Neurologic manifestations in emerging arboviral diseases in Rio de Janeiro City, Brazil, 2015-2016

Azevedo, Marina Baptista de; Coutinho, Márcia Sandre Coelho; Silva, Mônica Agostinho da; Arduini, Denise Bastos; Lima, Juliana Dias Vieira; Monteiro, Rosangela; Mendes, Bárbara Nicácio Bahia; Lemos, Maria Cristina Ferreira; Noronha, Claudio Pompeiano; Saraceni, Valéria

doi:10.1590/0037-8682-0327-2017

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Short Communication • Rev. Soc. Bras. Med. Trop. 51 (03) • May-Jun 2018 • https://doi.org/10.1590/0037-8682-0327-2017 linkcopy

Neurologic manifestations in emerging arboviral diseases in Rio de Janeiro City, Brazil, 2015-2016

Authorship SCIMAGO INSTITUTIONS RANKINGS

INTRODUCTION Dengue has affected Rio de Janeiro City since the 1980s. The sequential Zika and chikungunya virus introductions during 2015 aggravated the health scenario, with 97,241 cases of arboviral diseases reported in 2015-2016, some with neurological disorders.

METHODS Arbovirus-related neurologic cases were descriptively analyzed, including neurological syndromes and laboratory results.

RESULTS In total, 112 cases with non-congenital neurologic manifestations (Guillain-Barré syndrome, 64.3%; meningoencephalitis, 24.1%; acute demyelinating encephalomyelitis, 8%) were arbovirus-related; 43.7% were laboratory-confirmed, of which 57.1% were chikungunya-positive.

CONCLUSIONS Emerging arbovirus infections brought opportunities to study atypical, severe manifestations. Surveillance responses optimized case identification and better clinical approaches.

Keywords:
Neurologic disorder; Arbovirus; Emerging infectious disease

Age group (years)	ADEM	Meningo-encephalitis	Transverse myelitis	Optic neuritis	Guillain-Barré syndrome	Total
	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)
<10	2 (22.2)	3 (11.1)	0 (0.0)	1 (100.0)	3 (4.2)	9 (8.0)
10-19	0 (0.0)	4 (14.8)	0 (0.0)	0 (0.0)	3 (4.2)	7 (6.3)
20-29	1 (11.1)	4 (14.8)	0 (0.0)	0 (0.0)	7 (9.7)	12 (10.7)
30-39	1 (11.1)	3 (11.1)	0 (0.0)	0 (0.0)	12 (16.7)	16 (14.3)
40-49	0 (0.0)	1 (3.7)	1 (33.3)	0 (0.0)	17 (23.6)	19 (17.0)
50-59	2 (22.2)	2 (7.4)	2 (66.7)	0 (0.0)	15 (20.8)	21 (18.7)
60-69	1 (11.1)	5 (18.6)	0 (0.0)	0 (0.0)	7 (9.7)	13 (11.6)
70-79	1 (11.1)	4 (14.8)	0 (0.0)	0 (0.0)	5 (6.9)	10 (8.9)
≥80	1 (11.1)	1 (3.7)	0 (0.0)	0 (0.0)	3 (4.2)	5 (4.5)
Total	9 (100.0)	27 (100.0)	3 (100.0)	1 (100.0)	72 (100.0)	112 (100.0)

Etiology	ADEM	Meningo-encephalitis	Transverse myelitis	Optic neuritis	Guillain-Barré syndrome	Total
	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)
Chikungunya	1 (25.0)	15 (71.4)	0 (0.0)	1 (100.0)	11 (52.4)	28 (57.2)
CHIKV/dengue	0 (0.0)	1 (4.8)	1 (50.0)	0 (0.0)	1 (4.8)	3 (6.1)
Dengue	0 (0.0)	1 (4.8)	1 (50.0)	0 (0.0)	5 (23.8)	7 (14.3)
Zika	3 (75.0)	3 (14.2)	0 (0.0)	0 (0.0)	3 (14.2)	9 (18.4)
Zika/dengue	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	1 (4.8)	1 (2.0)
Zika/CHIKV	0 (0.0)	1 (4.8)	0 (0.0)	0 (0.0)	0 (0.0)	1 (2.0)
Total	4 (100.0)	21 (100.0)	2 (100.0)	1 (100.0)	21 (100.0)	49 (100.0)

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[TFN1] ADEM: acute demyelinating encephalomyelitis; SINAN: Sistema de Informação de Agravos de Notificação; RJC: Rio de Janeiro City. Source: SINAN and Arboviral Neurologic Manifestations Report Form, RJC.