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Zika Linked to Second Neurological Disorder as NIAID Predicts Local Outbreaks

APR 18, 2016 | SARAH ANWAR
According to the National Institutes of Health (NIH), the first case of locally transmitted Zika virus infection in the continental United States is now inevitable. The virus already brings with it fears for pregnant women, and those women trying to become pregnant, but now, a Zika virus infection is likely a risk for all adults as the virus has been linked to yet another neurological disorder.

Anthony Fauci, MD, director of the United States National Institute of Allergy and Infectious Diseases (NIAID) of the NIH confirmed on April 17, 2016 that the continental US might face a “local outbreak” of the Zika virus. Transferred through the bite of an Aedes aegypti mosquito, or through several forms of sexual contact, the Zika virus has been confirmed by the Centers for Disease Control and Prevention (CDC) to be a likely cause of microcephaly and other birth defects. Although there are Ae. aegypti mosquito populations within 30 US states, Dr. Fauci believes that it is likely that the US will only experience a couple dozen of cases at most.

Researchers are finding out, however, that Zika is not only dangerous to pregnant women and their fetuses. The virus has already been associated with several cases of Guillain-Barré Syndrome (GBS), and now, a small study, which will be presented at the American Academy of Neurology’s 68th Annual Meeting in Vancouver, Canada this week, has linked the Zika virus to a second neurological disorder.

Maria Lucia Brito Ferreira, MD, and colleagues, working with Restoration Hospital in Recife, Brazil, analyzed all cases admitted to the hospital between December 2014 and June 2015 which presented with symptoms associated with an arbovirus (such as Zika, Dengue, or Chikungunya). Dr. Ferreira and colleagues identified 6 cases in which the individual developed neurological symptoms after being admitted to the hospital. All of the cases initially presented with fever and then a rash, and some developed neurological symptoms immediately, while others developed symptoms up to 15 days after admittance.

Tests for the 6 cases revealed that all of the patients had Zika virus infection.

Four of the 6 patients developed GBS, while the remaining two developed acute disseminated encephalomyelitis (ADEM), an autoimmune disorder which, according to the National Institute of Neurological Disorders and Stroke, causes an “attack of inflammation in the brain and spinal cord that damages myelin.” The disorder is sometimes misdiagnosed as severe multiple sclerosis (MS), but differs from MS in that most patients experience only one attack. Likewise, MS rarely affects children, whereas ADEM is more likely to be seen in children than in adults. ADEM usually develops after a viral or bacterial infection, and attacks white matter which may cause visual loss in one or both eyes, weakness to the point of paralysis, and difficulty with motor functions. Most ADEM patients recover within 6 months, however, some patients may develop mild to moderate lifelong cognitive impairments, weakness, blindness or even numbness. 

Five of the patients left the hospital with motor functioning difficulties, while one had vision problems and another had memory and cognitive problems.

Dr. Ferreira stated, “This doesn’t mean that all people infected with Zika will experience these brain problems. Of those who have nervous system problems, most do not have brain symptoms. However, our study may shed light on possible lingering effects the virus may be associated with in the brain.” 
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