The spectrum of neurological disease associated with Zika and chikungunya viruses in adults in Rio de Janeiro, Brazil: A case series

被引：79

作者：

Mehta, Ravi ^{[1
,2
]}

Soares, Cristiane Nascimento ^{[3
]}

Medialdea-Carrera, Raquel ^{[1
,2
]}

Ellul, Mark ^{[1
,2
,4
]}

Texeira da Silva, Marcus Tulius ^{[5
,6
]}

Rosala-Hallas, Anna ^{[7
]}

Jardim, Marcia Rodrigues ^{[8
]}

Burnside, Girvan ^{[7
]}

Pamplona, Luciana ^{[9
]}

Bhojak, Maneesh ^{[4
]}

Manohar, Radhika ^{[4
]}

Medeiros da Silva, Gabriel Amorelli ^{[3
]}

Adriano, Marcus Vinicius ^{[10
]}

Brasil, Patricia ^{[11
]}

Ribeiro Nogueira, Rita Maria ^{[12
]}

Dos Santos, Carolina Cardoso ^{[12
]}

Turtle, Lance ^{[1
,2
,4
]}

de Sequeira, Patricia Carvalho ^{[12
]}

Brown, David W. ^{[13
,14
]}

Griffiths, Michael J. ^{[1
,15
]}

Bispo de Filippis, Ana Maria ^{[12
]}

Solomon, Tom ^{[1
,2
,4
]}

机构：

[1] Univ Liverpool, Natl Inst Hlth Res, Hlth Protect Res Unit Emerging & Zoonot Infect, Liverpool, Merseyside, England

[2] Univ Liverpool, Inst Infect & Global Hlth, Liverpool, Merseyside, England

[3] Hosp Fed Servidores Estado, Dept Neurol, Rio De Janeiro, Brazil

[4] Walton Ctr NHS Fdn Trust, Dept Neurol, Liverpool, Merseyside, England

[5] Inst Nacl Infectol Evandro Chagas, Lab Pesquisa Neuroinfeccao, Rio De Janeiro, Brazil

[6] Hosp Clin Niteroi, Dept Neurol, Niteroi, RJ, Brazil

[7] Univ Liverpool, Inst Translat Med, Dept Biostat, Liverpool, Merseyside, England

[8] Hosp Univ Pedro Ernesto, Dept Neurol, Rio De Janeiro, Brazil

[9] Hosp Geral Bonsucesso, Dept Neurol, Rio De Janeiro, Brazil

[10] Hosp Barra Dor, Dept Neurol, Rio De Janeiro, Brazil

[11] Inst Nacl Infectol Evandro Chagas, Lab Pesquisa Clin Doencas Febris Agudas, Rio De Janeiro, Brazil

[12] Inst Oswaldo Cruz, Flavivirus Reference Lab, Rio De Janeiro, Brazil

[13] Inst Oswaldo Cruz, Influenza Reference Lab, Rio De Janeiro, Brazil

[14] Publ Hlth England, Virus Reference Dept, Natl Infect Serv, London, England

[15] Alder Hey Childrens NHS Fdn Trust, Dept Neurol, Liverpool, Merseyside, England

来源：

PLOS NEGLECTED TROPICAL DISEASES | 2018年 / 12卷 / 02期

基金：

欧盟地平线“2020”; 英国医学研究理事会;

关键词：

GUILLAIN-BARRE-SYNDROME; ANTIBODY-DEPENDENT ENHANCEMENT; INFECTION; ENCEPHALITIS; MANIFESTATIONS; COLOMBIA;

D O I：

10.1371/journal.pntd.0006212

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background During 2015-16 Brazil experienced the largest epidemic of Zika virus ever reported. This arthropod-borne virus (arbovirus) has been linked to Guillain-Barre syndrome (GBS) in adults but other neurological associations are uncertain. Chikungunya virus has caused outbreaks in Brazil since 2014 but associated neurological disease has rarely been reported here. We investigated adults with acute neurological disorders for Zika, chikungunya and dengue, another arbovirus circulating in Brazil. Methods We studied adults who had developed a new neurological condition following suspected Zika virus infection between 1st November 2015 and 1st June 2016. Cerebrospinal fluid (CSF), serum, and urine were tested for evidence of Zika, chikungunya, and dengue viruses. Results Of 35 patients studied, 22 had evidence of recent arboviral infection. Twelve had positive PCR or IgM for Zika, five of whom also had evidence for chikungunya, three for dengue, and one for all three viruses. Five of them presented with GBS; seven had presentations other than GBS, including meningoencephalitis, myelitis, radiculitis or combinations of these syndromes. Additionally, ten patients positive for chikungunya virus, two of whom also had evidence for dengue virus, presented with a similar range of neurological conditions. Conclusions Zika virus is associated with a wide range of neurological manifestations, including central nervous system disease. Chikungunya virus appears to have an equally important association with neurological disease in Brazil, and many patients had dual infection. To understand fully the burden of Zika we must look beyond GBS, and also investigate for other co-circulating arboviruses, particularly chikungunya.

引用

页数：20

共 39 条

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