Zika Linked To Neurological Disorder ADEM in Brazil

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Zika may be associated with other neurological disease

By: Robério Sá

Monday | 11.04.2016 at 09:23

 

 

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In addition to the microcephaly and Guillain-Barré syndrome, Zika virus may be associated with another neurological disease: acute disseminated encephalomyelitis (ADEM, in its English acronym), autoimmune syndrome that causes inflammation in the central nervous system.

A study in Recife, which will be released on Friday at the annual meeting of the American Academy of Neurology, in Vancouver, Canada, found evidence of association between the virus and the ADEM in at least two cases.

Scientists have suspected a connection between zika and ADEM, as shown by the newspaper O Estado de S. Paulo in February. But only now will present the scientific results of the study led by Maria Lucia Ferreira Brito, head of the Restoration Hospital Neurology Service in Recife.

"Although it is a small study, it can provide evidence that the virus causes brain effects different from those that had been identified in the ongoing studies. But a lot of research still needs to be done to explore whether there is a causal relationship between zika and these brain problems, "said Maria Lucia.

In the study, scientists followed between December 2014 and June 2015, all cases brought to the Restoration Hospital with symptoms of infection by arboviruses - the family of viruses that includes zika, dengue and chikungunya.

All patients arrived at the hospital with fever and rash. Some also had itches, pains in muscles and joints, and red eyes. Some had neurological symptoms soon after and the other had about 15 days later.

The authors recorded 151 cases with some type of neurological manifestation, but six of them developed typical neurological symptoms of autoimmune diseases - those in which the patient's immune system attacks and destroys healthy tissue cells of your own body.

The six patients underwent blood tests and tests. Four had Guillain-Barré syndrome, as well as microcephaly, has been linked to infection zika. The other two were diagnosed with ADEM. The tests revealed that the six had been infected zika, but none of chikungunya or dengue.

In patients with ADEM, according to experts, the defense cells of the body in the brain and spinal cord attack the myelin sheath a fat covering that surrounds nerve fibers and has function similar to the cover of a wire conductor of electricity. Guillain-Barré syndrome is also autoimmune and involves damage to the myelin sheath.

damage

In both reported cases, the brain scans showed that patients with ADEM had signs of damage in brain white matter. According to scientists, they are similar to the symptoms of a multiple sclerosis ADEM but in general causes a single attack which most patients recover in about six months.

When discharged from hospital, five of the six patients continued with motor problems. One had vision problems and another had problems with memory and thinking ability.

"This does not mean that all people infected with zika have this type of brain problem. Of those who had nervous system problems, most do not have cerebral symptoms. However, our study may help clarify possible lasting effects with which the virus can be associated in the brain, "said Maria Lucia.

"Right now, it does not seem that cases of ADEM are occurring with an incidence as large as the cases of Guillain-Barré, but these findings in Brazil suggest that physicians should be vigilant about the possible occurrence of ADEM and other diseases autoimmune related to the central nervous system, "said James Sejvar, the Center for Disease Control and Prevention (CDC, its acronym in English) in Atlanta, USA. "The question is: why zika virus seems to have this strong association with Guillain-Barré syndrome and potentially other autoimmune and inflammatory diseases of the nervous system," questioned Sejvar. The information is the newspaper O Estado de S. Paulo.

http://ancoradosertao.com.br/zika-pode-estar-associado-a-outra-doenca-neurologica/

 

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Zika virus may cause broader range of brain disorders than previously believed

Study says five patients who tested positive for virus in Brazil reported difficulty with motor functioning while another had trouble with vision and memory

 

 The Zika virus is spread by mosquitoes. Photograph: Daniel Becerril/Reuters

Alan Yuhas

@alanyuhas

Sunday 10 April 2016 16.00 EDTLast modified on Sunday 10 April 201616.12 EDT

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The Zika virus may cause a wider range of brain disorders than previously thought, according to a small study released on Sunday. Scientists already suspect the mosquito and sex-spread virus causes fetal brain disorder and temporary paralysis.

Analysis Zika virus: its effects, how it is spread, and the possible threat to women

The disease is believed to have infected 1.5 million people since its outbreak in Brazil and dramatic spread around the world

 

Read more

The study followed patients with symptoms of arboviruses, the family of infectious agents that includes Zika and dengue, who came to a hospital in Recife, Brazil, between December 2014 and June 2015.

