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Guillain-barre in pregnancy

Luis D Pacheco, Antonio F Saad, Gary D V Hankins, Giuseppe Chiosi, George Saade
Guillain-Barré syndrome has been reported in pregnancy and is a potentially lethal condition. It affects the nervous system with acute onset of symmetric ascending weakness and may result in frank respiratory failure and autonomic dysfunction. Most patients recall symptoms of a respiratory or gastrointestinal illness in the weeks preceding the onset of weakness. Recent evidence suggests a potential role of the Zika virus as a trigger for the syndrome. The diagnosis of Guillain-Barré is clinical. Supportive measures include venous thromboembolism prophylaxis, aggressive physical therapy, pressure ulcer prevention, enteral nutrition, and respiratory support...
October 6, 2016: Obstetrics and Gynecology
Alyson B Goodman, Eric J Dziuban, Krista Powell, Rebecca H Bitsko, Gayle Langley, Nicole Lindsey, Jessica L Franks, Kate Russell, Sharoda Dasgupta, Wanda D Barfield, Erika Odom, Emily Kahn, Stacey Martin, Marc Fischer, J Erin Staples
Zika virus is an emerging mosquito-borne flavivirus that typically causes an asymptomatic infection or mild illness, although infection during pregnancy is a cause of microcephaly and other serious brain abnormalities. Guillain-Barré syndrome and other neurologic complications can occur in adults after Zika virus infection. However, there are few published reports describing postnatally acquired Zika virus disease among children. During January 2015-July 2016, a total of 158 cases of confirmed or probable postnatally acquired Zika virus disease among children aged <18 years were reported to CDC from U...
October 7, 2016: MMWR. Morbidity and Mortality Weekly Report
Stephanie Mlacker, Golsa Shafa, Adam S Aldahan, Vidhi V Shah, Sahal Samarkandy, Keyvan Nouri
BACKGROUND: Zika virus (ZIKV) is an arbovirus within the Flaviviridae family, the recent spread of which has promoted public concern. METHODS: This study outlines the clinical features, potential for teratogenicity, diagnosis, and treatment of ZIKV infection. RESULTS: Zika virus is transmitted through the bite of an infected Stegomyia (= Aedes) mosquito, blood transfusion, sexual intercourse, and perinatal routes. Infection has been characterized as mildly symptomatic...
September 21, 2016: International Journal of Dermatology
William L Walker, Nicole P Lindsey, Jennifer A Lehman, Elisabeth R Krow-Lucal, Ingrid B Rabe, Susan L Hills, Stacey W Martin, Marc Fischer, J Erin Staples
Zika virus is a mosquito-borne flavivirus primarily transmitted to humans by Aedes aegypti mosquitoes (1). Zika virus infections have also been documented through intrauterine transmission resulting in congenital infection; intrapartum transmission from a viremic mother to her newborn; sexual transmission; blood transfusion; and laboratory exposure (1-5). Most Zika virus infections are asymptomatic (1,6). Clinical illness, when it occurs, is generally mild and characterized by acute onset of fever, maculopapular rash, arthralgia, or nonpurulent conjunctivitis...
September 16, 2016: MMWR. Morbidity and Mortality Weekly Report
David A Schirmer, Jennifer Fay Kawwass
Over the past year, the Zika virus, an arthropod-borne Flavivirus, has transitioned from a relatively unknown tropical disease to the cause of a public health emergency. The Zika virus is transmitted by the Aedes species of mosquito as well as by sexual intercourse. Although the symptoms of acute Zika virus infection are usually mild and self-limited, it causes fetal microcephaly in pregnant women, and is associated with an increased risk of Guillain-Barré syndrome. The risk of microcephaly from Zika virus infection is estimated to be highest in women who are infected during the first trimester of pregnancy...
September 2016: Seminars in Reproductive Medicine
Laura Adams, Melissa Bello-Pagan, Matthew Lozier, Kyle R Ryff, Carla Espinet, Jomil Torres, Janice Perez-Padilla, Mitchelle Flores Febo, Emilio Dirlikov, Alma Martinez, Jorge Munoz-Jordan, Myriam Garcia, Marangely Olivero Segarra, Graciela Malave, Aidsa Rivera, Carrie Shapiro-Mendoza, Asher Rosinger, Matthew J Kuehnert, Koo-Whang Chung, Lisa L Pate, Angela Harris, Ryan R Hemme, Audrey Lenhart, Gustavo Aquino, Sherif Zaki, Jennifer S Read, Stephen H Waterman, Luisa I Alvarado, Francisco Alvarado-Ramy, Miguel Valencia-Prado, Dana Thomas, Tyler M Sharp, Brenda Rivera-Garcia
Zika virus is a flavivirus transmitted primarily by Aedes aegypti and Aedes albopictus mosquitoes, and infection can be asymptomatic or result in an acute febrile illness with rash (1). Zika virus infection during pregnancy is a cause of microcephaly and other severe birth defects (2). Infection has also been associated with Guillain-Barré syndrome (GBS) (3) and severe thrombocytopenia (4,5). In December 2015, the Puerto Rico Department of Health (PRDH) reported the first locally acquired case of Zika virus infection...
