1. Guillain-Barré Syndrome Associated With Zika Virus Infection in Martinique in 2016: A Prospective Study
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Benoît, Rozé, Fatiha, Najioullah, Jean-Louis, Fergé, Frédérique, Dorléans, Kossivi, Apetse, Jose-Luis, Barnay, Elise, Daudens-Vaysse, Yannick, Brouste, Raymond, Césaire, Laurence, Fagour, Ruddy, Valentino, Martine, Ledrans, Hossein, Mehdaoui, Sylvie, Abel, Isabelle, Leparc-Goffart, Aissatou, Signate, André, Cabié, Rosalie, Vilain, Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Unité de soins intensifs [CHU Martinique], Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-CHU de la Martinique [Fort de France], Laboratoire de Virologie-Immunologie [Fort de France, Martinique] (EA 4537), Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Unité Régionale Antilles Guyane [Saint-Maurice] (Agence Nationale de la Santé Publique ), Département d'Electrophysiologie [Fort de France, Martinique], Unité de Réhabilitation [Fort de France, Martinique], Hôpital Le Lamentin Bourg [CHU de la Martinique], Service d'Urgence [Fort de France, Martinique], Institut de Recherche Biomédicale des Armées [Antenne Marseille] (IRBA), Environnement, Santé, Sociétés (ESS), Centre National de la Recherche Scientifique (CNRS), Service de neurologie [Fort-de-France, Martinique], CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), This research was sponsored by University Hospital of Martinique (UHM) for regulatory and ethic submission and supported by the Clinical Research Hospital Program from the French Ministry of Health (PHRC 2009, NCT01099852). This research was support by the French network for Research and Action targeting emerging infectious diseases (REACTING)., Guillain-Barré Syndrome Zika Working Group of Martiniquea : Gwenole Jean Abgrall, Véronique Aïm, Alessandro Arrigo, Philippe Cabre, Cyrille Chabartier, Sylvie Colombani, Julien Cuziat, Christophe Deligny, Nicole Desbois, Anne-Laure Dessoy, Gaëlle Dunoyer, Régis Duvauferrier, N’Guyen Duc, Mireille Edimonana, Pierre Garrigou, Stéphane Gaucher, Sarah Gourgoudou, Karine Guitteaud, Patrick Hochedez, Gwladys Ivanes, Yolène Jacquens, Sandrine Julié, Armelle Jean-Etienne, Séverine Jeannin, Joux Julien, Pasquier Jérémie, Jean- Louis Lamaignère, Ingrid Laudarin, Maud Le Gall, Véronique Legris- Allusson, Mehdi Mejdoubi, Corinne Michel, Franck Michel, Charline Miossec, Florence Moinet, Cervantes Minerva, Claude Olive, Pascale Olive, Karine Pailla, Céline Paysant, Sandrine Pierre-François, Mathilde Pircher, Katlyne Polomat, Alain Putot, Patrick René-Corail, Dabor Resiere, Christiane Richer, Jean-Romain Risson, Karen Rome, Marie Sabia, Michel Schloesser, Pauline Simonnet-Vigeral, Rafaelle Théodose, Rosalie Vilain., Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and BUISINE, Soline
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Microbiology (medical) ,Male ,Pediatrics ,medicine.medical_specialty ,030231 tropical medicine ,Guillain-Barre Syndrome ,Zika virus ,Serology ,Disease Outbreaks ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Intensive care ,Medicine ,Humans ,Martinique ,Prospective Studies ,Aged ,[SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,biology ,Guillain-Barre syndrome ,business.industry ,Outbreak ,Retrospective cohort study ,vector-borne infections ,Zika Virus ,Middle Aged ,Zika virus infection ,biology.organism_classification ,medicine.disease ,bacterial infections and mycoses ,Guillain-Barré syndrome ,3. Good health ,Infectious Diseases ,outbreaks ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Etiology ,Female ,business ,030217 neurology & neurosurgery - Abstract
International audience; Background: Guillain-Barré syndrome (GBS) has been reported to be associated with Zika virus (ZIKV) infection in case reports and retrospective studies, mostly on the basis of serological tests, with the problematic cross-reacting antibodies of the Flavivirus genus. Some GBS cases do not exhibit a high level of diagnostic certainty. This prospective study aimed to describe the clinical profiles and the frequency of GBS associated with ZIKV during the ZIKV outbreak in Martinique in 2016.Methods: We recorded prospective data from GBS meeting levels 1 or 2 of diagnostic certainty for the Brighton Collaboration, with proof of recent ZIKV infection and negative screening for etiologies of GBS.Results: Of the sample of 34 patients with suspected GBS during the outbreak, 30 had a proven presence of GBS, and 23 had a recent ZIKV infection. The estimated GBS incidence rate ratio (2016 vs 2006-2015) was 4.52 (95% confidence interval, 2.80-7.64; P = .0001). Recent ZIKV infection was confirmed by urine reverse-transcription polymerase chain reaction (RT-PCR) analysis in 17 cases and by serology in 6 cases. Patients, 65% of whom were male, had a median age of 61 years (interquartile range, 56-71 years) and experienced severe GBS. Electrophysiological tests were consistent with the primary demyelinating form of the disease.Conclusions: ZIKV infection is usually benign, when symptomatic, but in countries at risk of ZIKV epidemics, adequate intensive care bed capacity is required for management of severe GBS cases. Arbovirus RNA detection by RT-PCR should be part of the management of GBS cases.
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- 2017
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