First reported case of Zika virus infection associated with Guillian Barre Syndrome in Asia, Phetchabun Province, Thailand, 2016
Keywords:
Zika virus surveillance system, Guillian Barre Syndrome, Lomsak district, PhetchabunAbstract
Backgrounds: One suspected ZIKV patient with GBS was reported in Lomsak district, Phetchabun province that had prolong ZIKV outbreak in previous three months.
Methods: During investigation, we obtain patient’s clinical data from medical records and relatives. The district level ZIKV surveillance system coverage was assessed by comparing number of reported cases with number of medical records meeting surveillance case definition. We interviewed related staff and some villagers about control measure implementation and assessed larva control in houses of recent confirmed cases or patients under investigation of ZIKV and in Lomsak hospital.
Results: The case was a 52-year-old Thai female presented with rash and arthralgia for six days, followed by progressive muscle weakness one day later. Zika associated GBS was diagnosed by high protein and low cell count in CSF and positive urine PCR for ZIKV. Intravenous immunoglobulin was administered immediately after having CSF profile and 2 days later she got endotracheal tube intubation due to progressive muscle weakness which then resulted in respiratory failure. She had hospital acquired pneumonia and muscle atrophy during hospitalization. The patient was discharged and fully recovered in 3 months later. ZIKV surveillance system coverage was 61.22%. Assessment of control measures found several problems including inadequate skill of larva control of local staff and the fatigue of control system due to prolong outbreak situation.
Conclusion and Recommendations: This patient was the first reported case of zika associated GBS in Asia. Improved surveillance coverage and proactive measures are needed to control ZIKV infection in this area.
References
Plourde AR, Bloch EM. A Literature Review of Zika Virus. Emerging Infectious Disease. 2016; 22(7):1185-92.
Thiery G, Valentino R, Meddhaoui H. Zika virus– associated Guillain–Barré syndrome: a warning for critical care physicians. Intensive Care Med. 2016; 42(9): 1485–6.
Center for Disease Control and Prevention. Zika Virus. [cited 2016 August 19]. Available from: https://www.cdc.gov/zika/index.html
Lahani S., Connor C.,Kirkbride H., Brook T., Morgan D. Outbreak of Zika virus disease in the Americas and the association with microcephaly, congenital malformations and Guillain–Barré syndrome. Arch Dis Child. 2016; (107): 600-2.
Hamel R, Dejarnac O, Wichit S, Ekchariyawat P, Neyret A, Luplertlop N, et al. Biology of Zika Virus Infection in Human Skin Cells. Journal of Virology. 2015; 89(17): 8880–96.
Rönnberg B, Gustafsson Å, Vapalahti O, Emmerich P. Compensating for cross–reactions using avidity and computation in a suspension multiplex immunoassay for serotyping of Zika versus other flavivirus infections. Med Microbiol Immunol. 2017; 206(5): 383–401.
Laura S Muñoz, Beatriz Parra, Carlos A Pardo. Neurological Implications of Zika Virus Infection in Adults. The Journal of Infectious Diseases. 2017; 216: 897–905.
Apostolski S, Doorn P Van, Gilhus NE, Hietaharju A, Honkaniemi J, Schaik IN Van, et al. EFNS guidelines for the use of intravenous immunoglobulin in treatment of neurological diseases: EFNS task force on the use of intravenous immunoglobulin in treatment of neurological disease. European Journal of Neurology. 2008; 15: 893–908.
Cao-lormeau WV, Avelino-silva VI, Martin JN. Association between Guillain-Barré syndrome and Zika virus infection. The Lancet. 2016; 387: 2599-600.
Pojaman Siriarayaporn, et al. Zika virus investigation and surveillance guideline in Thailand, 17 November 2016. [cited 2016 August 19]. Available from: http://zika.ddc.moph.go.th/
Salvador E. Zika Virus and the Guillain–Barré Syndrome - Case Series from Seven Countries. The New England Journal of Medicine. 2016; 375: 1598–601.
Manrique GG, Vargas J, Angarita JA, Zuñiga G, Gonzalez RL, Beltran CL, et al. Guillain–Barré Syndrome Associated with Zika Virus Infection in Colombia, The New England journal of Medicine. 2016; 375: 1513–23.
Loise Watrin, Phillipe Larre et al. Guillain-Barre’ syndrome (42 cases) occurring during zika virus outbreak in French Polynesia. Journal of Medicine. 2016; 95: 1–8.
Barcellos C, Xavier DR, Pavão AL, Boccolini CS, Pina MF, Pedroso M, et al. Increased Hospitalizations for Neuropathies as Indicators of Zika Virus Infection, according to Health Information System Data, Brazil. Emerging Infectious Disease. 2016; 22: 1894–9.
World Health Organization. Identification and management of Guillain-Barré syndrome in the context of Zika virus. Intergrim guidance update. 2016.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2018 Weekly Epidemiological Surveillance Report
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Responsibility and Copyright
1. Author Responsibility and Editorial Disagreement
The content and data in all articles published in WESR are the direct opinions and responsibility of the article authors, and the Journal's Editorial Board is not necessarily in agreement with, or jointly responsible for, them.
2. Copyright and Referencing
All articles, data, content, figures, etc., published in WESR are considered the copyright of the academic journal. If any individual or entity wishes to disseminate all or any part of the published material, appropriate citation of the article is required.
