A post I made in another thread, same topic:
Zika virus associated neurologic disease, from a posting on an Infectious Diseases bulletin board I belong to, Emerging Infections Network. There's considerably more to it than microcephaly, food for thought:
Date: Fri 11 Nov 2016 17:47
From: Sejvar, James (CDC/OID/NCEZID)
Although Zika virus, a mosquito-borne flavivirus, has been around for decades, until recently it has been associated only with sporadic cases of mild febrile illness. In 2013, however, the virus was associated with a large outbreak of Guillain-Barre syndromé (GBS) in French Polynesia. Subsequently, since 2014, it has caused explosive outbreaks of severe neurologic illness throughout Central and South America, the Caribbean, and, more recently, the continental United States. The virus has been associated with dramatically high rates of GBS, particularly in regions of Brazil, Colombia, and more recently, Puerto Rico. There is some anecdotal evidence that Zika-associated GBS may have a poorer prognosis and be associated with more severe sequelae than ‘typical’ GBS. In addition to GBS, Zika virus has been temporally associated with several other neurologic conditions, including encephalitis, myelitis, and acute disseminated encephalomyelitis (ADEM); many of these cases have had evidence of presence of Zika virus in cerebrospinal fluid (CSF). These other neurologic manifestations of Zika virus infection have largely limited to case reports or small case series; however, limited surveillance for these manifestations may be leading to an underestimation of burden of disease. Congenital abnormalities, including microcephaly, have largely dominated the discussions of neurologic sequelae associated with Zika virus, and indeed infants born with these devastating developmental abnormalities will represent a tremendous public health burden. It is important, however, to recognize GBS and these other neurologic manifestations.
In addition, unusual modes of transmission, including sexual transmission, have been recognized. The nature of the epidemic, and the possible future ramifications of this emerging virus, have yet to be fully explored. There is a great unmet need for the clinical community to focus on the neurologic implications of this virus, including epidemiology, recognized clinical features, and possible future directions for this latest emerging pathogen. Investigations conducted in Brazil, the most highly affected country, Colombia, and Puerto Rico have shed considerable light on neurologic manifestations of Zika infection. However, as more travel-associated Zika cases arrive in the United States, and the continental United States potentially witnesses ongoing local transmission, it will be important for U.S. clinicians to understand and help describe the various neurologic syndromes associated with the virus, including GBS, microcephaly, encephalitis, and acute myelitis.
James J. Sejvar, MD
Neuroepidemiologist
National Center for Emerging and Zoonotic Diseases
U.S. Centers for Disease Control and Prevention
Atlanta, GA
