Sonja E Leonhard1, Susan Halstead2, Suzannah B Lant3, Maria de Fatima Pessoa Militão de Albuquerque4, Carlos Alexandre Antunes de Brito5, Lívia Brito Bezerra de Albuquerque6, Mark A Ellul7, Rafael Freitas de Oliveira França8, Dawn Gourlay2, Michael J Griffiths9, Adélia Maria de Miranda Henriques-Souza10, Maria Í de Morais Machado10, Raquel Medialdea-Carrera3, Ravi Mehta3, Roberta da Paz Melo11, Solange D Mesquita11, Álvaro J P Moreira11, Lindomar J Pena8, Marcela Lopes Santos4, Lance Turtle12, Tom Solomon7, Hugh J Willison2, Bart C Jacobs13, Maria L Brito Ferreira11. 1. Department of Neurology, Erasmus University Medical Center, Rotterdam, Netherlands. Electronic address: s.leonhard@erasmusmc.nl. 2. Department of Neurology and Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK. 3. National Institute for Health Research Health Protection Research Unit on Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK. 4. Department of Collective Health, Institute Aggeu Magalhães (CPqAM), Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil. 5. Department of Clinical Medicine, Federal University of Pernambuco, Recife, Brazil. 6. Instituto de Medicina Integral Professor Fernando Figueira (IMIP) Recife, Brazil. 7. National Institute for Health Research Health Protection Research Unit on Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; The Walton Centre NHS Foundation Trust, Liverpool, UK. 8. Department of Virology, Institute Aggeu Magalhães (CPqAM), Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil. 9. National Institute for Health Research Health Protection Research Unit on Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Alder Hey Children's NHS Foundation Trust, Liverpool, UK. 10. Department of Paediatrics Neurology, Hospital da Restauração, Recife, Brazil. 11. Department of Neurology, Hospital da Restauração, Recife, Brazil. 12. National Institute for Health Research Health Protection Research Unit on Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK. 13. Department of Neurology, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Immunology, Erasmus University Medical Center, Rotterdam, Netherlands.
Abstract
OBJECTIVE: To determine the clinical phenotype of Guillain-Barré syndrome (GBS) after Zika virus (ZIKV) infection, the anti-glycolipid antibody signature, and the role of other circulating arthropod-borne viruses, we describe a cohort of GBS patients identified during ZIKV and chikungunya virus (CHIKV) outbreaks in Northeast Brazil. METHODS: We prospectively recruited GBS patients from a regional neurology center in Northeast Brazil between December 2014 and February 2017. Serum and CSF were tested for ZIKV, CHIKV, and dengue virus (DENV), by RT-PCR and antibodies, and serum was tested for GBS-associated antibodies to glycolipids. RESULTS: Seventy-one patients were identified. Forty-eight (68%) had laboratory evidence of a recent arbovirus infection; 25 (52%) ZIKV, 8 (17%) CHIKV, 1 (2%) DENV, and 14 (29%) ZIKV and CHIKV. Most patients with a recent arbovirus infection had motor and sensory symptoms (72%), a demyelinating electrophysiological subtype (67%) and a facial palsy (58%). Patients with a recent infection with ZIKV and CHIKV had a longer hospital admission and more frequent mechanical ventilation compared to the other patients. No specific anti-glycolipid antibody signature was identified in association with arbovirus infection, although significant antibody titres to GM1, GalC, LM1, and GalNAc-GD1a were found infrequently. CONCLUSION: A large proportion of cases had laboratory evidence of a recent infection with ZIKV or CHIKV, and recent infection with both viruses was found in almost one third of patients. Most patients with a recent arbovirus infection had a sensorimotor, demyelinating GBS. We did not find a specific anti-glycolipid antibody signature in association with arbovirus-related GBS.
OBJECTIVE: To determine the clinical phenotype of Guillain-Barré syndrome (GBS) after Zika virus (ZIKV) infection, the anti-glycolipid antibody signature, and the role of other circulating arthropod-borne viruses, we describe a cohort of GBS patients identified during ZIKV and chikungunya virus (CHIKV) outbreaks in Northeast Brazil. METHODS: We prospectively recruited GBS patients from a regional neurology center in Northeast Brazil between December 2014 and February 2017. Serum and CSF were tested for ZIKV, CHIKV, and dengue virus (DENV), by RT-PCR and antibodies, and serum was tested for GBS-associated antibodies to glycolipids. RESULTS: Seventy-one patients were identified. Forty-eight (68%) had laboratory evidence of a recent arbovirus infection; 25 (52%) ZIKV, 8 (17%) CHIKV, 1 (2%) DENV, and 14 (29%) ZIKV and CHIKV. Most patients with a recent arbovirus infection had motor and sensory symptoms (72%), a demyelinating electrophysiological subtype (67%) and a facial palsy (58%). Patients with a recent infection with ZIKV and CHIKV had a longer hospital admission and more frequent mechanical ventilation compared to the other patients. No specific anti-glycolipid antibody signature was identified in association with arbovirus infection, although significant antibody titres to GM1, GalC, LM1, and GalNAc-GD1a were found infrequently. CONCLUSION: A large proportion of cases had laboratory evidence of a recent infection with ZIKV or CHIKV, and recent infection with both viruses was found in almost one third of patients. Most patients with a recent arbovirus infection had a sensorimotor, demyelinating GBS. We did not find a specific anti-glycolipid antibody signature in association with arbovirus-related GBS.
Authors: Annelies Wilder-Smith; Elizabeth B Brickley; Ricardo Arraes de Alencar Ximenes; Demócrito de Barros Miranda-Filho; Celina Maria Turchi Martelli; Tom Solomon; Bart C Jacobs; Carlos A Pardo; Lyda Osorio; Beatriz Parra; Suzannah Lant; Hugh J Willison; Sonja Leonhard; Lance Turtle; Maria Lúcia Brito Ferreira; Rafael Freitas de Oliveira Franca; Louis Lambrechts; Johan Neyts; Suzanne Kaptein; Rosanna Peeling; Deborah Boeras; James Logan; Helen Dolk; Ieda M Orioli; Andreas Neumayr; Trudie Lang; Bonny Baker; Eduardo Massad; Raman Preet Journal: Glob Health Action Date: 2021-10-26 Impact factor: 2.640
Authors: Sonja E Leonhard; Cheng Yin Tan; Annemiek A van der Eijk; Ricardo R Reisin; Suzanne C Franken; Ruth Huizinga; Samuel Arends; Manou R Batstra; Selma M Bezerra Jeronimo; Judith Drenthen; Laura de Koning; Luciana Leon Cejas; Cintia Marchesoni; Wilson Marques; Nortina Shahrizaila; Dardo F Casas; Andrea Sotelo; Belen Tillard; Mario-Emilio Dourado; Bart C Jacobs Journal: J Peripher Nerv Syst Date: 2021-09-30 Impact factor: 5.188
Authors: Lakshmi Chauhan; Elizabeth Matthews; Amanda L Piquet; Andrés Henao-Martinez; Carlos Franco-Paredes; Kenneth L Tyler; David Beckham; Daniel M Pastula Journal: Curr Trop Med Rep Date: 2022-09-15