Neuroviruses Emerging in the Americas Study (NEAS): The Colombian experience during the 2016 outbreak of Zika virus infection (N4.002)

Objective: To evaluate neurological problems associated with Zika virus (ZIKV) during the 2016 outbreak of infection in Colombia (South America) Background: In parallel with the ZIKV outbreak in Latin America, an increased number of acute neurological problems was observed in the adult population. The Neuroviruses Emerging in the Americas Study (NEAS), a multicenter collaborative network focused on assessment of the spectrum of neurological disorders associated with arboviruses particularly in the context of the ZIKV outbreak in Colombia. Design/Methods: From January through September 2016, NEAS centers at nine university-based hospitals in Colombia evaluated 114 patients presenting with neuroinflammatory disorders . Patients underwent clinical-neurological and virological studies. Reverse-transcriptase polymerase-chain-reaction (RT-PCR) for ZIKV and Dengue virus in blood, urine and cerebrospinal fluid (CSF), as well as anti-flavivirus antibody assays were performed. Results: Out of the 114 included patients with neuroinflammatory disorders, 93 (82%) corresponded to Guillain-Barre syndrome (GBS), 9 (8%) to encephalitis, 6 (5%) to meningitis, 4 (3%) to myelitis and 2 (2%) to optic neuritis cases. ZIKV infection was confirmed by RT-PCR in 20 patients with GBS, as well as in patients with encephalitis (n=3), myelitis (n=2), meningitis (n=1) and optic neuritis (n=1). Most of the ZIKV detection was found in urine (23/27), followed by CSF (6/27) and blood (1/27). Flavivirus serological assessment was limited due to the high cross-reactivity between ZIKV and Dengue virus in Colombia. Conclusions: Our findings support a link between ZIKV infection and neuroinflammatory disorders including GBS, encephalitis and myelitis. We demonstrated the presence of the ZIKV in patients presenting with neurological syndromes other than GBS, an observation which supports a wider spectrum of neurological complications related to ZIKV in Colombia. The medical community in endemic areas should be aware of the potential role of ZIKV infection as a pathogenic factor in other central nervous system syndromes in otherwise healthy adults. Study Supported by: The Bart Mclean Fund for Neuroimmunology Research Disclosure: Dr. Munoz has nothing to disclose. Dr. Barreras has nothing to disclose. Dr. Lizarazo has nothing to disclose. Dr. Jimenez-Arango has nothing to disclose. Dr. Gonzalez-Manrique has nothing to disclose. Dr. Zea-Vera has nothing to disclose. Dr. Angarita Diaz has nothing to disclose. Dr. Vargas has nothing to disclose. Dr. Zuniga has nothing to disclose. Dr. Beltran has nothing to disclose. Dr. Lopez-Gonzalez has nothing to disclose. Dr. Munoz has nothing to disclose. Dr. Gomez has nothing to disclose. Dr. Ramos has nothing to disclose. Dr. Reyes-Mantilla has nothing to disclose. Dr. Pradilla-Ardila has nothing to disclose. Dr. Kumar has nothing to disclose. Dr. Cornblath has received personal compensation for activities with Abbott Laboratories, Acorda Therapeutics, Inc., Alexion Pharmaceuticals Inc., Ardea Biosciences, Inc., Astellas Pharma US, Inc., Avigen, Inc., AxelaCare Health Solutions as a consultant. Dr. Osorio has nothing to disclose. Dr. Parra has nothing to disclose. Dr. Pardo-Villamizar has nothing to disclose.