Venezuela and Colombia in late January and early February notified the WHO of increases in Guillain-Barre Syndrome cases. Zika Virus?
February 13th, 2016Guillain-Barré syndrome – Colombia and Venezuela
Between 30 January and 2 February 2016, the National IHR Focal Points of Colombia and Venezuela informed PAHO/WHO of increases in the number of Guillain-Barre Syndrome (GBS) cases recorded at the national level.
Colombia
From epidemiological week (EW) 51 of 2015 to EW 3 of 2016, 86 GBS cases were reported. On average, Colombia registers 242 GBS cases per year or approximately 19 cases per month or 5 cases per week. The 86 GBS cases reported in those 5 weeks is three times higher than the averaged expected cases of the 6 previous years.
Initial reports indicated that all the 86 reported GBS cases presented with symptoms compatible with a Zika virus infection. Of the 58 cases for which information is available, 57% were male and 94.8% were 18 years old or older.
Venezuela
From 1 January to 31 January 2016, 252 GBS cases with a spatiotemporal association to Zika virus were reported. While cases were recorded in the majority of the federal territories of the country, 66 were detected in the state of Zulia, mainly in the Maracaibo municipality.
Preliminary analysis of the GBS cases in the state of Zulia indicates that the 66 cases originated from six municipalities. Of the 66 cases, 30% were 45 to 54 years old and 29% were 65 years or older; 61% were male and 39% were female. A clinical history consistent with Zika virus infection was observed in the days prior to onset of neurological symptoms in 76% of the GBS cases in the state of Zulia. Associated comorbidities were present in 65% of the cases. Patients were treated with plasmapheresis and/or immunoglobulin. In some cases, according to medical indication, both treatments were used following the treatment protocol established by the Ministry of Popular Power for Health.
Zika virus infection was confirmed by polymerase chain reaction in three GBS cases, including a fatal case with no comorbidities. A total of three cases presenting with other neurological disorders were also biologically confirmed.
Between late November to 28 January 2016, 192 cases of Zika virus infection were laboratory confirmed through reverse transcription polymerase chain reaction. Of the 192 cases, 110 (57%) are from the state of Zulia.