Zika virus disease-associated Guillain-Barré syndrome-Barranquilla, Colombia 2015-2016.

Abstract Background An outbreak of Guillain-Barre syndrome (GBS), a disorder characterized by acute, symmetric limb weakness with decreased or absent deep-tendon reflexes, was reported in Barranquilla, Colombia, after the introduction of Zika virus in 2015. We reviewed clinical data for GBS cases in Barranquilla and performed a case-control investigation to assess the association of suspect and probable Zika virus disease with GBS. Methods We used the Brighton Collaboration Criteria to confirm reported GBS patients in Barranquilla during October 2015–April 2016. In April 2016, two neighborhood and age range-matched controls were selected for each confirmed GBS case-patient. We obtained demographics and antecedent symptoms in the 2-month period before GBS onset for case-patients and the same period for controls. Sera were collected for Zika virus antibody testing. Suspected Zika virus disease was defined as a history of rash and ≥ 2 other Zika-related symptoms (fever, arthralgia, myalgia, or conjunctivitis). Probable Zika virus disease was defined as suspected Zika virus disease with laboratory evidence of a recent Zika virus or flavivirus infection. Conditional logistic regression adjusted for sex and race/ethnicity was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results We confirmed 47 GBS cases. Incidence increased with age (10-fold higher in those ≥ 60 years versus those Conclusions Older individuals and those with suspected and probable Zika virus disease had higher odds of developing GBS. Key points We confirmed a Guillain-Barre syndrome (GBS) outbreak in Barranquilla, Colombia, during October 2015–April 2016. A case-control investigation using neighborhood controls showed an association of suspected and probable Zika virus disease with GBS.