2016: MMWR. Morbidity and Mortality Weekly Report
Ana Cristina Simões E Silva, Janaina Matos Moreira, Roberta Maia Castro Romanelli, Antonio Lucio Teixeira
Before 2007, Zika virus (ZIKV) was generally considered as an arbovirus of low clinical relevance, causing a mild self-limiting febrile illness in tropical Africa and Southeast Asia. Currently, a large, ongoing outbreak of ZIKV that started in Brazil in 2015 is spreading across the Americas. Virus infection during pregnancy has been potentially linked to congenital malformations, including microcephaly. In addition to congenital malformations, a temporal association between ZIKV infection and an increase in cases of Guillain-Barré syndrome is currently being observed in several countries...
2016: Neuropsychiatric Disease and Treatment
Indira U Mysorekar, Michael S Diamond
No abstract text is available yet for this article.
August 4, 2016: New England Journal of Medicine
Anthony R Mawson
A strong causal association has become evident between Zika virus (ZIKV) infection during pregnancy and the occurrence of fetal growth restriction, microcephaly and eye defects. Circumstantial evidence is presented in this paper in support of the hypothesis that these effects, as well as the Guillain-Barré syndrome, are due to an endogenous form of hypervitaminosis A resulting from ZIKV infection-induced damage to the liver and the spillage of stored vitamin A compounds ("retinoids") into the maternal and fetal circulation in toxic concentrations...
2016: BioResearch Open Access
Zubia Jamil, Yasir Waheed, Taimoor Zeb Durrani
The current Zika outbreak is largest of its kind with 1.4 million cases in Brazil alone. World Health Organization declared the current outbreak as the public health emergency of international concerns. The major route of Zika virus transmission is mosquito bites. Sexual transmission and monkey bites are also observed in few cases. There is dire need to evaluate the other routes of transmission like blood transfusion, lactation and contact with body fluids. Zika virus is infecting infants, not only causing microcephaly but also creating number of complications resulting in bad outcomes of pregnancy...
July 2016: Asian Pacific Journal of Tropical Medicine
Dawn M Dudley, Matthew T Aliota, Emma L Mohr, Andrea M Weiler, Gabrielle Lehrer-Brey, Kim L Weisgrau, Mariel S Mohns, Meghan E Breitbach, Mustafa N Rasheed, Christina M Newman, Dane D Gellerup, Louise H Moncla, Jennifer Post, Nancy Schultz-Darken, Michele L Schotzko, Jennifer M Hayes, Josh A Eudailey, M Anthony Moody, Sallie R Permar, Shelby L O'Connor, Eva G Rakasz, Heather A Simmons, Saverio Capuano, Thaddeus G Golos, Jorge E Osorio, Thomas C Friedrich, David H O'Connor
Infection with Asian-lineage Zika virus (ZIKV) has been associated with Guillain-Barré syndrome and fetal abnormalities, but the underlying mechanisms remain poorly understood. Animal models of infection are thus urgently needed. Here we show that rhesus macaques are susceptible to infection by an Asian-lineage ZIKV closely related to strains currently circulating in the Americas. Following subcutaneous inoculation, ZIKV RNA is detected in plasma 1 day post infection (d.p.i.) in all animals (N=8, including 2 pregnant animals), and is also present in saliva, urine and cerebrospinal fluid...
June 28, 2016: Nature Communications
Christopher T Lee, Neil M Vora, Waheed Bajwa, Lorraine Boyd, Scott Harper, Daniel Kass, Aileen Langston, Emily McGibbon, Mario Merlino, Jennifer L Rakeman, Marisa Raphael, Sally Slavinski, Anthony Tran, Ricky Wong, Jay K Varma
Zika virus has rapidly spread through the World Health Organization's Region of the Americas since being identified in Brazil in early 2015. Transmitted primarily through the bite of infected Aedes species mosquitoes, Zika virus infection during pregnancy can cause spontaneous abortion and birth defects, including microcephaly (1,2). New York City (NYC) is home to a large number of persons who travel frequently to areas with active Zika virus transmission, including immigrants from these areas. In November 2015, the NYC Department of Health and Mental Hygiene (DOHMH) began developing and implementing plans for managing Zika virus and on February 1, 2016, activated its Incident Command System...
2016: MMWR. Morbidity and Mortality Weekly Report
Nitwara Wikan, Duncan R Smith
Zika virus was originally identified in a sentinel rhesus monkey in the Zika Forest of Uganda in 1947. The virus is a member of the family Flaviviridae, genus Flavivirus, and is transmitted to humans by Aedes species mosquitoes. The first report of Zika virus outside Africa and Asia was in 2007 when the virus was associated with a small outbreak in Yap State, part of the Federated States of Micronesia. Since then, Zika virus infections have been reported around the world, including in southeast Asia; French Polynesia and other islands in the Pacific Ocean; and parts of South, Central, and North America...
