Correction: Latin America Zika story

AP News
Posted: Feb 16, 2016 6:51 PM
Correction: Latin America Zika story

RIO DE JANEIRO (AP) — In a story Jan. 22 about the Zika virus in Latin America, The Associated Press reported incorrect figures for the number of people who were being treated for Guillain-Barre syndrome and the number of those who died of the condition in 2015 at the Hospital da Restauracao in Recife, Brazil. The hospital neurologist, Dr. Maria Lucia Ferreira, says that nine patients died of Guillain-Barre at the hospital last year and that a total of 55 patients were diagnosed and treated for the syndrome.

A corrected version of the story is below

BC-LT--Latin America-Zika

Health officials probe tie between Zika, paralyzing syndrome

Health officials say they're trying to determine if an unusual jump in cases of the rare Guillain-Barre Syndrome is related to the spread of the mosquito-borne Zika virus in Brazil and El Salvador. Fears the illness might cause birth defects already has led authorities in both Latin American nation to warn women against becoming pregnant.

By Marcos Aleman and Jenny Barchfield

RIO DE JANEIRO (AP) - Two Latin American countries are investigating whether recent outbreaks of the mosquito-borne Zika virus are behind a rise in a rare and sometimes life-threatening nerve condition that can cause paralysis and leave victims on life-support, health officials say.

Zika virus has already been linked to a rash of the birth defect microcephaly, when babies are born with unusually small heads, and although the exact mechanics of how the virus may affect infants remains murky, authorities in Brazil, Colombia and El Salvador are urging women to avoid the risk by postponing pregnancies. The U.S. Centers for Disease Control and Prevention has issued a warning to pregnant women potentially travelling to countries with Zika outbreaks, on Friday expanding the warning to encompass 22 destinations, most in Latin America and the Caribbean.

The dramatic rise in cases of the nerve disorder Guillain-Barre has also raised alarm bells among health officials throughout the region.

Guillain-Barre is a condition that causes muscle weakness that generally begins in the legs and spreads to the arms and face and can cause numbness, trouble walking or even paralysis of some of the limbs. While most patients recover in weeks or months, in severe cases, the muscles used for breathing weaken so much that patients require life-support.

Anyone of any age can get Guillain-Barre, although it's very rare. It's thought to be triggered by an infection — often something as simple as food poisoning — and happens when the patient's immune system attacks the body's own nervous system.

Researchers have been wary of the virus since French Polynesia noted a jump in cases of Guillain-Barre and microcephaly in tandem with a wave of Zika cases, though the populations were far smaller than in the recent outbreaks.

The World Health Organization said Salvadoran authorities reported 46 cases of Guillain-Barre in just five weeks, from Dec. 1 to Jan. 6. The full-year average for the country is 169 cases. It said that of 22 patients on which there was information, at least 12 patients had experienced a rash-fever illness in the 15 days before developing Guillain-Barre.

In Brazil, officials are also probing last year's near-simultaneous rise in Guillain-Barre and Zika, a dengue-like illness spread by the Aedes aegypti mosquito that was first identified in the South American nation last May. It's thought the virus may have arrived in the country in a tourist during the 2014 World Cup, or possibly during an international canoeing event here the same year.

In the midst of the Zika outbreak that ravaged the northeastern coastal city of Salvador during last year's rainy season, Dr. Antonio Bandeira, and infectologist with the Couto Maia Hospital there, experienced an unprecedented influx of patients suffering from Guillain-Barre.

"Zika was really bad here from February to July and then all but disappeared in August. In May, June and July, we had 24 patients come in with Guillain-Barre, and none since August," he said, adding that in previous years he generally only saw two or three patients with the condition per year. The vast majority of last year's patients said they'd had Zika-like symptoms, which can include a fever and red splotchy skin, before they came down with Guillain-Barre, he said.

The Hospital da Restauracao in Recife, another hotbed of Brazil's recent Zika outbreak, also treated about six times the normal number of patients with Guillain-Barre, said Dr. Maria Lucia Ferreira, a neurologist. Of the 55 patients treated for Guillain-Barre syndrome at the hospital last year nine of them died, she said.

Still, the exact scope of the problem is not clear, as Guillain-Barre used to be so rare here that the Health Ministry still doesn't track the exact number of cases. But they've has acknowledged a connection and are researching the matter.

Dr. Albert Ko, a professor of epidemiology with the Yale School of Public Health, called the possible connection between Zika and Guillain-Barre "plausible and highly likely."

Still, he said the difficulty of definitively diagnosing Zika, combined with the fact that Guillain-Barre sets in days or even weeks after the initial trigger infection have complicated proving the link between the two.

"While many of us are convinced and believe it's highly plausible that Zika virus caused this epidemic of Guillain-Barre, and can cause it anywhere the virus is being transmitted, we still lack really firm really firm evidence to make that diagnosis," said Ko, who has conducted research in northeastern Brazil for two decades. "The problem has been confirming using laboratory tests that these cases are due to Zika virus."

Zika virus originated in Africa and expanded to parts of Asia. When it was first detected in Brazil, health official here weren't initially alarmed, as the virus appeared to be like a less potent form of dengue. But then health officials noticed the sudden rise in case of microcephaly: Since the start of October, the country has recorded 3,893 suspected cases of microcephaly, compared with fewer than 150 cases for all of 2014.

Brazilian officials say they're convinced of a link. International health bodies have said that's not yet scientifically established, but they are on the alert.

The CDC said Friday it had acted "out of an abundance of caution" in issuing its call for pregnant women "to consider postponing travel to any area where Zika virus transmission was ongoing."

El Salvador's government this week suggested that women avoid getting pregnant for the next two years, and some say they're taking that advice.

"We were very lucky. My son was born before this," said 19-year-old Fatima Mejia, who was visiting a clinic in Santa Tecla, just outside the Salvadoran capital, for a checkup on her 17-day-old infant.

"I'm not going to get pregnant until this passes. I'm not going to risk a child," she said.

Another woman in for a checkup at the clinic, 22-year-old Sandra Barrios, also said she might avoid having more children.

"If this continues I'm going to speak with my husband about an operation on myself. I already have three children and I don't want problems."

In Colombia, Deputy Health Minister Fernando Ruiz told The Associated Press the country has recorded 13,531 suspected cases of Zika and said the number could rise to half a million this year.

He said at least 560 cases involve pregnant women, though there have been no detected cases of microcephaly. The Health Ministry recently urged all women in the country to avoid getting pregnant while the virus is spreading, saying that could extend until July.

Ruiz said there have been 12 cases of people with Guillain-Barre who had earlier had symptoms similar to those of Zika.


Marcos Aleman reported from San Salvador, El Salvador. Associated Press writers Lauran Neergaard in Washington and Cesar Garcia in Bogota, Colombia, contributed to this report.