1680. Guillain Barré Syndrome in Arbovirus Outbreak in Veracruz, Mexico: The Follow-up to 3 Years of the Pandemic

Abstract

Background. From the arrival of Zika to America in 2015, and the increase in cases of Guillain sweeten in South America apparently associated with acute viral infection , Mexico had its first contact in 2016, with an increase in the incidence of cases of the syndrome, initiating a protocol study to look for the causal association of the Zika virus syndrome Methods. We conducted a descriptive, prospective, and longitudinal study in Veracruz, Mexico, where follow-up of cases of Guillain Barre Syndrome (GBS) occurred during 2016 to 2018. The central point of the study is to look for the etio-logical association of GBS with the presence of acute zika infection. Secondarily, other know neutropic agents, both viral and bacterial were searched. The diagnosis techniques used were PCR-RT (blood and urine) and IgM/IgG for Zika; serum PCR-RT and IgM/IgG for Dengue and Chikungunya; IgM/IgG for TORCH; PCR-RT in CSF for Herpes and Enterovirus; serological panel of Hepatitis B and C; PCR-RT in rectal swab for Campylobacter. Results. A cohort of 39 patients has been formed over 3 years of study. 38 patients met the operational definition of a suspected case of Zika, of which only 2 cases were identified by PCR-RT in urine; During the search protocol for infectious agents, others were identified such as: Dengue, Chikungunya, Enterovirus, Herpes and Hepatitis B; however, the identification of Campylobacter was even more remarkable, also highlighting that only four patients had diarrhea. Regarding the treatment, 37 patients received IVIG, 1 patient received plasma-pheresis and 1 patient received both. The prognosis was good in 34 patients (basal Hugues from 4-5 to 2), 5 had poor functional prognosis and died. Conclusion. The incidence of Zika as a cause of GBS is relatively low (5%), so the etiological association could not be demonstrated; other neurotropic viral agents were identified, however the presence of Campylobacter cases was more notable (asymp-tomatic campylobacteriosis).