Other symptoms include headache, muscle pain, joint swelling, and rash. In contrast, two of the eight case-control studies previously mentioned did not demonstrate any association [21,26]. Formal analysis, Serum samples were processed for the determination of IgM antibodies against ZIKV and DENV by commercial qualitative methods using the commercial kits Anti-Zika Virus ELISA IgM (Cat. The results were evaluated together to discard cross-reactivity between flaviviruses (ZIKV and DENV). The study protocol was approved by the National Committee for Scientific Research (R-2016-785-026), under the Instituto Mexicano del Seguro Social (IMSS). 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, Mexico, Affiliation Il n’y a pas, actuellement, d’épidémie de chikungunya, de dengue ou de Zika en France métropolitaine. Despite the foregoing, we consider this type of design to be the appropriate one to determine whether or not we are on the right track to associate GBS with any of the viral infections under study [18,30,31]. Other symptoms may include headache, muscle pain, joint swelling, or rash. Il peut être vecteur des virus du chikungunya, de la dengue et du zika. Dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV) are widely distributed arboviruses, affecting tropical and subtropical areas [].In Brazil, the 4 DENV serotypes have co-circulated since 2010 [], and in September 2014, the first autochthonous cases of chikungunya were reported in the country, almost simultaneously in the northern (Amapá state) and … No, Is the Subject Area "Chikungunya virus" applicable to this article? Positive ZIKV and negative DENV and CHIKV results: acute ZIKV infection. Other clinical outcomes of GBS patients are shown in Table 4. https://doi.org/10.1371/journal.pntd.0008032.t004. Yes The sample size was calculated considering published data by Cao-Lormeau et al. Citation: Grijalva I, Grajales-Muñiz C, González-Bonilla C, Borja-Aburto VH, Paredes-Cruz M, Guerrero-Cantera J, et al. After the interviews, serum and urine samples were collected to determine exposure to ZIKV, DENV and CHIKV during the first seven days after the onset of the neurological picture. A p-value ≤ 0.05 was considered as significant. Writing – original draft, Roles Chikungunya disease does not often result in death, but the symptoms can be severe and disabling. View Article Once a person has been infected, he or she is likely to be protected from future infections of the same virus. Hospital General Regional No.1, Instituto Mexicano del Seguro Social, Tijuana, Baja California, Mexico, Affiliation Symptoms No symptoms in most people (70-80%) 1 in 5 will develop: Fever, Headache, Body Aches, Joint Pains, Vomiting, Diarrhea, or Rash Many will have no symptoms or mild symptoms Fever, Rash, Joint Pain, Conjunctivitis, Muscle Pain, Headache Generally, young children will have less severe infection than older children & adults Fever, Headache, Eye Patients were evaluated by a neurologist, who diagnosed GBS based on the clinical features and neurological manifestations of the disease, as well as cerebrospinal fluid (CSF) analysis and electrodiagnostic test results, in keeping with international criteria [14]. Whole blood, CSF, urine or amniotic fluid must be accompanied by a serum. Yes Chikungunya disease is very rarely fatal, but the virus sometimes causes serious complications, mostly in older people, babies or people with underlying medical conditions. 1 Je consulte un médecin en cas de symptômes Je reste vigilant 2 ’évite de me faire piquer par un moustique Si je suis contaminé, j’évite alors de me faire piquer. 2017. Patient information included age, gender, place of residence, clinical history of comorbidities, signs and symptoms, duration and severity of the disease based on the GBS Disability Score and Medical Research Council Scale for Muscle Strength (MRC) and treatment. PLOS Neglected Tropical Diseases is the top Open Access tropical medicine journal, featuring an International Editorial Board and increased support for developing country authors. The limitations of this study are the following: In conclusion, the present study demonstrates laboratory evidence of ZIKV infection associated with GBS as well as laboratory evidence of the association of GBS with both ZIKV and DENV (flavivirus) infection. A lumbar puncture was performed by standard technique to obtain CSF for cytological and cytochemical analysis. Zika, dengue and chikungunya viruses (ZIKV, CHIKV and DENV) are temporally associated with neurological diseases, such as Guillain-Barré syndrome (GBS). All the participants were interviewed by nursing personnel hired and trained to perform this task to seek more information about risk factors and exposure during the last two months, before the onset of the neurological symptoms for cases or in general the last two months for controls. Methodology, o Zika o Chikungunya o Dengue RT-PCR Testing: VRDL is currently using the Trioplex Real-time RT-PCR