Guillain Barre and Zika Virus Infection

iStock_000062992601_MediumZika virus infection has circumnavigated the globe, with ongoing research efforts identifying more deleterious effects of infection.  This week, as Rick and I discuss on PodMed and as published in the New England Journal of Medicine, evidence has more definitively linked Zika in adults with the neurological syndrome Guillain Barre.  As we discuss in the podcast, since Guillain Barre may result in an ICU stays and the need for ventilation, and may also have long term sequelae, recognition of this association is important.

Investigators identified 68 patients with Guillain Barre syndrome in Colombia, South America.  A total of 66 (97%) had symptoms consistent with Zika infection prior to development of Guillain Barre, and virological studies were completed on 44 of those.  A median of 7 days elapsed between the onset of Zika virus infection symptoms and development of the neurological syndrome.  The researchers take the evidence of Zika virus infection in toto, including positive biological samples as well as antibody levels, along with the temporal relationship between development of Guillain Barre symptoms and Zika infection, and no evidence of Dengue infection or chikungunya, as consistent with a causative role for Zika.

Rick points out that such information is important clinically, since immune globulin may be helpful, and we both agree that this is a story that continues to unfold.  Other topics this week include Hospital Performance and Life Expectancy after MI,  Association Between Therapeutic Hypothermia and Survival After In-Hospital Cardiac Arrest. JAMA. 2016;316(13):1375-1382. doi:10.1001/jama.2016.14380, and Stimulant Medications and Bone Mass in Children and Adolescents With ADHD.  Until next week, y'all live well.



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