Guillain-Barré syndrome associated with arboviruses in the state of Pernambuco in 2016

Abstract

Introduction: In 2016, Brazil presented an increase in the notifications related to neurological syndromes with previous register of a febrile illness compatible with arboviruses, including Guillain-Barré syndrome (GBS). Such disease is responsible for the most frequent occurrence of flaccid paralysis in the world, causing bilateral ascending muscle weakness that might affect the respiratory tract. Objective: To investigate the incidence of Guillain-Barré syndrome associated with arboviruses in Pernambuco in 2016 and to describe the confirmed/probable cases. Method: This is an observational retrospective study of GBS cases with a background of infection from dengue, chikungunya, or Zika virus notified to the Pernambuco Health State Secretariat (SES-PE). Cases notified from January 1st to December 31st, 2016 were included, which were considered as possible GBS at the time of notification. The suspect cases were investigated and classified as confirmed/probable by the positive laboratory test result, excluding the possibility of infection. Results: Forty-three suspect cases of GBS after previous arbovirus infection were notified. From these, 23 were classified as confirmed/probable for the etiological agents chikungunya and/or dengue. The mean age of the affected individuals was 37.22 ± 21.29 years and they were mostly female (56.5%). The annual incidence of GBS after arbovirus infection was 0.24 cases per 100 thousand inhabitants in the state. The neurological condition was mainly characterized by the presence of movement (91.3%) and walking (78.3%) alterations. Conclusion: The findings of this research confirm the current set of evidence and show the likelihood of GBS being a severe neurological complication of these arboviruses.

Incidence, clinical, risk factors and outcomes of Guillain‐Barré in Covid‐19

“…Nine COVID‐GBS patients had respiratory symptoms at presentation to the ED, and the length of these symptoms was significantly longer than in COVID–non‐GBS patients. On the other hand, neurological symptoms started a median of 10 days 7–17 after COVID respiratory symptoms, and the length of neurological symptoms was similar in both GBS groups. Remarkably, an olfactory–gustative disorder (OGD) was more frequent in cases than in control group A (OR = 27.59, 95% CI = 1.296–587) and control group B (OR = 7.875, 95% CI = 1.587–39.09) patients.…”

Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil

“…There was also a series of cases of combined arbovirus infection in Rio de Janeiro, Brazil, however, there were few data on neurological complications 5 . In a case study of neurological manifestations in patients with GBS in Pernambuco State, only 6.7% of prior DENV/ CHIKV infections were reported and these cases did not evolve to death 7 . However, studies have demonstrated that individuals with coinfection appear to be more likely to present with complications and a higher risk of death than those with monoinfections 33,34 .…”

“…However, there are a number of cases that describe a high frequency of death 6 . Within this scenario, Pernambuco State, located in Northeast Brazil, experienced a triple epidemic with confirmed cases of neuro-invasive arboviral diseases caused by DENV, ZIKV in 2015, and afterwards, by CHIKV in 2016 7 . One study with 41 cases in Pernambuco reported an association of encephalitis, GBS and myelitis with DENV 8 , as well as a cohort of 6 patients diagnosed with ZIKV-related disseminated encephalomyelitis (2) and GBS (4) in which patients had motor dysfunction, low visual acuity and cognitive decline 9 .…”

Síndrome de Guillain-Barré associada a infecções virais

“…A pesquisa realizada por Firmino & Cavalcanti (2019) Em 2016, o aumento de casos da SGB foi evidente em países com relatos de Zika vírus e Chikungunya. Pode-se observar fraqueza das extremidades com flacidez bilateral atribuível a danos nos nervos periféricos, além da presença de hipo ou areflexia, parestesias nos membros inferiores, fraqueza muscular, mialgia e paralisia facial periférica.…”