assay which is validated for serum, whole blood, CSF, urine and amniotic fluid. (2020) Zika and dengue but not chikungunya are associated with Guillain-Barré syndrome in Mexico: A case-control study. The neurophysiological evaluation included motor and sensory nerve conduction studies of upper and lower extremity peripheral nerves. Le virus Zika est un virus qui a été découvert pour la première fois en Ouganda en 1947. Methodology, Treatment with aspirin and other and non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided because of a potential increased risk of hemorrhagic syndrome. Il ne peut le transmettre que s’il a piqué, au préalable, une personne déjà infectée. Although no conclusive role of DENV in the triggering of GBS has been demonstrated, an association between GBS and flavivirus (ZIKV and DENV) seems to be established. Unfortunately, although over 75% of the population in Mexico is considered to be in a situation of poverty and vulnerability, socioeconomic level was not taken into account. Considering that ZIKV, DENV, and CHIKV produce large epidemics worldwide [1], and these three arboviruses coexist in Mexico since 2015 [35], this study confirms their presence in both GBS cases and controls. https://doi.org/10.1371/journal.pntd.0008032, Editor: Maya Williams, Naval Medical Research Center, UNITED STATES, Received: December 30, 2019; Accepted: October 5, 2020; Published: December 17, 2020. If necessary, patients were sent to a third−level−care hospital. We know that these three arboviruses have coexisted in Mexico since 2015. Primary Health-Care Unit. These findings agree with those previously reported by Salinas et al. This article is not intended to provide medical advice, diagnosis or treatment, but simply to provide information about the diseases. Identifié pour la première fois en 1947 en Ouganda, le virus Zika est un virus proche de ceux de la dengue et du chikungunya, qui se transmet par des moustiques. [23], Styczynski et al. Investigation, La transmission du virus est importante en Amérique du sud, en Martinique et en Guyane. Other symptoms may include headache, muscle pain, joint swelling, or rash. More information can be found at: www.cdc.gov/chikungunya/ In this work, symptoms prior to the development of GBS related to the symptoms of ZIKV suspected disease, such as rash, fever and conjunctivitis, showed significant differences to controls. Formal analysis, Sudden onset of high fever ( 39° to 40°C), , that gets worse with the eye movement (retro-orbital pain), Skin maculopapular rash (usually appears from two to five days after the onset of fever), Bleeding (such as nose and gum bleed or easy bruising). For those with symptoms, Zika virus tends to cause a mild, short-lived (2 to 7 days) illness. On 16 April 2016, a 7.8 magnitude earthquake struck coastal Ecuador, resulting in significant mortality and morbidity, damages to infrastructure, and psychological trauma. Positive ZIKV RT-qPCR or positive ZIKV IgM and positive DENV RT-qPCR or positive DENV IgM and negative CHIKV RT-qPCR or negative CHIKV IgM results: laboratory evidence of flavivirus infection. GBS is an acute immune-mediated inflammatory polyradiculoneuropathy that typically produces predominantly distal symmetrical muscular weakness, unsteady gait, and hyporeflexia or areflexia [8]. Leur transmission s’effectue de personne à personne par l’intermédiaire de moustiques infectés. Other causes of GBS were not considered, such as. Toutefois, la prise d’aspirine est à éviter tant que le diagnostic n’a pas clairement écarté la possibilité d’une infection par le virus de la dengue, car dans ce cas l’action anticoagulante du médicament pourrait induire des saignements. Methodology, However, zika might be linked with Guillain-Barré syndrome and birth defects (zika virus can be spread from a pregnant woman to her fetus). Supervision, We also would like to thank Anel Cantera Salinas, Osvaldo Jiménez Pacheco, Vidaris Toledo Arrazola and Mario Villegas Rivera, who helped us to produce the clinical database. The joint pain can vary from mild to be very debilitating, and may last from a few days to many months or years, depending on the strain. According to laboratory results, an association between ZIKV or ZIKV and DENV infection in patients with GBS was found. Funding: This project was totally funded by the Instituto Mexicano del Seguro Social (https://www.imss.gob.mx) through Fondo de Investigación en Salud, grant number FIS/IMSS/PROT/PRIO/16/055. Some describe a greater severity of GBS symptoms [12,13,21]. SDS software version 1.4 was used for the analysis of the results. Significant differences can be observed between ZIKV+ and ZIKV- cases in oculomotor and global hypotonia (p = 0.02 and 0.02, respectively) but not in facial paresis (p = 0.14). Consequently, individuals were invited to participate in the study and were given informed consent forms. CHKM-C, InBios International, Inc. USA), following the instructions of the