Abstract Details

Title The Zika Epidemic Is Gone But Other Pathogens Are Triggering Guillain-Barré Syndrome in Colombia: A Case-control Study

Topic General Neurology

Presentation(s) S11 - Global Health and Neuroepidemiology (12:03 PM-12:15 PM)

Poster/Presentation
Number 005

Background

GBS is frequently associated with sporadic or epidemic infectious disorders. The role of preceding infections as a risk factor for GBS has been highlighted recently by emerging viral and bacterial infectious disorders, as major clusters of GBS have been observed recently in Latin America.

Objective

We aimed to investigate the association of emerging infectious disorders with Guillain-Barré syndrome (GBS) in Colombia following the 2015-2016 Zika outbreak.

Design/Methods

A prospective case-control study was conducted between June 2016 and December 2019 in 9 university-based hospitals across 5 Colombian cities, included in the Neuroinfections Emerging in the Americas Study (NEAS). Newly diagnosed patients with GBS were matched with healthy household and age and season-matched hospital controls. Clinical information, blood, CSF, and urine samples were used for immunological and molecular assays to establish the presence of recent infection preceding enrollment into the study. Serum was used to identify anti-gangliosides antibodies. Analyses were performed using conditional logistic regression.

Results Fifty-seven patients with GBS, 67% male, with a median age (IQR) of 52 years (24–64) were recruited along with 77 controls. The associations of GBS with male sex (aOR, 4.4; 95% CI 2-9.7; p<0·0001), preceding diarrhea (aOR, 5.5; 95% CI 1.6-19.4; p=0·008), and history of recent upper respiratory tract infection (aOR, 8.25; 95% CI 2.4-28.3 p=0·001) were statistically significant. Specific recent infections did not significantly differ between cases and controls, but the number of infections was significantly associated with GBS (aOR=1.77 CI 1.04-3.01 p=0.034). Overall, C. jejuni , M. pneumoniae and Chikungunya virus were the most frequent infections in GBS cases.

Conclusions

After the ZIKV epidemic, C. jejuni, M. pneumoniae, and Chikungunya virus were the most common preceding infections in GBS in Colombia. The high frequency of C. jejuni, diarrhea, and upper respiratory infections underlies the importance of such risk factors as pathogenic triggers for GBS.

Authors/Disclosures
Carlos A. Pardo-Villamizar, MD (Johns Hopkins U, Med Dept of Neurology) PRESENTER	The institution of Dr. Pardo-Villamizar has received research support from National Institutes of Health. The institution of Dr. Pardo-Villamizar has received research support from Bart McLean Fund for Neuroimmunology Research .
Lyda Osorio	No disclosure on file
Beatriz Parra	No disclosure on file
Jose Enrique Vargas Manotas, MD, MSc (Private Office)	Dr. Vargas Manotas has nothing to disclose.
Reydmar Lopez	No disclosure on file
Jorge Jimenez	No disclosure on file
Jairo Lizarazo Niño	No disclosure on file
Martha Moyano	No disclosure on file
Gustavo E. Ramos, MD (Universidad Libre De Cali, Universidad Del Valle, Clinica Dime)	Dr. Ramos has nothing to disclose.
JUAN ROJAS	No disclosure on file
FERNANDO ROSSO (FUNDACION VALLE DEL LILI)	No disclosure on file
Christian Rojas Cerón	No disclosure on file
Julie Benavides	No disclosure on file
Viviana Martinez	No disclosure on file
Mario Llanos	No disclosure on file
Maria A. Garcia-Dominguez, MD (UMass Memorial Medical Center)	Dr. Garcia-Dominguez has nothing to disclose.
Jaime Quintero	No disclosure on file
Maria Fernanda Ramos Sanchez	No disclosure on file
Jose Enciso	No disclosure on file
Daniela Zuluaga Lotero	No disclosure on file
David Acero-Garces, MD (Johns Hopkins University)	The institution of Dr. Acero-Garces has received research support from Ministry of Science, Technology and Innovation of Colombia.
Susana Dominguez Penuela, MD (Johns Hopkins University School of Medicine)	Dr. Dominguez Penuela has nothing to disclose.