July 2016: Lancet Infectious Diseases
Rina Tilak, Sougat Ray, V W Tilak, Sandip Mukherji
Zika virus (ZIKV), a relative newcomer from the flavivirus group that includes dengue, Japanese encepahalitis and yellow fever, is one of the emerging pathogens that is fast transcending geographical boundaries. It is a vector-borne disease transmitted by the same Aedes aegypti and Aedes albopictus, which cause dengue and chikungunya. In addition to the vector-mediated transmission of Zika fever, probable human-to-human transmission through exchange of body fluids, including sexual and perinatal transmission and through blood transfusion, makes containment of this new entity more challenging...
April 2016: Medical Journal, Armed Forces India
Jorge A Alfaro-Murillo, Alyssa S Parpia, Meagan C Fitzpatrick, Jules A Tamagnan, Jan Medlock, Martial L Ndeffo-Mbah, Durland Fish, María L Ávila-Agüero, Rodrigo Marín, Albert I Ko, Alison P Galvani
BACKGROUND: As Zika virus continues to spread, decisions regarding resource allocations to control the outbreak underscore the need for a tool to weigh policies according to their cost and the health burden they could avert. For example, to combat the current Zika outbreak the US President requested the allocation of $1.8 billion from Congress in February 2016. METHODOLOGY/PRINCIPAL FINDINGS: Illustrated through an interactive tool, we evaluated how the number of Zika cases averted, the period during pregnancy in which Zika infection poses a risk of microcephaly, and probabilities of microcephaly and Guillain-Barré Syndrome (GBS) impact the cost at which an intervention is cost-effective...
May 2016: PLoS Neglected Tropical Diseases
Lucas Secchim Ribeiro, Rafael Elias Marques, Amélia Maria Ribeiro de Jesus, Roque Pacheco de Almeida, Mauro Martins Teixeira
Infection with the Zika virus (ZIKV) usually causes a mild acute illness, but two major severe syndromes have been described during the epidemic in Brazil: microcephaly and the Guillain-Barré Syndrome. There is now much evidence to show that ZIKV can infect and damage neuronal cells in vitro. In experimental animals, ZIKV has significant neurotropism and can cause brain damage. At present, diagnosis is still a challenge in the field and there is no treatment available. Another major challenge is that one must devise therapies for pregnant women, at all stages of pregnancy...
June 2016: Current Opinion in Virology
Emilio Dirlikov, Kyle R Ryff, Jomil Torres-Aponte, Dana L Thomas, Janice Perez-Padilla, Jorge Munoz-Jordan, Elba V Caraballo, Myriam Garcia, Marangely Olivero Segarra, Graciela Malave, Regina M Simeone, Carrie K Shapiro-Mendoza, Lourdes Romero Reyes, Francisco Alvarado-Ramy, Angela F Harris, Aidsa Rivera, Chelsea G Major, Marrielle Mayshack, Luisa I Alvarado, Audrey Lenhart, Miguel Valencia-Prado, Steve Waterman, Tyler M Sharp, Brenda Rivera-Garcia
Zika virus is a flavivirus transmitted primarily by Aedes species mosquitoes, and symptoms of infection can include rash, fever, arthralgia, and conjunctivitis (1).* Zika virus infection during pregnancy is a cause of microcephaly and other severe brain defects (2). Infection has also been associated with Guillain-Barré syndrome (3). In December 2015, Puerto Rico became the first U.S. jurisdiction to report local transmission of Zika virus, with the index patient reporting symptom onset on November 23, 2015 (4)...
2016: MMWR. Morbidity and Mortality Weekly Report
Aaron C Brault, Richard A Bowen
No abstract text is available yet for this article.
June 1, 2016: American Journal of Tropical Medicine and Hygiene
Sara Salinas, Vincent Foulongne, Fabien Loustalot, Chantal Fournier-Wirth, Jean-Pierre Molès, Laurence Briant, Nicolas Nagot, Philippe Van de Perre, Yannick Simonin
Zika virus, discovered in 1947, is particularly publicized because of its involvement in a major epidemic that began in 2015 and which epicenter is located in Latin America, mainly in Brazil. In the majority of cases (70-80 %) the infection is asymptomatic, however in some patients, moderate fever, skin rash, conjunctivitis and myalgia may occur. More alarming, neurological complications are reported, in particular cases of microcephaly probably resulting from the infection of women in the first or second trimester of pregnancy...
April 2016: Médecine Sciences: M/S
Julien Lupo, Raphaële Germi, Dominique Jean, Monique Baccard-Longère, Olivier Casez, Gérard Besson, Alain Rougé, Jean Boutonnat, Carole Schwebel, Pascale Hoffmann, Patrice Morand
Guillain-Barré syndrome (GBS) is an immune-mediated disorder which can be triggered by cytomegalovirus (CMV) infection. GBS following CMV primary infection is a rare event during pregnancy, which raises the question of maternal and fetal management. We describe an unusual case of GBS after CMV primary infection in a pregnant woman. The mother was successfully treated with standard immunoglobulins but in utero fetal death caused by CMV congenital infection unfortunately occurred. Similar cases have rarely been reported in the literature...
June 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
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