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Garrigou P, Barnay J. Post-Zika Guillain-Barre Syndrom: Description of clinical, biological, functional and electrophysiological characteristics observed during the Zika epidemic in Martinique. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Rozé B, Najioullah F, Fergé JL, Dorléans F, Apetse K, Barnay JL, Daudens-Vaysse E, Brouste Y, Césaire R, Fagour L, Valentino R, Ledrans M, Mehdaoui H, Abel S, Leparc-Goffart I, Signate A, Cabié A, Aïm V, Arrigo A, Cabre P, Chabartier C, Colombani S, Cuziat J, Deligny C, Desbois N, Dessoy AL, Dunoyer G, Duvauferrier R, Duc N, Edimonana M, Garrigou P, Gaucher S, Gourgoudou S, Guitteaud K, Hochedez P, Ivanes G, Jacquens Y, Julié S, Jean-Etienne A, Jeannin S, Julien J, Jérémie P, Lamaignère JL, Laudarin I, Le Gall M, Legris-Allusson V, Mejdoubi M, Michel C, Michel F, Miossec C, Moinet F, Minerva C, Olive C, Olive P, Pailla K, Paysant C, Pierre-François S, Pircher M, Polomat K, Putot A, René-Corail P, Resiere D, Richer C, Risson JR, Rome K, Sabia M, Schloesser M, Simonnet-Vigeral P, Théodose R, Vilain R. Guillain-Barré Syndrome Associated With Zika Virus Infection in Martinique in 2016: A Prospective Study. Clin Infect Dis 2018; 65:1462-1468. [PMID: 29020245 DOI: 10.1093/cid/cix588] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/06/2017] [Indexed: 11/14/2022] Open
Abstract
Background Guillain-Barré syndrome (GBS) has been reported to be associated with Zika virus (ZIKV) infection in case reports and retrospective studies, mostly on the basis of serological tests, with the problematic cross-reacting antibodies of the Flavivirus genus. Some GBS cases do not exhibit a high level of diagnostic certainty. This prospective study aimed to describe the clinical profiles and the frequency of GBS associated with ZIKV during the ZIKV outbreak in Martinique in 2016. Methods We recorded prospective data from GBS meeting levels 1 or 2 of diagnostic certainty for the Brighton Collaboration, with proof of recent ZIKV infection and negative screening for etiologies of GBS. Results Of the sample of 34 patients with suspected GBS during the outbreak, 30 had a proven presence of GBS, and 23 had a recent ZIKV infection. The estimated GBS incidence rate ratio (2016 vs 2006-2015) was 4.52 (95% confidence interval, 2.80-7.64; P = .0001). Recent ZIKV infection was confirmed by urine reverse-transcription polymerase chain reaction (RT-PCR) analysis in 17 cases and by serology in 6 cases. Patients, 65% of whom were male, had a median age of 61 years (interquartile range, 56-71 years) and experienced severe GBS. Electrophysiological tests were consistent with the primary demyelinating form of the disease. Conclusions ZIKV infection is usually benign, when symptomatic, but in countries at risk of ZIKV epidemics, adequate intensive care bed capacity is required for management of severe GBS cases. Arbovirus RNA detection by RT-PCR should be part of the management of GBS cases.
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Affiliation(s)
- Benoît Rozé
- Infectious and Tropical Diseases Unit, University Hospital of Martinique.,Intensive Care Unit, University Hospital of Martinique
| | - Fatiha Najioullah
- Laboratory of Virology, University Hospital of Martinique, Université des Antilles EA4537, Fort de France
| | | | - Frédérique Dorléans
- French National Public Health Agency, Regional Unit Antilles Guyane, Saint-Maurice
| | | | | | - Elise Daudens-Vaysse
- French National Public Health Agency, Regional Unit Antilles Guyane, Saint-Maurice
| | | | - Raymond Césaire
- Laboratory of Virology, University Hospital of Martinique, Université des Antilles EA4537, Fort de France
| | - Laurence Fagour
- Laboratory of Virology, University Hospital of Martinique, Fort de France
| | | | - Martine Ledrans
- French National Public Health Agency, Regional Unit Antilles Guyane, Saint-Maurice
| | | | - Sylvie Abel
- Infectious and Tropical Diseases Unit, University Hospital of Martinique
| | | | | | - André Cabié
- Infectious and Tropical Diseases Unit, University Hospital of Martinique, Université des Antilles, EA4537, INSERM CIC1424, Fort de France, France
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