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Zika virus associated with neurological manifestations
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Researchers reported 151 cases of neurological manifestations in a small group of patients with Zika virus infection in Pernambuco, Brazil. These findings, presented at the American Academy of Neurology Annual Meeting, suggest an association between Zika and an autoimmune disorder that attacks the brain’s myelin similar to multiple sclerosis.
“Though our study is small, it may provide evidence that in this case the virus has different effects on the brain than those identified in current studies,” study researcher Maria Lucia Brito Ferreira, MD, with Restoration Hospital in Recife, Brazil, said in a press release. “This doesn’t mean all people infected with Zika will experience these brain problems. Most do not have brain symptoms. However, our study may shed light on possible lingering effects the virus may be associated with in the brain.”
Ferreira and colleagues followed patients seen at the ER and neurology outpatient department at the Hospital da Restauração in Pernambuco with symptoms compatible with arboviruses — including dengue, chikungunya and Zika — from December 2014 to June 2015. Their symptoms included fever followed by cutaneous rash, itching, muscle and joint pain, and red eyes. Some patients also had pruritus, myalgia, arthralgia, and conjunctival hyperemia.
Six of these patients developed neurological symptoms consistent with autoimmune disorders and underwent additional clinical and neurological examinations, laboratory tests and real-time PCR viral genome detection. Some of these patients also had MRI scans, according to the researchers.
Through December 2015, Ferreira and colleagues recorded 151 cases of neurologic manifestations, which appeared from zero to 15 days after the onset of the patients’ first clinical symptoms. Of the six patients with neurologic problems, two developed acute disseminated encephalomyelitis (ADEM), and four developed Guillain-Barré syndrome (GBS), which has been previously associated with Zika. Blood and cerebrospinal fluid molecular tests for arboviruses were all positive for Zika. No patient tested positive for dengue and chikungunya.
After being discharged, five of the patients still had sustained motor dysfunction, one experienced low visual acuity, and another had difficulty with memory and thinking skills.
“At present, it does not seem that ADEM cases are occurring at a similarly high incidence as the GBS cases, but these findings from Brazil suggest that clinicians should be vigilant for the possible occurrences of ADEM and other immune-mediated illnesses of the central nervous system,” James J. Sejvar, MD, neuroepidemiologist, in the Division of Vector-Borne Infectious Diseases at the CDC, said in the release.
Reference:
Ferreira, MLB, et al. Abstract 9157. Presented at: American Academy of Neurology Annual Meeting; April 15-21, 2016; Vancouver, British Columbia.
Disclosure: Infectious Disease News was unable to confirm relevant financial disclosures at the time of publication.