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Guzman MG, Martinez E. Central and Peripheral Nervous System Manifestations Associated with Dengue Illness. Viruses 2024; 16:1367. [PMID: 39339843 PMCID: PMC11435791 DOI: 10.3390/v16091367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 08/09/2024] [Accepted: 08/19/2024] [Indexed: 09/30/2024] Open
Abstract
Dengue illness, caused by the dengue viruses, continues to be a major global health concern, with increasing incidence and the emergence of severe manifestations such as neurological complications. An overview of the current understanding of dengue epidemiology, clinical manifestations, and research priorities is presented here. Dengue transmission has escalated in recent years, exacerbated by factors such as vector expansion, climate change, and socioeconomic challenges. The clinical spectrum of dengue ranges from mild febrile illness to severe manifestations, including hemorrhagic fever and neurological complications. Neurological manifestations of dengue, once considered rare, are now increasingly reported, encompassing encephalitis, myelitis, and Guillain-Barré Syndrome, among others. Diagnosis primarily relies on laboratory methods such as RT/PCR, NS1 antigen detection, and serological assays. Despite advancements in understanding the dengue pathogenesis, there remains a critical need for effective vaccines, antiviral drugs, improved surveillance methods, predictive models for disease severity, and long-term studies on post-Dengue sequelae. Integrated programs and holistic approaches to dengue control are essential for mitigating its impact. Addressing these research priorities will be pivotal in combating dengue and reducing its global burden.
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Affiliation(s)
- Maria G Guzman
- Institute of Tropical Medicine "Pedro Kouri", WHO/PAHO Collaborating Center for the Study of Dengue and Its Control, Autopista Novia del Mediodia, km 6 1/2, La Lisa 17100, Cuba
| | - Eric Martinez
- Institute of Tropical Medicine "Pedro Kouri", WHO/PAHO Collaborating Center for the Study of Dengue and Its Control, Autopista Novia del Mediodia, km 6 1/2, La Lisa 17100, Cuba
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Roberts JA, Kapadia RK, Pastula DM, Thakur KT. Public health trends in neurologically relevant infections: a global perspective. Ther Adv Infect Dis 2024; 11:20499361241274206. [PMID: 39301451 PMCID: PMC11412215 DOI: 10.1177/20499361241274206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 07/16/2024] [Indexed: 09/22/2024] Open
Abstract
Neuroinfectious diseases represent a growing threat to public health globally. Infections of the central nervous system remain challenging to diagnose and treat, partially driven by the fact that a high proportion of emerging pathogens are capable of causing neurological disease. Many of the trends driving the emergence of novel pathogens, including climate change, ecological degradation, urbanization, and global travel, have accelerated in recent years. These circumstances raise concern for the potential emergence of additional pathogens of pandemic potential in the coming years, necessitating a stronger understanding of the forces that give rise to the emergence and spread of neuroinvasive pathogens and a commitment to public health infrastructure to identify and treat these diseases. In this review, we discuss the clinical and epidemiological features of three types of emerging neuroinvasive pathogens of significant public health consequences that are emblematic of key ongoing trends in global health. We first discuss dengue viruses in the context of climate change, considering the environmental factors that allow for the expansion of the geographic range and seasonal population of the viruses' vector. We then review the rising prevalence of fungal meningitis secondary to medical tourism, a trend representative of the highly globalized nature of modern healthcare. Lastly, we discuss the increasing prevalence of antibiotic-resistant neurological infections driven by the intersection of antibiotic overuse in medical and agricultural settings. Taken together, the rising prevalence of these conditions necessitates a recommitment to investment in public health infrastructure focused on local and global infectious disease surveillance coupled with ongoing development of novel therapeutics and vaccines for emerging pathogens. Such emerging threats also obviate the need to address the root causes driving the emergence of novel infectious diseases, including a sustained effort to address anthropogenic climate change and environmental degradation.
