Association of Japanese encephalitis virus infection with Guillain-Barré syndrome in endemic areas of South India*

Ravi, Vasanthapuram; Taly, Arun B.; Shankar, Susarla Krishna; Shenoy, Poornima K.; Desai, Anita; Nagaraja, D; Gourie-Devi, Mandaville; Chandramuki, A

doi:10.1111/j.1600-0404.1994.tb02681.x

Cited by 43 publications

(27 citation statements)

References 11 publications

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“…The reported latency between gastrointestinal symptoms and onset of paralysis of approximately 9 d (range 1–23 d) [124, 126, 127] is similar to Zika virus-associated cases. Other mosquito-borne neurotropic flaviviruses have been reported as possible triggers of GBS in case reports and case series: dengue virus [128], West Nile virus [129], Japanese B encephalitis virus [130, 131], or yellow fever 17D vaccination [132]. An acute poliomyelitis-like flaccid paralysis, resulting from direct neural infection, presumably of anterior horn cells, has also been reported as a clinical consequence of these viruses [129, 133, 134].…”

Section: Resultsmentioning

confidence: 99%

Zika Virus Infection as a Cause of Congenital Brain Abnormalities and Guillain–Barré Syndrome: Systematic Review

et al. 2017

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BackgroundThe World Health Organization (WHO) stated in March 2016 that there was scientific consensus that the mosquito-borne Zika virus was a cause of the neurological disorder Guillain–Barré syndrome (GBS) and of microcephaly and other congenital brain abnormalities based on rapid evidence assessments. Decisions about causality require systematic assessment to guide public health actions. The objectives of this study were to update and reassess the evidence for causality through a rapid and systematic review about links between Zika virus infection and (a) congenital brain abnormalities, including microcephaly, in the foetuses and offspring of pregnant women and (b) GBS in any population, and to describe the process and outcomes of an expert assessment of the evidence about causality.Methods and FindingsThe study had three linked components. First, in February 2016, we developed a causality framework that defined questions about the relationship between Zika virus infection and each of the two clinical outcomes in ten dimensions: temporality, biological plausibility, strength of association, alternative explanations, cessation, dose–response relationship, animal experiments, analogy, specificity, and consistency. Second, we did a systematic review (protocol number CRD42016036693). We searched multiple online sources up to May 30, 2016 to find studies that directly addressed either outcome and any causality dimension, used methods to expedite study selection, data extraction, and quality assessment, and summarised evidence descriptively. Third, WHO convened a multidisciplinary panel of experts who assessed the review findings and reached consensus statements to update the WHO position on causality. We found 1,091 unique items up to May 30, 2016. For congenital brain abnormalities, including microcephaly, we included 72 items; for eight of ten causality dimensions (all except dose–response relationship and specificity), we found that more than half the relevant studies supported a causal association with Zika virus infection. For GBS, we included 36 items, of which more than half the relevant studies supported a causal association in seven of ten dimensions (all except dose–response relationship, specificity, and animal experimental evidence). Articles identified nonsystematically from May 30 to July 29, 2016 strengthened the review findings. The expert panel concluded that (a) the most likely explanation of available evidence from outbreaks of Zika virus infection and clusters of microcephaly is that Zika virus infection during pregnancy is a cause of congenital brain abnormalities including microcephaly, and (b) the most likely explanation of available evidence from outbreaks of Zika virus infection and GBS is that Zika virus infection is a trigger of GBS. The expert panel recognised that Zika virus alone may not be sufficient to cause either congenital brain abnormalities or GBS but agreed that the evidence was sufficient to recommend increased public health measures. Weaknesses are the limited assessment of ...

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Section: Resultsmentioning

confidence: 99%

Zika Virus Infection as a Cause of Congenital Brain Abnormalities and Guillain–Barré Syndrome: Systematic Review

et al. 2017

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“…4 Only a few sporadic cases of GBS have been reported secondary to dengue virus (DENV) infection, 5,6 West Nile virus (WNV) infection, 7 and Japanese encephalitis virus (JEV) outbreaks. 8 …”

Section: Introductionmentioning

confidence: 99%

Guillain–Barré Syndrome (42 Cases) Occurring During a Zika Virus Outbreak in French Polynesia

et al. 2016

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Zika virus (transmitted by mosquitoes) reached French Polynesia for the first time in 2013, leading to an epidemic affecting 10% of the total population. So far, it has not been known to induce any neurological complications, but, a few weeks after the outbreak, an unexpectedly high number of 42 patients presented with Guillain–Barré syndrome.We report the clinical and electrophysiological characteristics of this series. Males predominated with a sex ratio of 2.82 (mean age: 46). All patients (except 2) were native Polynesian. At admission, 55% were able to walk unaided against 38% at nadir, 24% had swallowing troubles (nadir: 45%), 74% had motor weakness of the limbs (nadir: 86%) and deep tendon reflexes were diminished or not found in the vast majority of patients. Mean duration of the progressive phase and of the plateau phase was respectively 7 and 9 days. Thirty-eight percent of the patients were admitted in intensive care unit and 10 patients underwent tracheotomy. Nerve electrophysiological studies at admission showed marked distal motor conduction alterations, which had almost completely disappeared at the 4th month; this pattern was more suggestive of acute motor axonal neuropathy (AMAN) than of acute inflammatory demyelinating polyneuropathy (AIDP). Lumbar puncture showed elevated proteins in 90% of the cases, with cell count always inferior to 50/μL.This epidemic raises several questions, such as the potential existence of interactions between Zika virus and Polynesian HLA system and/or the consequences of several recombination events of this virus. This situation should call for increased vigilance, especially in countries where Aedes mosquitoes are present.

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“…[14][15][16][17] The current ZIKV outbreak in the Americas began in May 2015 with confirmed autochthonous transmission in Brazil. 18 ZIKV has since spread rapidly throughout the region and, as of September 2016, endemic transmission has been reported in nearly every country or territory in the Americas and Caribbean including the United States.…”

Section: Introductionmentioning

confidence: 99%

Guillain–Barré Syndrome Associated with Zika Virus Infection in a Traveler Returning from Guyana

Fabrizius

Anderson

Hendel-Paterson

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Zika virus (ZIKV) is a mosquito-borne flavivirus with a significant public health impact highlighted by the ongoing epidemic in the Americas. We describe a 44-year-old male presenting to our tropical medicine center with complaints of fever, headache, joint pain, and rash after recent travel to Guyana. The patient subsequently developed gait imbalance and lower extremity weakness with clinical examination, cerebrospinal fluid studies, and magnetic resonance imaging of the spine consistent with a diagnosis of Guillain-Barré syndrome (GBS). ZIKV infection was confirmed via detection of ZIKV RNA in urine by polymerase chain reaction. The patient was treated with intravenous immunoglobulin and experienced near-complete neurologic recovery, reporting ongoing mild paresthesia up to 2 months later. This case highlights the diagnostic challenges posed by ZIKV and underscores the need for clinician awareness of the potential for neurological complications such as GBS with ZIKV infection. BACKGROUND

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Association of Japanese encephalitis virus infection with Guillain-Barré syndrome in endemic areas of South India*

Cited by 43 publications

References 11 publications

Zika Virus Infection as a Cause of Congenital Brain Abnormalities and Guillain–Barré Syndrome: Systematic Review

Zika Virus Infection as a Cause of Congenital Brain Abnormalities and Guillain–Barré Syndrome: Systematic Review

Guillain–Barré Syndrome (42 Cases) Occurring During a Zika Virus Outbreak in French Polynesia

Guillain–Barré Syndrome Associated with Zika Virus Infection in a Traveler Returning from Guyana

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