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Sebastián UU, Ricardo AVA, Alvarez BC, Cubides A, Luna AF, Arroyo-Parejo M, Acuña CE, Quintero AV, Villareal OC, Pinillos OS, Vieda E, Bello M, Peña S, Dueñas-Castell C, Rodriguez GMV, Ranero JLM, López RLM, Olaya SG, Vergara JC, Tandazo A, Ospina JPS, Leyton Soto IM, Fowler RA, Marshall JC. Zika virus-induced neurological critical illness in Latin America: Severe Guillain-Barre Syndrome and encephalitis. J Crit Care 2017; 42:275-281. [PMID: 28806562 PMCID: PMC7127615 DOI: 10.1016/j.jcrc.2017.07.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 06/30/2017] [Accepted: 07/20/2017] [Indexed: 12/13/2022]
Abstract
Zika virus (ZIKAV) is classically described as causing minor symptoms in adult patients, however neurologic complications have been recognized. The recent outbreak in Central and South America has resulted in serious illness in some adult patients. We report adult patients in Latin America diagnosed with ZIKAV infection admitted to Intensive Care Units (ICUs). METHODS Multicenter, prospective case series of adult patients with laboratory diagnosis of ZIKAV in 16 ICUs in 8 countries. RESULTS Between December 1st 2015 and April 2nd 2016, 16 ICUs in 8 countries enrolled 49 critically ill patients with diagnosis of ZIKAV infection. We included 10 critically ill patients with ZIKAV infection, as diagnosed with RT-PCR, admitted to the ICU. Neurologic manifestations concordant with Guillain-Barre Syndrome (GBS) were present in all patients, although 2 evolved into an encephalitis-like picture. 2 cases died, one due to encephalitis, the other septic shock. CONCLUSIONS Differing from what was usually reported, ZIKAV infection can result in life-threatening neurologic illness in adults, including GBS and encephalitis. Collaborative reporting to identify severe illness from an emerging pathogen can provide valuable insights into disease epidemiology and clinical presentation, and inform public health authorities about acute care priorities.
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Affiliation(s)
- Ugarte Ubiergo Sebastián
- Critical Care Department, Clínica Indisa, Universidad Andrés Bello, Santiago de Chile, Chile; FEPIMCTI, Council WFSICCM, Chile
| | | | | | - Angela Cubides
- Universidad Santiago de Cali, Cali, Colombia; Universidad del Valle, Cali, Colombia
| | - Angélica F Luna
- General Critical Care Unit and Intermediate Care, Neiva, Colombia
| | - Max Arroyo-Parejo
- Hospital Privado Clínica Santa Sofía, Caracas, Venezuela; Hospital Vargas de Caracas, Caracas, Venezuela
| | | | | | - Orlando Ch Villareal
- Clínica Evaluamos, Córdoba, Colombia; Facultad de Medicina, Universidad del Sinú, Córdoba, Colombia
| | - Oscar S Pinillos
- Metabolic Disorders and Intensive Care Research Group, Cali, Colombia
| | - Elías Vieda
- Hospital Universitario del Valle, Cali, Colombia
| | - Manuel Bello
- Critical Care Department, Hospital Nacional San Rafael, San Salvador, El Salvador; Salvadorean Critical Care Association, El Salvador
| | - Susana Peña
- Ministry of Health, San Salvador, El Salvador
| | | | | | - Jorge L M Ranero
- Hospital General de Enfermedades, Instituto Guatemalteco de Seguridad Social, Guatemala City, Guatemala
| | | | - Sandra G Olaya
- Obstetric and Gynecologic Intensive Care Unit, Hospital San Jorge Pereira, Colombia
| | - José C Vergara
- Hospital Luis Vernaza, Holy Spirit University of Guayaquil Ecuador, Guayaquil, Ecuador; Universidad Espíritu Santo de Guayaquil, Ecuador
| | - Ana Tandazo
- Hospital Luis Vernaza, Holy Spirit University of Guayaquil Ecuador, Guayaquil, Ecuador; Universidad Espíritu Santo de Guayaquil, Ecuador
| | | | | | - R A Fowler
- Clinical Epidemiology, Sunnybrook Research Institute, Canada; Sunnybrook Health Sciences Centre, Canada; Department of Medicine and Interdepartmental Division of Critical Care Medicine, University of Toronto, Canada
| | - John C Marshall
- Surgery, University of Toronto, Canada; Michael Hospital, Toronto, Canada
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