Six people developed neurological symptoms and two suffered attacks that swelled the brain and damaged its myelin, the fatty material that protects nerves there and at the spinal cord.

The research was presented on Sunday at the annual conference for the American Academy of Neurology in Vancouver. Its abstract concluded that “there is strong evidence that this epidemic has different neurological manifestations” than those already documented.

All the people arrived in the hospital with a fever, then a rash, and some suffered red eyes, itching and aching muscles and joints – the known symptoms of the Zika virus. The neurological symptoms sometimes began immediately, or as long as 15 days after patients first sought treatment.

All six people tested positive for the Zika virus, and negative for dengue fever and chikungunya.

After they left hospital, five reported problems with motor functioning; one reported trouble with vision and memory.

“Though our study is small, it may provide evidence that in this case the virus has different effects on the brain than those identified in current studies,” said the study’s author, Dr Maria Lucia Brito Ferreira of the Restoration hospital in Recife, Brazil.

Brito Ferreira repeated a common refrain of Zika research: the research is early and still inconclusive, and meant to add to the growing investigation to discover what the virus actually does. In all, her team documented 151 cases with neurological symptoms.

“This doesn’t mean that all people infected with Zika will experience these brain problems,” Ferreira said. “Of those who have nervous system problems, most do not have brain symptoms.

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“However, our study may shed light on possible lingering effects the virus may be associated with in the brain.”

The brain swelling, called acute disseminated encephalomyelitis (ADEM), resembles multiple sclerosis in some symptoms but is not a permanent condition. ADEM usually consists of a single or occasional attack, from which most people can recover over several months.

Four of the people followed for Ferreira’s research developed Guillain-Barré syndrome (GBS), a serious brain condition that enervates muscles, and can leave people temporarily paralyzed and breathing through ventilators.

Like ADEM, the condition attacks myelin, and many people also recover from GBS after several months. Earlier this year, scientists published strong evidence that Zika is linked to GBS through a study on 42 cases in French Polynesia.

Dr James Sejvar, a neurologist with the US Centers for Disease Control and Prevention, said that cases of ADEM do not appear to afflict people with Zika as often as cases of GBS.

“But these findings from Brazil suggest that clinicians should be vigilant,” he said, for signs of ADEM and other central nervous system diseases.

“Of course, the remaining question is ‘why,’” Sejvar said. “Why does Zika virus appear to have this strong association with GBS and potentially other immune-inflammatory diseases of the nervous system?”

Experts at the World Health Organization also “implicated” Zika in a disorder called microcephaly, which causes babies to suffer brain damage and abnormally small heads. In February, a few days after experts warned that the virus could be a greater threat than Ebola, the organization declared a global public health emergency.

Scientists have yet to confirm what conditions the virus actually causes, although research has raced to study the once rare pathogen, which emerged from a remote forest in Uganda.

That the evidence is still inconclusive has many scientists cautioning the public and leaders not to fuel hysteria around it.

http://www.theguardian.com/world/2016/apr/10/zika-virus-brain-disorders-brazil-study

 

[niman]

Apr 11, 2016

Zika Virus Tied to MS-like Brain Disorder

• Scientists report that the Zika virus may be associated with an autoimmune disorder that attacks the brain's myelin similar to multiple sclerosis. The investigators will discuss the results of their research at the upcoming American Academy of Neurology's 68th Annual Meeting in Vancouver, Canada.

  "Though our study is small, it may provide evidence that in this case the virus has different effects on the brain than those identified in current studies," said study author Maria Lucia Brito Ferreira, MD, with Restoration Hospital in Recife, Brazil. "Much more research will need to be done to explore whether there is a causal link between Zika and these brain problems."

  For the study, researchers followed people who came to the hospital in Recife from December 2014 to June 2015 with symptoms compatible with arboviruses, the family of viruses that includes Zika, dengue and chikungunya. Six people then developed neurologic symptoms that were consistent with autoimmune disorders and underwent exams and blood tests. The authors saw 151 cases with neurological manifestations during a period of December 2014 to December 2015.

  All of the people came to the hospital with fever followed by a rash. Some also had severe itching, muscle and joint pain and red eyes. The neurologic symptoms started right away for some people and up to 15 days later for others.

