• Jorge L Salinas, Diana M Walteros, Ashley Styczynski, Flavio Garzón, Hernán Quijada, Elsa Bravo, Pablo Chaparro, Javier Madero, Jorge Acosta-Reyes, Jeremy Ledermann, Zuleima Arteta, Erin Borland, Paul Burns, Maritza Gonzalez, Ann M Powers, Marcela Mercado, Alma Solano, James J Sejvar, and Martha L Ospina.
• Centers for Disease Control and Prevention, United States. Electronic address: jsalinas@cdc.gov.
• J. Neurol. Sci. 2017 Oct 15; 381: 272-277.

BackgroundAn outbreak of Guillain-Barré syndrome (GBS), a disorder characterized by acute, symmetric limb weakness with decreased or absent deep-tendon reflexes, was reported in Barranquilla, Colombia, after the introduction of Zika virus in 2015. We reviewed clinical data for GBS cases in Barranquilla and performed a case-control investigation to assess the association of suspect and probable Zika virus disease with GBS.MethodsWe used the Brighton Collaboration Criteria to confirm reported GBS patients in Barranquilla during October 2015-April 2016. In April 2016, two neighborhood and age range-matched controls were selected for each confirmed GBS case-patient. We obtained demographics and antecedent symptoms in the 2-month period before GBS onset for case-patients and the same period for controls. Sera were collected for Zika virus antibody testing. Suspected Zika virus disease was defined as a history of rash and ≥2 other Zika-related symptoms (fever, arthralgia, myalgia, or conjunctivitis). Probable Zika virus disease was defined as suspected Zika virus disease with laboratory evidence of a recent Zika virus or flavivirus infection. Conditional logistic regression adjusted for sex and race/ethnicity was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsWe confirmed 47 GBS cases. Incidence increased with age (10-fold higher in those ≥60years versus those <20years). We interviewed 40 case-patients and 79 controls. There was no significant difference in laboratory evidence of recent Zika virus or flavivirus infection between case-patients and controls (OR: 2.2; 95% CI: 0.9-5.1). GBS was associated with having suspected (OR: 3.0, 95% CI: 1.1-8.6) or probable Zika virus disease (OR: 4.6, CI: 1.1-19.0).ConclusionsOlder individuals and those with suspected and probable Zika virus disease had higher odds of developing GBS.Key PointsWe confirmed a Guillain-Barré syndrome (GBS) outbreak in Barranquilla, Colombia, during October 2015-April 2016. A case-control investigation using neighborhood controls showed an association of suspected and probable Zika virus disease with GBS.Published by Elsevier B.V.

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