More Evidence for Zika as a Causal Agent Of Guillain-Barré Syndrome Interview with:

Emilio Dirlikov, PhD Epidemic Intelligence Service Officer CDC 

Dr. Dirlikov

Emilio Dirlikov, PhD
Epidemic Intelligence Service Officer
CDC What is the background for this study? What are the main findings?

Response: In December 2015, Puerto Rico Department of Health (PRDH) reported its first confirmed locally acquired case of Zika virus disease. In February 2016, PRDH reported the first person diagnosed with Guillain-Barré syndrome (GBS) who also had evidence of Zika virus infection. At the time, scientific evidence of the potential association between Zika virus infection and GBS was lacking, and rigorous studies were needed.

Through a collaboration between PRDH, CDC, and the University of Puerto Rico (UPR), we conducted a case-control study to determine risk factors for GBS during the 2016 Zika virus epidemic. By prospectively enrolling case-patients, we shortened the time to enrollment, increasing the likelihood of detecting Zika virus nucleic acids to confirm Zika virus infection.

As a result, we found that an acute Zika virus infection confirmed by laboratory testing is a risk factor for developing Guillain-Barré syndrome. This is the first case-control study to find laboratory evidence showing this given the difficulty of confirming Zika virus infection among people diagnosed with GBS. What should readers take away from your report?

Response: The results of this study add important evidence toward establishing a causal association between Zika virus infection and Guillain-Barré syndrome.

During Zika virus outbreaks, public health outreach should alert the community about the risk of developing GBS and clinical suspicion should be raised to improved Guillain-Barré syndrome patient prognosis. What recommendations do you have for future research as a result of this study?

Response: Future investigations should determine mechanisms and risk factors for developing GBS following Zika virus infection. Furthermore, clinical trials of the Zika virus vaccine should monitor for Guillain-Barré syndrome  as a potential outcome.  Is there anything else you would like to add? Any disclosures?

Response: The results of this study will contribute to our global understanding of Zika virus, made possible through a strong collaboration between PRDH, CDC, and UPR, as well as healthcare providers, patients and their families, and communities across Puerto Rico. CDC responds to and reduces the impact of global health threats, such as Zika virus, through partnerships with countries, including within the Caribbean.

Nothing to disclose. Thank you for your contribution to the community.


Dirlikov E, Medina NA, Major CG, Munoz-Jordan JL, Luciano CA, Rivera-Garcia B, Sharp TM. Acute Zika Virus Infection as a Risk Factor for Guillain-Barré Syndrome in Puerto Rico. JAMA. 2017;318(15):1498–1500. doi:10.1001/jama.2017.11483

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.


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Last Updated on October 19, 2017 by Marie Benz MD FAAD