  Of the six people who had neurologic problems, two of the people developed acute disseminated encephalomyelitis (ADEM), an attack of swelling of the brain and spinal cord that attacks the myelin. In both cases, brain scans showed signs of damage to the brain's white matter. Unlike MS, acute disseminated encephalomyelitis usually consists of a single attack that most people recover from within six months. In some cases, the disease can reoccur. Four of the people developed Guillain-Barré syndrome (GBS), a syndrome that involves myelin of the peripheral nervous system and has a previously reported association with the Zika virus.

  When they were discharged from the hospital, five of the six people still had problems with motor functioning. One person had vision problems and one had problems with memory and thinking skills. Tests showed that the participants all had Zika virus. Tests for dengue and chikungunya were negative.

  "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," said Dr. Ferreira. "However, our study may shed light on possible lingering effects the virus may be associated with in the brain."

  "At present, it does not seem that ADEM cases are occurring at a similarly high incidence as the GBS cases, but these findings from Brazil suggest that clinicians should be vigilant for the possible occurrence of ADEM and other immune-mediated illnesses of the central nervous system," noted James Sejvar, MD, with the Centers for Disease Control and Prevention in Atlanta and a member of the American Academy of Neurology. "Of course, the remaining question is 'why'-why does Zika virus appear to have this strong association with GBS and potentially other immune/inflammatory diseases of the nervous system? Hopefully, ongoing investigations of Zika virus and immune-mediated neurologic disease will shed additional light on this important question."

  http://www.genengnews.com/gen-news-highlights/zika-virus-tied-to-ms-like-brain-disorder/81252591/

   

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HEALTH

 

APR 11 2016, 11:00 AM ET

There's More Evidence Zika Goes Straight to the Brain

by MAGGIE FOX

 

Aedes aegypti mosquitoes Paulo Whitaker / Reuters

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Two studies published this week show that the Zika virus seems to prefer brain cells — and that it can cause many different types of damage to those cells.

One of the studies shows that Zika — but not its close cousin, the dengue virus — destroys developing nerve cells. Another describes the cases of two Zika patients who developed nerve damage similar to that caused by multiple sclerosis.

 

Confocal microscopy of human neural stem cell culture infected with Zika virus (red). Cell nuclei are shown in blue. Credit: Erick Loiola, PhD and Rodrigo Madeiro, PhD - IDOR / Science

Both add to the growing body of evidence that Zika virus, once virtually ignored as a rather harmless infection, is causing severe and sometimes deadly birth defects and other types of damage to victims of all ages. And because it's spreading so fast among so many people, it's adding up to thousands of victims.

Patricia Garcez of the Federal University of Rio de Janeiro in Brazil and colleagues used human induced pluripotent stem (iPS) cells — lab-created stem cells — which they coaxed into become immature brain cells.

Zika virus infected and killed them, they report in the journal Science.

When they directed these iPS cells to become little batches of brain cells, the virus slowed their growth and development by 40 percent.

But when Garcez's team tried the same thing with dengue virus, they did not see the same effects. The virus, which is very closely related to Zika, infected the nerve and brain cells but did not kill them.

"THOUGH OUR STUDY IS SMALL, IT MAY PROVIDE EVIDENCE THAT IN THIS CASE THE VIRUS HAS DIFFERENT EFFECTS ON THE BRAIN THAN THOSE IDENTIFIED IN CURRENT STUDIES."

This helps explain why Zika's effects were so unexpected. Viruses such as rubella and those in the herpes family are well known to cause birth defects and sometimes severe neurological effects in adults and children. But not so-called flaviviruses such as Zika and its cousin dengue.

Zika was once believed to cause little more than a rash and some achiness - and even then only in a small percentage of people infected. Now it's known it can have serious effects on developing fetuses and adults as well.

A second study shows more startling neurological effects.

Dr. Maria Lucia Brito Ferreira of Restoration Hospital in Recife, Brazil and colleagues described the cases of two Zika patients who developed a condition called acute disseminated encephalomyelitis. It's an inflammation of the brain and spinal cord that damages the protective fatty myelin layer that covers nerve cells.

That's similar to what multiple sclerosis does, but it's usually temporary - although the recovery can take months.

