Open AccessZika Virus infection and Guillain-Barré syndrome in Northeastern Mexico: A case-control study
Author(s) -
Fernando GóngoraRivera,
Israel Grijalva,
Adrián Infante-Valenzuela,
Carlos R. Cámara-Lemarroy,
Elvira GarzaGonzález,
Martín Paredes-Cruz,
Concepción Grajales-Muñíz,
José Guerrero-Cantera,
Ignacio Vargas-Ramos,
Jesus Soares,
Joseph Y. Abrams,
Ashley Styczynski,
Adrián Camacho-Ortíz,
Margarita E. Villarino,
Ermias D. Belay,
Lawrence B. Schonberger,
James J. Sejvar
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0230132
Subject(s) - medicine , zika virus , guillain barre syndrome , rash , case control study , prospective cohort study , pediatrics , immunology , virus
Background Beginning August 2017, we conducted a prospective case-control investigation in Monterrey, Mexico to assess the association between Zika virus (ZIKV) and Guillain-Barré syndrome (GBS). Methods For each of 50 GBS case-patients, we enrolled 2–3 afebrile controls (141 controls in total) matched by sex, age group, and presentation to same hospital within 7 days. Results PCR results for ZIKV in blood and/or urine were available on all subjects; serum ZIKV IgM antibody for 52% of case-patients and 80% of controls. Subjects were asked about antecedent illness in the two months prior to neurological onset (for case-patients) or interview (for controls). Laboratory evidence of ZIKV infection alone (PCR+ or IgM+) was not significantly different between case-patients and controls (OR: 1.26, 95% CI: 0.45–3.54) but antecedent symptomatic ZIKV infection [a typical ZIKV symptom (rash, joint pain, or conjunctivitis) plus laboratory evidence of ZIKV infection] was higher among case-patients (OR: 12.45, 95% CI: 1.45–106.64). GBS case-patients with laboratory evidence of ZIKV infection were significantly more likely to have had typical ZIKV symptoms than controls with laboratory evidence of ZIKV infection (OR: 17.5, 95% CI: 3.2–96.6). This association remained significant even when only GBS case-patients who were afebrile for 5 days before onset were included in the analysis, (OR 9.57 (95% CI: 1.07 to 85.35). Conclusions During ZIKV epidemics, this study indicates that increases in GBS will occur primarily among those with antecedent symptomatic ZIKV.