A comprehensive analysis and immunobiology of autoimmune neurological syndromes during the Zika virus outbreak in Cúcuta, Colombia

Juan Manuel Anaya, Yhojan Rodríguez, Diana M. Monsalve, Daniel Vega, Ernesto Ojeda, Diana González-Bravo, Mónica Rodríguez-Jiménez, Carlos A. Pinto-Díaz, Pablo Chaparro, María L. Gunturiz, Aftab A. Ansari, M. Eric Gershwin, Nicolás Molano-González, Carolina Ramírez-Santana, Yeny Acosta-Ampudia

Resultado de la investigación: revisión exhaustivaArtículo

  • 9 Citas

Resumen

© 2016 The AuthorsWe have focused on the epidemiology and immunobiology of Zika virus (ZIKV) infection and factors associated with the development of Guillain-Barré syndrome (GBS) and other neurological syndromes in Cúcuta, the capital of North Santander department, Colombia. Data of patients with ZIKV disease reported to the national population-based surveillance system were used to calculate the basic reproduction number (R0) and the attack rates (ARs) as well as to develop epidemiological maps. Patients with neurological syndromes were contacted and their diagnoses were confirmed. A case-control study in which 29 patients with GBS associated with ZIKV compared with 74-matched control patients with ZIKV infection alone was undertaken. Antibodies against arboviruses and other infections that may trigger GBS were evaluated. The estimated value of R0 ranged between 2.68 (95% CI 2.54–2.67) to 4.57 (95% CI 4.18–5.01). The sex-specific ARs were 1306 per 100,000 females, and 552 per 100,000 males. A non-linear interaction between age and gender on the ARs was observed. The incidence of GBS in Cúcuta increased 4.41 times secondary to ZIKV infection. The lag time between ZIKV infection and neurological symptoms was 7 days (interquartile range 2–14.5). Patients with GBS appeared to represent a lower socioeconomic status and were living near to environmentally contaminated areas. All GBS patients were positive for IgG antibodies against both ZIKV and Dengue virus, and 69% were positive for Chikungunya virus. Noteworthy, GBS was associated with a previous infection with M. pneumoniae (OR: 3.95; 95% CI 1.44–13.01; p = 0.006). No differences in antibody levels against C. jejuni, Epstein-Barr virus and cytomegalovirus were observed. High rates of cranial nerves involvement and dysautonomia were present in 82% and 75.9%, respectively. Intensive care unit (ICU) admission was necessary in 69% of the GBS patients. Most of the patients disclosed a high disability condition (Hughes grade 4). Dysautonomia was the main risk factor of poor GBS prognosis (i.e., ICU admission and disability). Thirteen patients were diagnosed with other neurological syndromes different to GBS (6 with transverse myelitis, 3 with encephalitis, 3 with peripheral facial palsy and one with thoraco-lumbosacral myelopathy). Our data confirm an increased transmission of ZIKV in Cúcuta, and provide support to the view that severe neurological syndromes are related to ZIKV disease. The complex ways by which previous infections and socioeconomic status interact to increase the risk of GBS in people infected by ZIKV should be further investigated.
IdiomaEnglish (US)
Páginas123-138
Número de páginas16
PublicaciónJournal of Autoimmunity
DOI
EstadoPublished - feb 1 2017

Huella dactilar

Guillain-Barre Syndrome
Colombia
Disease Outbreaks
Zika Virus
Zika Virus Infection
Antibodies
Primary Dysautonomias
Social Class
Intensive Care Units
Infection
Arbovirus Infections
Basic Reproduction Number
Chikungunya virus
Population Surveillance
Transverse Myelitis
Dengue Virus
Cranial Nerves
Facial Paralysis
Spinal Cord Diseases
Encephalitis

