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Abstract Details

The Spectrum of Neuroinflammatory Disorders After the Outbreak of Zika Infection in Colombia: A Multi-center Observational Study
Global Health and Neuroepidemiology
P9 - Poster Session 9 (12:00 PM-1:00 PM)
13-009

NA
Outbreaks of Chikungunya and Zika virus infection emerged in the Americas in 2014 and 2015. Along with such outbreaks, an increase in the incidence of disorders such as Guillain-Barré syndrome (GBS), encephalitis and other acute neuroinflammatory disorders was observed. The Neuroviruses Emerging in the Americas Study (NEAS) was established in Colombia as a multicenter-based observatory of acute neuroinflammatory disorders (ANIDs) to investigate the role of viral infections as etiological factors in neuroinflammatory disease.
NEAS network comprises clinical centers localized in 7 cities in Colombia. Patients with ANIDs fitting the criteria for GBS, encephalitis, myelitis, meningoencephalitis and cranial nerve disorders were evaluated clinically and with molecular and/or immunological diagnostic methods to investigate the role of viral infections as etiological factors.

Between 2016 and August 2019, 523 patients with ANIDs were studied. Of this group, 149 were recruited prospectively along with 97 controls for studying clinical and biological biomarkers of exposure to infection. GBS cases (249, 47.6%) and facial paralysis (169, 32.3%) were the most frequent ANIDs while encephalitis (29, 5.4%), optic neuritis (18, 3.4%) and myelitis (19, 3.4%) were less frequent. Almost 60% of GBS cases had a demyelinating type as compared with 21% with axonal forms. While Zika-related GBS was frequent (36%) among GBS cases, mostly during the 2016 Zika epidemic, 22% of the GBS appeared to be associated with Campylobacter jejuni exposure, most of them during the post-Zika epidemic.

An increased number of ANIDs was observed in Colombia after the 2016 Zika outbreak. More than half of the cases of ANIDs were related with GBS and cranial nerve involvement.  Although Zika infection played an important role in the increase of GBS cases in 2016, current evidence indicates that C. jejuni is an important driver of pathogenesis of GBS during the post-Zika period in Colombia.
Authors/Disclosures
Lyda Osorio
PRESENTER 		Lyda Osorio has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Reydmar Lopez Reydmar Lopez has nothing to disclose.
Guillermo Gonzalez-Manrique Guillermo Gonzalez-Manrique has nothing to disclose.
Gustavo E. Ramos, MD (Universidad Libre De Cali, Universidad Del Valle, Clinica Dime) Dr. Ramos has nothing to disclose.
No disclosure on file
Jorge A. Angarita Diaz (Bayer) No disclosure on file
Julie Benavides Julie Benavides has nothing to disclose.
Viviana Martinez Viviana Martinez has nothing to disclose.
Paula Barreras, MD (Cedars-Sinai Medical Center) Dr. Barreras has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. The institution of Dr. Barreras has received research support from Foundation for Sarcoidosis Research. The institution of Dr. Barreras has received research support from Â鶹´«Ã½Ó³»­.
Maria A. Garcia-Dominguez, MD (UMass Memorial Medical Center) Dr. Garcia-Dominguez has received personal compensation for serving as an employee of Genentech.
No disclosure on file
Katherine Claros Katherine Claros has nothing to disclose.
No disclosure on file
Linda C. Jaramillo Rojas No disclosure on file
No disclosure on file
No disclosure on file
Jonathan Urrego Jonathan Urrego has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Gonzalo Zuniga No disclosure on file
No disclosure on file
Martha Moyano Martha Moyano has nothing to disclose.
Laura S. Munoz-Arcos, MD (Johns Hopkins Hospital) No disclosure on file
Beatriz Parra Beatriz Parra has nothing to disclose.
Carlos A. Pardo-Villamizar, MD (Johns Hopkins U, Med Dept of Neurology) The institution of Dr. Pardo-Villamizar has received research support from National Institutes of Health. The institution of Dr. Pardo-Villamizar has received research support from Bart McLean Fund for Neuroimmunology Research .