Surto de síndrome de Guillain-Barré possivelmente relacionado à infecção prévia pelo vírus Zika, Região Metropolitana do Recife, Pernambuco, Brasil, 2015

Nóbrega, Martha Elizabeth Brasil da; Araújo, Emerson Luiz de Lima; Wada, Marcelo Yoshito; Leite, Priscila Leal e; Dimech, George Santiago; Pércio, Jadher

doi:10.5123/s1679-49742018000200016

Cited by 35 publications

(35 citation statements)

References 20 publications

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“…We reviewed 135 full-text articles, of which 31 were eligible for inclusion ( Fig 1). Of the 31 studies, 28 reported countryspecific GBS rates from 13 LAC countries (Tables 1 & 2), 3 regional rates, [18,35,36] 15 background rates [18,[35][36][37][38][39][40][41][42][43][44][45][46][47][48], 11 rates during an arboviral outbreak [49][50][51][52][53][54][55][56][57][58][59], and 5 compared rates before and during an outbreak [27,[60][61][62][63]. Many studies presented data from Brazil (29%) and Colombia (16%), and the majority (68%) were published in 2015 or later.…”

Section: Resultsmentioning

confidence: 99%

“…In Veracruz, Mexico, 75% of GBS patients tested positive for C. jejuni infection in 2017 (after the peak of ZIKV) [49]. Studies in Aruba, Brazil, and Colombia-all except the one from Aruba were conducted during the ZIKV epidemic-found no association between C. jejuni infection and GBS [43,46,50,52,55,58]. A study in Brazil found respiratory infections to be present in 27% of GBS patients compared to 7% with gastrointestinal infections in pre-ZIKV years (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002) [43].…”

Section: Discussionmentioning

confidence: 99%

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Incidence of Guillain-Barré Syndrome (GBS) in Latin America and the Caribbean Before and During the 2015-2016 Zika Virus Epidemic: A Systematic Review and Meta-Analysis

et al. 2019

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BackgroundA severe neurological disorder, Guillain-Barré syndrome (GBS) is the leading cause of acute flaccid paralysis. Enhanced surveillance of GBS in Latin America and the Caribbean (LAC) following the 2015-2016 Zika virus (ZIKV) epidemic presents an opportunity to estimate, for the first time, the regional incidence of GBS. Methods and findingsFor this systematic review and meta-analysis, we searched nine scientific databases and grey literature from January 1, 1980 to October 1, 2018. Sources with primary data on incident GBS cases in LAC within a well-defined population and timeframe, published in English, Spanish, Portuguese, or French, were included. We calculated the annual GBS incidence rates (IRs) and 95% confidence intervals (CIs) for each source based on published data. Following an assessment of heterogeneity, we used random-effects meta-analysis to calculate the pooled annual IR of GBS. The study is registered with PROSPERO, number CRD42018086659. Of the 6568 initial citation hits, 31 were eligible for inclusion. Background annual GBS IRs in Latin America ranged from 0.40 in Brazil to 2.12/100,000 in Chile. The pooled annual IR in the Caribbean was 1.64 (95% CI 1.29-2.12, I 2 <0.01, p = 0.44). During the ZIKV epidemic, GBS IRs ranged from 0.62 in Mexico to 9.35/100,000 in Martinique. GBS increased 2.6 (95% CI 2.3-2.9) times during ZIKV and 1.9 (95% CI 1.1-3.4) times during chikungunya outbreaks over background rates. ConclusionsBackground IRs of GBS appear to peak during arboviral disease outbreaks. The current review contributes to an understanding of the epidemiology of GBS in the LAC region, which can inform healthcare system planning and preparedness, particularly during arboviral epidemics. Trial registrationRegistered with PROSPERO: CRD42018086659. Author summaryA severe neurological disorder, Guillain-Barré syndrome (GBS) is the leading cause of acute flaccid paralysis. This is the first systematic review on GBS incidence in Latin America and the Caribbean before and during arboviral disease outbreaks. There is a large subregional and annual fluctuation in the incidence of GBS. Background annual GBS incidence rates (IRs) in Latin America ranged from 0.40 in Brazil to 2.12/100,000 in Chile. The pooled annual IR in the Caribbean was 1.64 (95% CI 1.29-2.12, I 2 <0.01, p = 0.44). During the ZIKV epidemic, GBS IRs ranged from 0.62 in Mexico to 9.35/100,000 in Martinique. GBS increased 2.6 times during ZIKV and 1.9 times during chikungunya outbreaks over background rates. GBS is a costly disease, which can result in long-term disability and high mortality rates in resource constrained healthcare settings. Because GBS can be triggered by arboviral infections, baseline incidence of GBS is critical for detecting neglected tropical disease outbreaks. The current review contributes to an understanding of the epidemiology of GBS in the LAC region, which can inform healthcare system planning and preparedness.Incidence of Guillain-Barré Syndrome in LAC and arboviral disease outbreaks PLOS Neglected Tropic...