Citar esto

Anaya, J. M., Rodríguez, Y., Monsalve, D. M., Vega, D., Ojeda, E., González-Bravo, D., ... Acosta-Ampudia, Y. (2017). A comprehensive analysis and immunobiology of autoimmune neurological syndromes during the Zika virus outbreak in Cúcuta, Colombia. Journal of Autoimmunity, 123-138. DOI: 10.1016/j.jaut.2016.12.007
Anaya, Juan Manuel ; Rodríguez, Yhojan ; Monsalve, Diana M. ; Vega, Daniel ; Ojeda, Ernesto ; González-Bravo, Diana ; Rodríguez-Jiménez, Mónica ; Pinto-Díaz, Carlos A. ; Chaparro, Pablo ; Gunturiz, María L. ; Ansari, Aftab A. ; Gershwin, M. Eric ; Molano-González, Nicolás ; Ramírez-Santana, Carolina ; Acosta-Ampudia, Yeny. / A comprehensive analysis and immunobiology of autoimmune neurological syndromes during the Zika virus outbreak in Cúcuta, Colombia. En: Journal of Autoimmunity. 2017 ; pp. 123-138
@article{37e51d75535b48b6af32d71650898ecc,
title = "A comprehensive analysis and immunobiology of autoimmune neurological syndromes during the Zika virus outbreak in Cúcuta, Colombia",
abstract = "© 2016 The AuthorsWe have focused on the epidemiology and immunobiology of Zika virus (ZIKV) infection and factors associated with the development of Guillain-Barré syndrome (GBS) and other neurological syndromes in Cúcuta, the capital of North Santander department, Colombia. Data of patients with ZIKV disease reported to the national population-based surveillance system were used to calculate the basic reproduction number (R0) and the attack rates (ARs) as well as to develop epidemiological maps. Patients with neurological syndromes were contacted and their diagnoses were confirmed. A case-control study in which 29 patients with GBS associated with ZIKV compared with 74-matched control patients with ZIKV infection alone was undertaken. Antibodies against arboviruses and other infections that may trigger GBS were evaluated. The estimated value of R0 ranged between 2.68 (95% CI 2.54–2.67) to 4.57 (95% CI 4.18–5.01). The sex-specific ARs were 1306 per 100,000 females, and 552 per 100,000 males. A non-linear interaction between age and gender on the ARs was observed. The incidence of GBS in Cúcuta increased 4.41 times secondary to ZIKV infection. The lag time between ZIKV infection and neurological symptoms was 7 days (interquartile range 2–14.5). Patients with GBS appeared to represent a lower socioeconomic status and were living near to environmentally contaminated areas. All GBS patients were positive for IgG antibodies against both ZIKV and Dengue virus, and 69% were positive for Chikungunya virus. Noteworthy, GBS was associated with a previous infection with M. pneumoniae (OR: 3.95; 95% CI 1.44–13.01; p = 0.006). No differences in antibody levels against C. jejuni, Epstein-Barr virus and cytomegalovirus were observed. High rates of cranial nerves involvement and dysautonomia were present in 82% and 75.9%, respectively. Intensive care unit (ICU) admission was necessary in 69% of the GBS patients. Most of the patients disclosed a high disability condition (Hughes grade 4). Dysautonomia was the main risk factor of poor GBS prognosis (i.e., ICU admission and disability). Thirteen patients were diagnosed with other neurological syndromes different to GBS (6 with transverse myelitis, 3 with encephalitis, 3 with peripheral facial palsy and one with thoraco-lumbosacral myelopathy). Our data confirm an increased transmission of ZIKV in Cúcuta, and provide support to the view that severe neurological syndromes are related to ZIKV disease. The complex ways by which previous infections and socioeconomic status interact to increase the risk of GBS in people infected by ZIKV should be further investigated.",
author = "Anaya, {Juan Manuel} and Yhojan Rodríguez and Monsalve, {Diana M.} and Daniel Vega and Ernesto Ojeda and Diana González-Bravo and Mónica Rodríguez-Jiménez and Pinto-Díaz, {Carlos A.} and Pablo Chaparro and Gunturiz, {María L.} and Ansari, {Aftab A.} and Gershwin, {M. Eric} and Nicolás Molano-González and Carolina Ramírez-Santana and Yeny Acosta-Ampudia",
year = "2017",
month = "2",
doi = "10.1016/j.jaut.2016.12.007",
pages = "123--138",
journal = "Journal of Autoimmunity",
issn = "0896-8411",
publisher = "Academic Press Inc.",

