Neurological complications associated with emerging viruses in Brazil

Int J Gynaecol Obstet. 2020 Jan;148 Suppl 2(Suppl 2):70-75. doi: 10.1002/ijgo.13050.

Abstract

Objective: To test the hypotheses that emerging viruses are associated with neurological hospitalizations and that statistical models can be used to predict neurological sequelae from viral infections.

Methods: An ecological study was carried out to observe time trends in the number of hospitalizations with inflammatory polyneuropathy and Guillain-Barré syndrome (GBS) in the state of Rio de Janeiro from 1997 to 2017. Increases in GBS from month to month were assessed using a Farrington test. In addition, a cross-sectional study was conducted analyzing 50 adults hospitalized for inflammatory polyneuropathies from 2015 to 2017. The extent to which Zika virus symptoms explained GBS hospitalizations was evaluated using a calibration test.

Results: There were significant increases (Farrington test, P<0.001) in the incidence of GBS following the introduction of influenza A/H1N1 in 2009, dengue virus type 4 in 2013, and Zika virus in 2015. Of 50 patients hospitalized, 14 (28.0%) were diagnosed with arboviruses, 9 (18.0%) with other viruses, and the remainder with other causes of such neuropathies. Statistical models based on cases of emerging viruses accurately predicted neurological sequelae, such as GBS.

Conclusion: The introduction of novel viruses increases the incidence of inflammatory neuropathies.

Keywords: Arboviruses; Guillain-Barré syndrome; Human influenza; Peripheral nervous system diseases; Polyneuropathies; Public hospitals; Sentinel surveillance.

MeSH terms

  • Adult
  • Autoimmune Diseases of the Nervous System / virology
  • Brazil / epidemiology
  • Cross-Sectional Studies
  • Epidemiological Monitoring
  • Female
  • Guillain-Barre Syndrome / epidemiology*
  • Guillain-Barre Syndrome / virology
  • Hospitalization / statistics & numerical data
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Zika Virus / immunology
  • Zika Virus Infection / epidemiology*
  • Zika Virus Infection / virology