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Incidence of Guillain-Barré Syndrome (GBS) in Latin America and the Caribbean Before and During the 2015-2016 Zika Virus Epidemic: A Systematic Review and Meta-Analysis

et al. 2019

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“…Three studies only included patients admitted to the ICU, [17,22,28] and nine studies only included GBS patients with a clinical suspicion or laboratory evidence of a ZIKV infection. [14,17,[20][21][22][28][29][30][31] Seven studies were set in a specialized hospital (academic or reference centre), [4,16,18,23,26,31,32] and two multi-centre studies were set in both specialized and non-specialized hospitals. [21,28] These differences are potential sources of selection bias within studies and heterogeneity across studies.…”

Section: Study Characteristics: Case Selection Case Ascertainment Anmentioning

confidence: 99%

Guillain-Barré syndrome related to Zika virus infection: A systematic review and meta-analysis of the clinical and electrophysiological phenotype

et al. 2020

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Background The Zika virus (ZIKV) has been associated with Guillain-Barré syndrome (GBS) in epidemiological studies. Whether ZIKV-associated GBS is related to a specific clinical or electrophysiological phenotype has not been established. To this end, we performed a systematic review and meta-analysis of all published studies on ZIKV-related GBS. Methods We searched Pubmed, EMBASE and LILACS, and included all papers, reports or bulletins with full text in English, Spanish or Portuguese, reporting original data of patients with GBS and a suspected, probable or confirmed recent ZIKV infection. Data were extracted according to a predefined protocol, and pooled proportions were calculated. Results Thirty-five studies were included (13 single case reports and 22 case series, case-control or cohort studies), reporting on a total of 601 GBS patients with a suspected, probable or confirmed ZIKV infection. Data from 21 studies and 587 cases were available to be summarized. ZIKV infection was confirmed in 21%, probable in 22% and suspected in 57% of cases. ZIKV PCR was positive in 30% (95%CI 15-47) of tested patients. The most common clinical features were: limb weakness 97% (95%CI 93-99), diminished/absent reflexes 96% (95%CI 88-100), sensory symptoms 82% (95%CI 76-88), and facial palsy 51% (95%CI 44-58). Median time between infectious and neurological symptoms was 5-12 days. Most PLOS NEGLECTED TROPICAL DISEASES

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“…91 In the first semester of 2015, a change was noted in the pattern of the occurrence of Guillain-Barré syndrome in two states of Brazil's Northeast region, namely Pernambuco and Bahia: in the former state the number of cases tripled compared to the previous year, with a peak in April, while Bahia recorded a peak in occurrence of the syndrome between June and July. 92,93 In the same period, four patients undergoing solid organ transplantation were infected with ZIKV, diagnosed by RT-PCR between June 2015 and January 2016. 94 In October of the same year, a change was detected in the epidemiological pattern of microcephaly occurrence, when Pernambuco state health authorities informed the Ministry of Health about a significant increase in the number of cases.…”

Section: Figure 2 -Countries or Territories Recording Zika Virus Circmentioning

confidence: 99%

Expansão da circulação do vírus Zika da África à América, 1947-2018: revisão da literatura*

Sampaio¹,

Brites²,

Drexler³

et al. 2019

Epidemiologia e Serviços de Saúde

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Objective: to describe the temporal and geographical expansion of Zika virus (ZIKV) circulation in countries and territories, from the time it was first isolated until 2018. Methods: This was a non-systematic literature review covering the period from 1947 to 2018 using the MEDLINE database and World Health Organization estimates. Results: Since its isolation in 1947, ZIKV circulation spread through Africa, Asia and the Pacific before reaching the Americas in 2013, causing serious clinical manifestations; the highest seroprevalence rates were recorded in Yap (74%) and in Brazil (63%); genetic mutations, absence of immunity and high vector susceptibility may have influenced ZIKV transmissibility and help to explain the magnitude of its expansion. Conclusion: The spread of ZIKV circulation in the Americas was the most extensive recorded thus far, possibly as a result of population and geographical characteristics of the sites where the virus circulated.

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Surto de síndrome de Guillain-Barré possivelmente relacionado à infecção prévia pelo vírus Zika, Região Metropolitana do Recife, Pernambuco, Brasil, 2015

Cited by 35 publications

References 20 publications

Incidence of Guillain-Barré Syndrome (GBS) in Latin America and the Caribbean Before and During the 2015-2016 Zika Virus Epidemic: A Systematic Review and Meta-Analysis

Incidence of Guillain-Barré Syndrome (GBS) in Latin America and the Caribbean Before and During the 2015-2016 Zika Virus Epidemic: A Systematic Review and Meta-Analysis

Guillain-Barré syndrome related to Zika virus infection: A systematic review and meta-analysis of the clinical and electrophysiological phenotype

Expansão da circulação do vírus Zika da África à América, 1947-2018: revisão da literatura*

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