}

Anaya, JM, Rodríguez, Y, Monsalve, DM, Vega, D, Ojeda, E, González-Bravo, D, Rodríguez-Jiménez, M, Pinto-Díaz, CA, Chaparro, P, Gunturiz, ML, Ansari, AA, Gershwin, ME, Molano-González, N, Ramírez-Santana, C & Acosta-Ampudia, Y 2017, 'A comprehensive analysis and immunobiology of autoimmune neurological syndromes during the Zika virus outbreak in Cúcuta, Colombia' Journal of Autoimmunity, pp. 123-138. DOI: 10.1016/j.jaut.2016.12.007

A comprehensive analysis and immunobiology of autoimmune neurological syndromes during the Zika virus outbreak in Cúcuta, Colombia. / Anaya, Juan Manuel; Rodríguez, Yhojan; Monsalve, Diana M.; Vega, Daniel; Ojeda, Ernesto; González-Bravo, Diana; Rodríguez-Jiménez, Mónica; Pinto-Díaz, Carlos A.; Chaparro, Pablo; Gunturiz, María L.; Ansari, Aftab A.; Gershwin, M. Eric; Molano-González, Nicolás; Ramírez-Santana, Carolina; Acosta-Ampudia, Yeny.

En: Journal of Autoimmunity, 01.02.2017, p. 123-138.

Resultado de la investigación: revisión exhaustivaArtículo

TY - JOUR

T1 - A comprehensive analysis and immunobiology of autoimmune neurological syndromes during the Zika virus outbreak in Cúcuta, Colombia

AU - Anaya,Juan Manuel

AU - Rodríguez,Yhojan

AU - Monsalve,Diana M.

AU - Vega,Daniel

AU - Ojeda,Ernesto

AU - González-Bravo,Diana

AU - Rodríguez-Jiménez,Mónica

AU - Pinto-Díaz,Carlos A.

AU - Chaparro,Pablo

AU - Gunturiz,María L.

AU - Ansari,Aftab A.

AU - Gershwin,M. Eric

AU - Molano-González,Nicolás

AU - Ramírez-Santana,Carolina

AU - Acosta-Ampudia,Yeny

PY - 2017/2/1

Y1 - 2017/2/1

N2 - © 2016 The AuthorsWe have focused on the epidemiology and immunobiology of Zika virus (ZIKV) infection and factors associated with the development of Guillain-Barré syndrome (GBS) and other neurological syndromes in Cúcuta, the capital of North Santander department, Colombia. Data of patients with ZIKV disease reported to the national population-based surveillance system were used to calculate the basic reproduction number (R0) and the attack rates (ARs) as well as to develop epidemiological maps. Patients with neurological syndromes were contacted and their diagnoses were confirmed. A case-control study in which 29 patients with GBS associated with ZIKV compared with 74-matched control patients with ZIKV infection alone was undertaken. Antibodies against arboviruses and other infections that may trigger GBS were evaluated. The estimated value of R0 ranged between 2.68 (95% CI 2.54–2.67) to 4.57 (95% CI 4.18–5.01). The sex-specific ARs were 1306 per 100,000 females, and 552 per 100,000 males. A non-linear interaction between age and gender on the ARs was observed. The incidence of GBS in Cúcuta increased 4.41 times secondary to ZIKV infection. The lag time between ZIKV infection and neurological symptoms was 7 days (interquartile range 2–14.5). Patients with GBS appeared to represent a lower socioeconomic status and were living near to environmentally contaminated areas. All GBS patients were positive for IgG antibodies against both ZIKV and Dengue virus, and 69% were positive for Chikungunya virus. Noteworthy, GBS was associated with a previous infection with M. pneumoniae (OR: 3.95; 95% CI 1.44–13.01; p = 0.006). No differences in antibody levels against C. jejuni, Epstein-Barr virus and cytomegalovirus were observed. High rates of cranial nerves involvement and dysautonomia were present in 82% and 75.9%, respectively. Intensive care unit (ICU) admission was necessary in 69% of the GBS patients. Most of the patients disclosed a high disability condition (Hughes grade 4). Dysautonomia was the main risk factor of poor GBS prognosis (i.e., ICU admission and disability). Thirteen patients were diagnosed with other neurological syndromes different to GBS (6 with transverse myelitis, 3 with encephalitis, 3 with peripheral facial palsy and one with thoraco-lumbosacral myelopathy). Our data confirm an increased transmission of ZIKV in Cúcuta, and provide support to the view that severe neurological syndromes are related to ZIKV disease. The complex ways by which previous infections and socioeconomic status interact to increase the risk of GBS in people infected by ZIKV should be further investigated.