manufacturer. For more information about PLOS Subject Areas, click About two-thirds of patients with GBS have reported a history of Campylobacter jejuni, cytomegalovirus, Epstein-Barr virus or Mycoplasma pneumoniae, as well as influenza A virus and Haemophilus influenzae infections. Most patients recover fully, but in some cases joint … Supervision, Clinical and demographic data were collected directly from the patients or their relatives. Categorical variables were presented as counts and proportions and continuous variables as mean and standard deviation. CHIKUNGUNYA: Chikungunya (CHIK) fever is a viral disease characterised by a sudden fever accompanied by skin rashes and joint pain, followed by persistent rheumatic symptoms. We have only taken into account the eight published case and control studies for the purpose of discussion for this paper, in spite of the comments published point out their limitations, such as: lack of precision in the clinical and differential diagnoses, flaws in the methodological design, biases and statistical limitations. Writing – review & editing, * E-mail: igrijalvao@yahoo.com, israelgrijalva1@gmail.com, Affiliation 03038505001, Roche Diagnostic, Basel, Switzerland) following the manufacturer's recommendations. Investigation, Le chikungunya, la dengue et le zika sont des maladies à transmission vectorielle. The most common symptoms of Zika are. Symptoms of chikungunya disease are similar to those of dengue and Zika, two other diseases spread by … PLoS Negl Trop Dis 14(12): The uniplex RT-qPCR assays to detect DENV were performed with the QuantiTect Probe RT-PCR Kit (Cat. En France métropolitaine, le moustique vecteur est l'Aedes albopictus (moustique tigre). Quel est le risque de voir ce virus se répandre en France métropolitaine ? Biovecblok is a spin-off of Camerino University involved in the development of new and biological tools for insects’ vector population control. No, Is the Subject Area "Arboviruses" applicable to this article? Mechanical ventilation was required in 17 of all the GBS patients (17%), of which three were ZIKV+ (3/8, 42.9%) and fourteen ZIKV- (14/89, 15.73%) with no statistical significance. Hospital General de Zona No. No, Is the Subject Area "Dengue virus" applicable to this article? Distribution of symptoms by patients with Zika, dengue, and chikungunya virus infections in the Guna Yala region of Panama, November 27, 2015–January 22, 2016; epidemiologic curve for the outbreak of Zika virus infection in this region; and maximum-likelihood tree of the Zika virus isolated during the outbreak. Several neurological manifestations, including Guillain-Barré syndrome (GBS), are associated with ZIKV, DENV or CHIKV [3–5]. Fritzell C, Rousset D, Adde A, Kazanji M, Van Kerkhove MD, Flamand C. Current challenges and implications for Dengue, chikungunya and Zika seroprevalence studies worldwide: A scoping review. The CHIKV+ case came from Nuevo León. presence of RNA from Zika, Dengue and Chikungunya viruses in symptomatic patients from Rondonia, where the epidemiological profile is still little known, by one-step real-time RT-PCR. Dengue (38–39), Zika (69) y Chikungunya (47). Roles The recent emergence and re-emergence of viral infections transmitted by vectors—Zika, chikungunya, dengue, Japanese encephalitis, West Nile, yellow fever and others—is a cause for international concern. By contrast, it was more common in the present work (42.9%). Because these three arboviruses coexist in Mexico, the frequency and severity of GBS could theoretically increase. Supervision, Affiliation The most common symptoms are fever and joint pain. Conceptualization, Many people infected with Zika virus won’t have symptoms or will only have mild symptoms. Writing – review & editing, Affiliation Despite significant differences between positive ZIKV cases and controls, the lower endpoint of the confidence interval is < 1; consequently, we were unable to demonstrate an association between ZIKV acute infection and GBS. Forty electrophysiological studies were conducted, of which four were ZIKV+ cases (three of the axonal type, acute motor-sensory axonal neuropathy [AMSAN] subtype, and one of the axonal type, acute inflammatory demyelinating polyneuropathy [AIDP] subtype); thirty-six were ZIKV- cases: 28 of the axonal type (15 AMSAN and 13 acute motor axonal neuropathy [AMAN] subtypes), and eight of the demyelinating type (AIDP subtype). 1 Je consulte un médecin en cas de symptômes Je reste vigilant 2 ’évite de me faire piquer par un moustique Si je suis contaminé, j’évite alors de me faire piquer. