Centers for Disease Control and Prevention, United States.
Instituto Nacional de Salud, Colombia.
J Neurol Sci. 2017 Oct 15;381:272-277. doi: 10.1016/j.jns.2017.09.001. Epub 2017 Sep 4.
An 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.
We 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).
We 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).
Older individuals and those with suspected and probable Zika virus disease had higher odds of developing GBS.
We 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.
2015 年，寨卡病毒在哥伦比亚巴兰基亚引入后，该地暴发了以急性、对称肢体无力为特征，伴有或不伴有深部腱反射减弱或消失的格林-巴利综合征（Guillain-Barré syndrome，GBS）。我们对巴兰基亚的 GBS 病例进行了临床数据分析，并开展了病例对照研究，以评估疑似和可能的寨卡病毒病与 GBS 的关联。
我们使用 Brighton 协作组标准来确认 2015 年 10 月至 2016 年 4 月期间在巴兰基亚报告的 GBS 患者。2016 年 4 月，为每例确诊的 GBS 患者选择了 2 名年龄匹配的邻居对照。我们获取了病例患者发病前 2 个月和对照组同一时期的人口统计学和前驱症状。采集血清进行寨卡病毒抗体检测。疑似寨卡病毒病定义为皮疹病史和≥2 种其他寨卡相关症状（发热、关节痛、肌痛或结膜炎）。可能的寨卡病毒病定义为疑似寨卡病毒病且实验室证据提示近期寨卡病毒或黄病毒感染。采用条件逻辑回归校正性别和种族/民族，计算比值比（OR）和 95%置信区间（CI）。
我们共确认了 47 例 GBS 病例。发病率随年龄增加（≥60 岁组是<20 岁组的 10 倍）。我们共访谈了 40 例病例患者和 79 名对照。病例患者和对照组近期寨卡病毒或黄病毒感染的实验室证据无显著差异（OR：2.2；95%CI：0.9-5.1）。GBS 与疑似（OR：3.0，95%CI：1.1-8.6）或可能的寨卡病毒病（OR：4.6，CI：1.1-19.0）相关。
年龄较大者、疑似和可能的寨卡病毒病患者发生 GBS 的几率更高。
我们确认了 2015 年 10 月至 2016 年 4 月期间哥伦比亚巴兰基亚的格林-巴利综合征（GBS）暴发。采用邻里对照的病例对照研究显示，疑似和可能的寨卡病毒病与 GBS 有关。
