Guillain-Barré Syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study

Summary Background Between October, 2013, and April, 2014, French Polynesia experienced the largest Zika virus outbreak ever described at that time. During the same period, an increase in Guillain-Barré syndrome was reported, suggesting a possible association between Zika virus and Guillain-Barré sy...

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Veröffentlicht in:The Lancet (British edition) 2016-04, Vol.387 (10027), p.1531-1539
Hauptverfasser: Cao-Lormeau, Van-Mai, PhD, Blake, Alexandre, MD, Mons, Sandrine, MSc, Lastère, Stéphane, PharmD, Roche, Claudine, MSc, Vanhomwegen, Jessica, PhD, Dub, Timothée, MPH, Baudouin, Laure, MD, Teissier, Anita, Larre, Philippe, MD, Vial, Anne-Laure, MSc, Decam, Christophe, MD, Choumet, Valérie, PhD, Halstead, Susan K, PhD, Willison, Hugh J, Prof, Musset, Lucile, PhD, Manuguerra, Jean-Claude, PhD, Despres, Philippe, Prof, Fournier, Emmanuel, Prof, Mallet, Henri-Pierre, MD, Musso, Didier, MD, Fontanet, Arnaud, Prof, Neil, Jean, MD, Ghawché, Frédéric, MD
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Sprache:eng
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Zusammenfassung:Summary Background Between October, 2013, and April, 2014, French Polynesia experienced the largest Zika virus outbreak ever described at that time. During the same period, an increase in Guillain-Barré syndrome was reported, suggesting a possible association between Zika virus and Guillain-Barré syndrome. We aimed to assess the role of Zika virus and dengue virus infection in developing Guillain-Barré syndrome. Methods In this case-control study, cases were patients with Guillain-Barré syndrome diagnosed at the Centre Hospitalier de Polynésie Française (Papeete, Tahiti, French Polynesia) during the outbreak period. Controls were age-matched, sex-matched, and residence-matched patients who presented at the hospital with a non-febrile illness (control group 1; n=98) and age-matched patients with acute Zika virus disease and no neurological symptoms (control group 2; n=70). Virological investigations included RT-PCR for Zika virus, and both microsphere immunofluorescent and seroneutralisation assays for Zika virus and dengue virus. Anti-glycolipid reactivity was studied in patients with Guillain-Barré syndrome using both ELISA and combinatorial microarrays. Findings 42 patients were diagnosed with Guillain-Barré syndrome during the study period. 41 (98%) patients with Guillain-Barré syndrome had anti-Zika virus IgM or IgG, and all (100%) had neutralising antibodies against Zika virus compared with 54 (56%) of 98 in control group 1 (p
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(16)00562-6