Four more patients developed Guillain-Barre syndrome, a paralyzing condition hat's also caused by nerve damage, Ferreira's team said in remarks released ahead of an annual meeting of the American Academy of Neurology.

"Though our study is small, it may provide evidence that in this case the virus has different effects on the brain than those identified in current studies," said Ferreira.

When they left the hospital, five of the six people still had problems with movement and coordination and one had memory problems.

"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," said Ferreira. "However, our study may shed light on possible lingering effects the virus may be associated with in the brain."

Zika's spreading in both Latin America and the South Pacific. The mosquito-borne virus is blamed for thousands of birth defects, notably one called microcephaly, marked by an underdeveloped brain and head.

The World Health Organization and the Centers for Disease Control and Prevention both warn travelers going to Zika-affected regions to do what they can to avoid mosquito bites. They're telling pregnant women to stay away completely if they can.

Both also warn travelers who may bring Zika back home to avoid infecting loved ones sexually and to watch out not to get bitten by mosquitoes at home.

The CDC predicts small, localized outbreaks in the U.S. as warmer weather fuels the breeding of the mosquitoes that spread Zika. 

http://www.nbcnews.com/health/health-news/there-s-more-evidence-zika-goes-straight-brain-n554041

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Brazilian study links Zika virus to more neurological disorders                   Source: Xinhua | 2016-04-30 22:14:46 | Editor: huaxia

Gabrielly Santana da Paz holds her child who suffered microcephaly while waiting for examination at the Oswaldo Cruz Hospital, in Cabo de Santo Agostinho, 35 km from Recife, capital of Pernambuco in northeastern Brazil, on Feb. 1, 2016. (Xinhua/Diego Herculano/Brazil Photo Press/AGENCIA ESTADO) RIO DE JANEIRO, April 29 (Xinhua) -- A Brazilian medical study reveals a link between the mosquito-borne virus Zika and acute disseminated encephalomyelitis (ADEM), a condition often misdiagnosed as multiple sclerosis (MS). The study, the findings of which was released on Friday, was carried out by a hospital in Recife, capital of the northeastern Pernambuco state worst affected by the Zika epidemic. The Zika epidemic has swept through Brazil and much of Latin America in the past two years. Pernambuco has seen a sharp rise in the number of microcephaly cases, babies born with abnormally small heads, leading health authorities to believe that it is Zika-related, though there has as yet been no definite scientific proof. Brazilian news network Globo reported on Friday that doctors at the hospital's department of neurology tested samples taken from 180 patients infected with the Zika virus and showing neurological symptoms, and found 30 of them had developed ADEM, encephalitis or myelitis. Another 60 patients came down with Guillain-Barre syndrome, a disorder previously associated with Zika that causes the immune system to mistakenly attack the nervous system, leading to muscle weakness and paralysis. "Without a doubt there is a link between the diseases and the Zika virus," Lucia Brito, head of the medical team, told the news agency. Brito said that ADEM is a more complicated condition in which "the patient's level of consciousness can change. In other words, they can enter into a coma." A woman walks pass a tent for accompanying suspected cases of dengue, zika and chinkungunya, in Sao Paulo, Brazil, on Feb. 24, 2016. (Xinhua/Ale Vianna/AGENCIA ESTADO) Of those with ADEM, two continue to suffer with symptoms almost a year after the onset of the disease, including "a boy with motor deficit and an adult with motor difficulty and impaired vision," Brito said. The National Multiple Sclerosis Society describes ADEM as "a brief but intense attack of inflammation (swelling) in the brain and spinal cord and occasionally the optic nerves that damages the brain's myelin (the white coating of nerve fibers)." Unlike MS, which is gradual, ADEM appears rapidly and is passing, though it can leave permanent damage. Common symptoms include rapid onset fever, weakness and loss of vision, and in extreme cases, coma. Mosquitos that carries the Zika virus also transmit dengue and chikungunya. Brazil has reported 31,616 confirmed cases of Zika and over 90,000 suspected cases, with three deaths caused by the disease. On Feb. 1, the World Health Organization (WHO) declared "the cluster of microcephaly cases and other neurological disorders a health emergency" and called for concerted efforts to curb the spread of Zika. http://news.xinhuanet.com/english/2016-04/30/c_135325685.htm