AB - © 2016 The AuthorsWe have focused on the epidemiology and immunobiology of Zika virus (ZIKV) infection and factors associated with the development of Guillain-Barré syndrome (GBS) and other neurological syndromes in Cúcuta, the capital of North Santander department, Colombia. Data of patients with ZIKV disease reported to the national population-based surveillance system were used to calculate the basic reproduction number (R0) and the attack rates (ARs) as well as to develop epidemiological maps. Patients with neurological syndromes were contacted and their diagnoses were confirmed. A case-control study in which 29 patients with GBS associated with ZIKV compared with 74-matched control patients with ZIKV infection alone was undertaken. Antibodies against arboviruses and other infections that may trigger GBS were evaluated. The estimated value of R0 ranged between 2.68 (95% CI 2.54–2.67) to 4.57 (95% CI 4.18–5.01). The sex-specific ARs were 1306 per 100,000 females, and 552 per 100,000 males. A non-linear interaction between age and gender on the ARs was observed. The incidence of GBS in Cúcuta increased 4.41 times secondary to ZIKV infection. The lag time between ZIKV infection and neurological symptoms was 7 days (interquartile range 2–14.5). Patients with GBS appeared to represent a lower socioeconomic status and were living near to environmentally contaminated areas. All GBS patients were positive for IgG antibodies against both ZIKV and Dengue virus, and 69% were positive for Chikungunya virus. Noteworthy, GBS was associated with a previous infection with M. pneumoniae (OR: 3.95; 95% CI 1.44–13.01; p = 0.006). No differences in antibody levels against C. jejuni, Epstein-Barr virus and cytomegalovirus were observed. High rates of cranial nerves involvement and dysautonomia were present in 82% and 75.9%, respectively. Intensive care unit (ICU) admission was necessary in 69% of the GBS patients. Most of the patients disclosed a high disability condition (Hughes grade 4). Dysautonomia was the main risk factor of poor GBS prognosis (i.e., ICU admission and disability). Thirteen patients were diagnosed with other neurological syndromes different to GBS (6 with transverse myelitis, 3 with encephalitis, 3 with peripheral facial palsy and one with thoraco-lumbosacral myelopathy). Our data confirm an increased transmission of ZIKV in Cúcuta, and provide support to the view that severe neurological syndromes are related to ZIKV disease. The complex ways by which previous infections and socioeconomic status interact to increase the risk of GBS in people infected by ZIKV should be further investigated.

U2 - 10.1016/j.jaut.2016.12.007

DO - 10.1016/j.jaut.2016.12.007

M3 - Article

SP - 123

EP - 138

JO - Journal of Autoimmunity

T2 - Journal of Autoimmunity

JF - Journal of Autoimmunity

SN - 0896-8411

ER -

Anaya JM, Rodríguez Y, Monsalve DM, Vega D, Ojeda E, González-Bravo D y otros. A comprehensive analysis and immunobiology of autoimmune neurological syndromes during the Zika virus outbreak in Cúcuta, Colombia. Journal of Autoimmunity. 2017 feb 1;123-138. Disponible desde, DOI: 10.1016/j.jaut.2016.12.007