55 house and 22 hospital) controls. GBS was associated with presenting diarrhea (adjusted OR 10·94; 95% CI 1·8-66·29; p=0·009) and a history of recent upper respiratory tract infection (aOR 13·91; 95% CI 2·38-81·1 p=0·003). Specific recent infections did not significantly differ between cases and controls, but the number of infections was associated with GBS (aOR=1·77 95% CI 1·04-3·01 p=0·03). C. jejuni (74%), M. pneumoniae (23%), and Chikungunya (7%) were the most frequent infections. Anti-glycolipid IgG against GM1 and their heterodimer complexes were identified to be associated with GBS.

Conclusions: After the Zika epidemic, infections causing diarrhea and upper respiratory diseases contributed to the burden of GBS in Colombia. Prevention and control of food-borne pathogens could reduce the incidence of GBS in Colombia.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of the selection process of GBS cases and controls across study locations.
Fig 2
Fig 2. Patterns of IgG reactivity to anti-glycolipids in GBS cases and controls.
See this image and copyright information in PMC

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