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Affiliation(s)
- Jackson A Roberts
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Ronak K Kapadia
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Daniel M Pastula
- Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, USA
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Kiran T Thakur
- Program in Neuroinfectious Diseases, Division of Critical Care and Hospitalist Neurology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
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Leonhard SE, Tan CY, van der Eijk AA, Reisin RR, Franken SC, Huizinga R, Arends S, Batstra MR, Bezerra Jeronimo SM, Drenthen J, de Koning L, Leon Cejas L, Marchesoni C, Marques W, Shahrizaila N, Casas DF, Sotelo A, Tillard B, Dourado ME, Jacobs BC. Antecedent infections in Guillain-Barré syndrome in endemic areas of arbovirus transmission: A multinational case-control study. J Peripher Nerv Syst 2021; 26:449-460. [PMID: 34549484 PMCID: PMC9291970 DOI: 10.1111/jns.12469] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/15/2021] [Accepted: 09/15/2021] [Indexed: 11/28/2022]
Abstract
Half of the world's population is at risk of arthropod‐borne virus (arbovirus) infections. Several arbovirus infections have been associated with Guillain‐Barré syndrome (GBS). We investigated whether arboviruses are driving GBS beyond epidemic phases of transmission and studied the antibody response to glycolipids. The protocol of the International Guillain‐Barré syndrome Outcome Study (IGOS), an observational prospective cohort study, was adapted to a case‐control design. Serum samples were tested for a recent infection with Zika virus (ZIKV), dengue virus (DENV), chikungunya (CHIKV) virus, hepatitis E virus, Epstein‐Barr virus (EBV), cytomegalovirus (CMV), Campylobacter jejuni, and Mycoplasma pneumoniae, and for antibodies to glycolipids. Forty‐nine patients were included from Brazil (63%), Argentina (14%), and Malaysia (22%). Evidence of a recent infection was found in 27/49 (55%) patients: C jejuni (n = 15, 31%), M pneumoniae (n = 5, 10%), CHIKV (n = 2, 4%), EBV (n = 1, 2%), C jejuni and M pneumoniae (n = 2, 4%), CMV and DENV (n = 1, 2%), and C jejuni and DENV (n = 1, 2%). In 22 patients, 35 paired controls were collected. Odds ratio for recent infections did not significantly differ between cases and controls. No typical anti‐ganglioside antibody binding was associated with recent arbovirus infection. We conclude that arbovirus infections occur in GBS patients outside of epidemic viral transmission, although not significantly more than in controls. Broad infection and anti‐ganglioside antibody serology are important to establish the most likely pathogenic trigger in GBS patients. Larger studies are necessary to determine the association between arboviruses and GBS.
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Affiliation(s)
- Sonja E Leonhard
- Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Cheng Yin Tan
- Department of Medicine, University of Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Annemiek A van der Eijk
- Department of Viroscience, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Ricardo R Reisin
- Department of Neurology, Hospital Británico, Buenos Aires, Argentina
| | - Suzanne C Franken
- Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Ruth Huizinga
- Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Samuel Arends
- Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Manou R Batstra
- Department RH-MDC - Immunology, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Selma M Bezerra Jeronimo
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Judith Drenthen
- Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Laura de Koning
- Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Cintia Marchesoni
- Department of Neurology, Hospital Británico, Buenos Aires, Argentina
| | - Wilson Marques
- Department of Neurology, Hospital das Clinicas da Faculdade de Medicina, Ribeirão Preto, Brazil
| | - Nortina Shahrizaila
- Department of Medicine, University of Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Dardo F Casas
- Department of Neurology, Hospital Dr Enrique Vera Barros, La Rioja, Argentina
| | - Andrea Sotelo
- Department of Neurology, Sanatorio Adventista del Plata, Entre Rios, Argentina
| | - Belen Tillard
- Department of Neurology, Sanatorio Los Arcos, Buenos Aires, Argentina
| | | | - Bart C Jacobs
- Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Lima MEDS, Bachur TPR, Aragão GF. Guillain-Barre syndrome and its correlation with dengue, Zika and chikungunya viruses infection based on a literature review of reported cases in Brazil. Acta Trop 2019; 197:105064. [PMID: 31220435 DOI: 10.1016/j.actatropica.2019.105064] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/12/2019] [Accepted: 06/16/2019] [Indexed: 01/27/2023]
Abstract
Guillain-Barre syndrome (GBS) is one of the main neurologic manifestations of arboviruses, especially Zika virus infection. As known, the prevalence of these diseases is high, so the risk of having an increase on GBS is relevant. The study purposes making a comparative survey between the involvement of dengue, Zika and chikungunya infections in the development of the GBS in Brazil, as well as search in literature resemblances and distinctions between beforehand reported cases. It was performed an electronic search in online databases, with articles published between the years of 2004-2018. A total of 729 articles about the proposed search were found, and 10 were selected according to inclusion and exclusion criteria. The medium age found in Brazilian studies was 429. The time lapse for the neurological symptoms manifest was 6,5-11 days. Facial palsy, paresthesia and member weakness were the main symptoms related. Pediatric cases are rare. There are many studies that implicated the association of GBS and arboviruses and point it to one of the main neurological manifestation of these infections. More research and consistent data are needed to clarify unanswered questions and guide public health measures.
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Zika virus outbreak in New Caledonia and Guillain-Barré syndrome: a case-control study. J Neurovirol 2018; 24:362-368. [PMID: 29594985 DOI: 10.1007/s13365-018-0621-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 01/03/2018] [Accepted: 02/12/2018] [Indexed: 12/21/2022]
Abstract
Zika virus (ZIKV) infection has been associated with neurologic disorders including Guillain-Barré syndrome (GBS). In New Caledonia during the ZIKV outbreak (2014-2015), case-control and retrospective studies have been performed to assess the link between ZIKV and GBS. Among the 15 cases included, 33% had evidence of a recent ZIKV infection compared to only 3.3% in the 30 controls involved. All patients were Melanesian, had facial diplegia and similar neurophysiological pattern consistent with acute inflammatory demyelinating polyneuropathy, and recovered well. Furthermore, during the peak of ZIKV transmission, we observed a number of GBS cases higher than the calculated upper limit, emphasizing the fact that ZIKV is now a major trigger of GBS.
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