Guillain-Barré syndrome associated with arboviruses in the state of Pernambuco in 2016

Abstract

Introduction: In 2016, Brazil presented an increase in the notifications related to neurological syndromes with previous register of a febrile illness compatible with arboviruses, including Guillain-Barré syndrome (GBS). Such disease is responsible for the most frequent occurrence of flaccid paralysis in the world, causing bilateral ascending muscle weakness that might affect the respiratory tract. Objective: To investigate the incidence of Guillain-Barré syndrome associated with arboviruses in Pernambuco in 2016 and to describe the confirmed/probable cases. Method: This is an observational retrospective study of GBS cases with a background of infection from dengue, chikungunya, or Zika virus notified to the Pernambuco Health State Secretariat (SES-PE). Cases notified from January 1st to December 31st, 2016 were included, which were considered as possible GBS at the time of notification. The suspect cases were investigated and classified as confirmed/probable by the positive laboratory test result, excluding the possibility of infection. Results: Forty-three suspect cases of GBS after previous arbovirus infection were notified. From these, 23 were classified as confirmed/probable for the etiological agents chikungunya and/or dengue. The mean age of the affected individuals was 37.22 ± 21.29 years and they were mostly female (56.5%). The annual incidence of GBS after arbovirus infection was 0.24 cases per 100 thousand inhabitants in the state. The neurological condition was mainly characterized by the presence of movement (91.3%) and walking (78.3%) alterations. Conclusion: The findings of this research confirm the current set of evidence and show the likelihood of GBS being a severe neurological complication of these arboviruses.