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Positive ZIKV RT-qPCR or positive ZIKV IgM and positive DENV RT-qPCR or positive DENV IgM and positive CHIKV RT-qPCR or positive CHIKV IgM results: laboratory evidence of arbovirus infection. Investigation, Competing interests: The authors have declared that no competing interest exist. Differentiating Between Malaria, Dengue, and Chikungunya Understand that the diseases are … 11. Although patients and interviewers did not take into account whether the recruited cases had presented prior infections related to any of the arboviruses, the interviews to identify prior diseases or symptomatology—of which individuals might be unaware—could be considered as another limitation of the study. The selection of controls with no fever might have generated an overestimation of the exposure (ZIKV and DENV) in cases and an underestimation in controls. Most patients feel better within a week. Yes Most of the infections remain asymptomatic (approximately 80%); Skin maculopapular rash (often appears in the first days of symptoms starting on the face and then spreading throughout the body), Mild joint pain ( this symptom can persist for one month, in some rare cases), Red eyes (non purulent conjunctivitis/conjunctival hyperaemia), Swelling (notably of the legs and small joints of the hands and feet), Gastro-intestinal signs (such as vomit and diarrhea), Pain behind the eyes (retro-orbital pain). Serum, whole blood or CSF: PCR can detect Zika, chikungunya, and dengue viruses. Le moustique Aedes albopictus est un moustique d'origine tropicale, également appelé moustique tigre. [25] in other populations (Colombia, Brazil, and New Caledonia, respectively). Supervision, Roles Patients with GBS and control subjects from nine States of Mexico were included. Other signs and symptoms may include headache, red eyes (conjunctivitis) and a general feeling of discomfort. Hence the virus can cause acute, subacute or chronic disease. Suspected case symptoms of ZIKV before the development of GBS in ZIKV+ cases, such as rash, fever and conjunctival hyperemia, were more frequent and significantly different than controls. Signs and symptoms suggestive of Zika virus infection may include a combination of the following: 1. rash 2. itching or pruritus 3. fever 4. headache 5. arthralgia or arthritis 6. myalgia 7. https://doi.org/10.1371/journal.pntd.0008032.t001. Le chikungunya, la dengue et le zika sont des maladies à transmission vectorielle. Mosquito populations exist throughout Texas, and some species are known to be disease vectors (carriers). Central Laboratory of Epidemiology, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico, Roles Some recent studies have also reported this association: Salinas et al. Supervision, Affiliation The joint pain is often very debilitating, but usually lasts for a few days or may be prolonged to weeks. Viral RNA extraction from serum and urine samples was carried out using the QIAmp Viral RNA Mini Kit (Cat. Le moustique n’est pas, en lui-même, porteur du virus de la dengue, du chikungunya ou du Zika. A case-control study was conducted (2016/07/01-2018/06/30) in Instituto Mexicano del Seguro Social (Mexican Social Security Institute) hospitals, using serum and urine samples that were collected to determine exposure to ZIKV, DENV, CHIKV by RT-qPCR and serology (IgM). Cases of GBS associated with ZIKV demonstrated a greater impairment of functional status and a higher percentage of mechanical ventilation. 01PE20/01PE21, Panbio Diagnostics, Korea) and following the indications of the manufacturer. Data Availability: All relevant data are within the manuscript and its Supporting Information files. En tant que professionnel de santé, vous trouverez ici toutes les informations et documents utiles pour … There is no commercial vaccine or specific antiviral drug treatment for dengue, chikungunya or zika virus infection. The present study results show an association between GBS and ZIKV, as well as between GBS and ZIKV/DENV, both flaviviruses, supported by laboratory analysis. Cases with co-infection were not found. The symptoms of these three mosquito-borne diseases are very similar, which makes the diagnosis more difficult. … A case-control study was conducted to identify the role of ZIKV, DENV and CHIKV infection in the development of GBS in Mexico, from July 1, 2016, to June 30, 2018. Positive CHIKV and negative ZIKV and DENV results: acute CHIKV infection. Individuals were invited to participate in the study and were given informed consent forms. On the one hand, the pre-existing immunity to DENV could strengthen ZIKV infection (both flaviviruses) by increasing the severity of the disease or co-infections [6,7,12,13]. Controls were matched by age, gender and place of residence. Medical Research Unit for Neurological Diseases, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico, Roles Recently, these viruses have produced major epidemics in tropical climate urban centers, and have been associated with neurological manifestations, including Guillain-Barre syndrome (GBS), which causes muscle weakness, unstable gait, and decreased or absent musculoskeletal reflexes. On the other hand, due to their coexistence and interactions, a probability of predominance of any of the three arboviruses exists—since the Mexican population had not been exposed to ZIKV earlier. EI2668-9601M, Euroimmun AG, Lübeck, Germany), as well as Panbio Dengue IgM Capture ELISA (Cat. 5 The joint pain associated with chikungunya can be very severe; duration can vary from few days to years, resulting in an acute, subacute or chronic disease. En France métropolitaine, le moustique vecteur est l'Aedes albopictus (moustique tigre). There is currently no vaccine to prevent or medicine to treat chikungunya virus. Project administration, To determine the association of GBS and viral infection diagnosis through laboratory and symptomatology before admission, we calculated the odds ratio (OR) and 95% confidence intervals (95%CI) using a 2x2 contingency table. 