The Spectrum of Neuroinflammatory Disorders After the Outbreak of Zika Infection in Colombia: A Multi-center Observational Study (2878)

Objective: NA Background: Outbreaks of Chikungunya and Zika virus infection emerged in the Americas in 2014 and 2015. Along with such outbreaks, an increase in the incidence of disorders such as Guillain-Barre syndrome (GBS), encephalitis and other acute neuroinflammatory disorders was observed. The Neuroviruses Emerging in the Americas Study (NEAS) was established in Colombia as a multicenter-based observatory of acute neuroinflammatory disorders (ANIDs) to investigate the role of viral infections as etiological factors in neuroinflammatory disease. Design/Methods: NEAS network comprises clinical centers localized in 7 cities in Colombia. Patients with ANIDs fitting the criteria for GBS, encephalitis, myelitis, meningoencephalitis and cranial nerve disorders were evaluated clinically and with molecular and/or immunological diagnostic methods to investigate the role of viral infections as etiological factors. Results: Between 2016 and August 2019, 523 patients with ANIDs were studied. Of this group, 149 were recruited prospectively along with 97 controls for studying clinical and biological biomarkers of exposure to infection. GBS cases (249, 47.6%) and facial paralysis (169, 32.3%) were the most frequent ANIDs while encephalitis (29, 5.4%), optic neuritis (18, 3.4%) and myelitis (19, 3.4%) were less frequent. Almost 60% of GBS cases had a demyelinating type as compared with 21% with axonal forms. While Zika-related GBS was frequent (36%) among GBS cases, mostly during the 2016 Zika epidemic, 22% of the GBS appeared to be associated with Campylobacter jejuni exposure, most of them during the post-Zika epidemic. Conclusions: An increased number of ANIDs was observed in Colombia after the 2016 Zika outbreak. More than half of the cases of ANIDs were related with GBS and cranial nerve involvement. Although Zika infection played an important role in the increase of GBS cases in 2016, current evidence indicates that C. jejuni is an important driver of pathogenesis of GBS during the post-Zika period in Colombia. Disclosure: Dr. Osorio has nothing to disclose. Dr. Vargas has nothing to disclose. Dr. Dominguez has nothing to disclose. Dr. Jimenez-Arango has nothing to disclose. Dr. Lizarazo has nothing to disclose. Dr. Lopez has nothing to disclose. Dr. Gonzalez-Manrique has nothing to disclose. Dr. Ramos has nothing to disclose. Dr. Zea-Vera has nothing to disclose. Dr. Angarita Diaz has nothing to disclose. Dr. Benavides has nothing to disclose. Dr. Martinez has nothing to disclose. Dr. Barreras has nothing to disclose. Dr. Garcia-Dominguez has received research support from Bart McLean Fund for Neuroimmunology Research. Dr. Quintero has nothing to disclose. Dr. Claros has nothing to disclose. Dr. Luque has nothing to disclose. Dr. Jaramillo Rojas has nothing to disclose. Dr. Rosso has nothing to disclose. Dr. Rojas has nothing to disclose. Dr. Urrego has nothing to disclose. Dr. Zuluaga has nothing to disclose. Dr. Ocampo has nothing to disclose. Dr. Morales has nothing to disclose. Dr. Rojas has nothing to disclose. Dr. Zuniga has nothing to disclose. Dr. Llanos has nothing to disclose. Dr. Moyano has nothing to disclose. Dr. Munoz-Arcos has nothing to disclose. Dr. Parra has nothing to disclose. Dr. Pardo-Villamizar has received research support from McLean’s foundation.