Work

Neurologic Complications of Zika Virus Infection: Prospective Descriptive Study of 52 Patients Attended at the Hospital Universitario de Caracas Between January and April 2016

Year: 2016

Type: article

Abstract: Background. Zika virus infection is an emergent disease, considered as an international public health emergency, with devastating neurologic complications. In Venezuela between 12 December 2015 and 13 February 2016, 578 Guillain-Barre Syndrome (GBS) cases were notified. From these, 235 reported symptoms related to Zika virus infection. The previous reported annual incidence was 1–2 cases/100,000 inhabitants. In the last four months the increase was remarkable. Our objective was to describe the neurologic complications of Zika virus infection, evaluated between January and April 2016 at the Neurology Service and Intensive Care Unit, Hospital Universitario de Caracas (HUC), Venezuela. Clinical characterization and severity of each case are established. Patients were stratified regarding age, sex, geographic origin and complications. Methods. Epidemiologic and clinical information was collected in a data base. A descriptive analysis was performed. Results. Of the 52 patients: 31 female, 21 male. Age distribution: 5 patients were <15 years old, 5 between 15 and 30, 6 between 30 and 40, 12 between 40 and 50, 10 between 50 and 60, and 12 >60. Patients came from Caracas (25 cases), Miranda State (19 cases), La Guaira (5 cases), Guarico, Amazonas, Portuguesa and Nueva Esparta 1 case each. From the 52 patients, 44 were diagnosed with GBS, 4 transverse myelitis, 3 meningoencephalitis and 1 optic neuritis. Neurologic characterization: 29 patients had areflexia, 9 hyporeflexia, 4 transverse myelitis with hyperactivity of muscle stretch reflexes. In 37 cases facial diplegia was present. Unilateral facial nerve palsy was observed in 8 patients. Seven patients had no facial nerve component. The 21 patients who required mechanic ventilation had comorbidities such as infection and hematologic complications. Eight patients died. Treatment: 20 patients were treated with intravenous immunoglobulin (IVIG). Nine plasmapheresis, 4 plasmapheresis followed by IVIG and 19 received no treatment. Conclusion. Neurologic complications of Zika virus infection include GBS, transverse myelitis, meningoencephalitis and optic neuritis. A significant increase in the number of cases occurred between December 2015 and February 2016. Severe forms of these complications lead to sequelae and death. Disclosures. All authors: No reported disclosures.

Source: Open Forum Infectious Diseases

DOI: 10.1093/ofid/ofw194.20