2017 Dec 5;14(12):1516. doi: 10.3390/ijerph14121516. For two years, ninety-seven cases and 184 control subjects fulfilled selection criteria and were recruited (87 cases with two controls and 10 cases with one control). Four of five people who get Zika virus won’t even know they are sick Common symptoms of Zika include: fever, rash, joint pain, red eyes, muscle pain, headache The grant was obtained by IG. For categorical variables, Pearson’s χ2, or Fisher exact tests were used, and the Mann-Whitney U test was used for continuous variables. Le chikungunya se caractérise par l'apparition brutale de fièvre souvent accompagnée d'arthralgie. Psychological Distress and Zika, Dengue and Chikungunya Symptoms Following the 2016 Earthquake in Bahía de Caráquez, Ecuador Int J Environ Res Public Health. The association of GBS with ZIKV acute infection (OR, 8.04; 95% CI, 0.89–73.01, p = 0.047), as well as laboratory evidence of ZIKV infection (OR, 16.45; 95% CI, 2.03–133.56; p = 0.001) or Flavivirus (ZIKV and DENV) infection (OR, 6.35; 95% CI, 1.99–20.28; p = 0.001) was observed. [24] and Simon et al. le chikungunya, la dengue ou le zika. 204445, Qiagen, Hilden, Germany), and the amplification of RT-PCR was performed with Superscript III Platinum One-Step reagents RT-qPCR System (Cat. This study aims to investigate the association between these viral infections and GBS. Biting female mosquitoes transmit many infectious agents that cause diseases such as encephalitis, malaria, dengue, chikungunya, Zika virus, and yellow fever. Similar to previous studies, the present report also demonstrated that GBS cases associated with ZIKV showed a more severe clinical picture [12,13], which should be considered for the treatment of these patients in countries where previous ZIKV infection could lead to this neurological disease. It was only after the outbreak of Chikungunya in Makonde Plateau, along the border between Mozambique and Tanganyika (Tanzania) that it was identified as a separate disease. No, Is the Subject Area "Arboviral infections" applicable to this article? Ninety-seven GBS cases and 184 controls were included. The incubation period ranges from 3 to 14 days after the bite of an infected mosquito, with an average of 4 to 7 days; In the severe cases of the disease, the symptoms may include: Sometimes, symptoms are mild and can be mistaken for those of the flu or another viral infection. Moreover, the previous infection by ZIKV was also considered through the combination of positive results with IgM and IgG anti ZIKV, along with the neutralising response against ZIKV, described by Cao-Lomeau et al. Most people infected with the Zika virus have no signs and symptoms, while others report mild fever, rash and muscle pain. Symptoms of infection with the Zika virus in Brazil may be masked by simultaneous infection with other mosquito-spread viruses common in the same region — such as dengue fever and chikungunya viruses — pointing to the need for comprehensive testing, according to a study led by a UCSF expert in DNA-based diagnostics in collaboration with Brazilian researchers. Project administration, Dengue and Chikungunya are viral diseases with very similar symptoms. Chikungunya virus was first isolated by RW Ross in 1953. Funding acquisition, Yes Even if you get dengue once, you can get it again. Symptoms may include: Symptoms can appear two to 15 days after being bitten by an infected mosquito. Zika is usually mild with symptoms lasting for several days to a week. Positive DENV and negative ZIKV and CHIKV results: acute DENV infection. No association between GBS and CHIKV infection was found, nor were co-infections demonstrated among these three viruses. Formal analysis, Yes On the other hand, GBS cases associated with ZIKV showed a more severe clinical picture (more significant impairment of functional status and incapacity, and higher percentage of mechanical ventilation). Moreover, higher severity of GBS is associated with ZIKV and co-infections were not demonstrated among these three viruses. Both has patient symptoms such as high fe… A case and control study was conducted nationwide, including 97 cases of GBS and 184 controls matched by age, gender, and locality, but not the disease.
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