• Ashley R Styczynski, Juliane M A S Malta, Elisabeth R Krow-Lucal, Jadher Percio, Martha E Nóbrega, Alexander Vargas, Tatiana M Lanzieri, Priscila L Leite, J Erin Staples, Marc X Fischer, Ann M Powers, Gwong-Jen J Chang, P L Burns, Erin M Borland, Jeremy P Ledermann, Eric C Mossel, Lawrence B Schonberger, Ermias B Belay, Jorge L Salinas, Roberto D Badaro, James J Sejvar, and Giovanini E Coelho.
• National Center for Emerging Zoonotic and Infectious Diseases, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
• PLoS Negl Trop Dis. 2017 Aug 1; 11 (8): e0005869.

AbstractIn mid-2015, Salvador, Brazil, reported an outbreak of Guillain-Barré syndrome (GBS), coinciding with the introduction and spread of Zika virus (ZIKV). We found that GBS incidence during April-July 2015 among those ≥12 years of age was 5.6 cases/100,000 population/year and increased markedly with increasing age to 14.7 among those ≥60 years of age. We conducted interviews with 41 case-patients and 85 neighborhood controls and found no differences in demographics or exposures prior to GBS-symptom onset. A higher proportion of case-patients (83%) compared to controls (21%) reported an antecedent illness (OR 18.1, CI 6.9-47.5), most commonly characterized by rash, headache, fever, and myalgias, within a median of 8 days prior to GBS onset. Our investigation confirmed an outbreak of GBS, particularly in older adults, that was strongly associated with Zika-like illness and geo-temporally associated with ZIKV transmission, suggesting that ZIKV may result in severe neurologic complications.

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