Exploring the relation between Zika virus and the Guillain-Barré syndrome
February 1, 2018
The epidemic of Zika virus (ZIKV) throughout the Americas and Asia, and the subsequent alarming rise in reported cases of Guillain-Barré syndrome (GBS) in over 23 countries, has caused worldwide concern. However, many issues remain unsolved regarding the link between Zika and GBS.
The International GBS Outcome Study (IGOS) aims to close this knowledge gap, by investigating the association, pathophysiology and clinical presentation and recovery of GBS. IGOS is a prospective observational study led bya research consortium of 150 centers from 19 countries worldwide. At present, 1553 patients have been included in the study, making it the largest international observational study on GBS. Funding from ZikaPLAN is enabling Erasmus MC and its research partners in IGOS to investigate the link between GBS and ZIKV using the IGOS framework.
In the first phase of the project, we have established IGOS-Zika: a case-controlled study based on the IGOS protocol that specifically investigates the association between GBS and arboviruses. This study is now operative in 11 centers across Brazil and Argentina and, in the near future, we expect to expand to Peru and Cuba where Institutional Review Board (IRB) approval is pending. Studying data and biosamples collected from IGOS-Zika will help to optimize diagnostics and care for GBS patients in arbovirus endemic countries and will provide the opportunity to further study the pathogenesis of GBS. Moreover, the IGOS study is designed to increase local research capacity and network building, and the protocols and network can be used to respond adequately to other future viral epidemics related to GBS.
With the collaborations fostered by the ZikaPLAN network, we have the unique opportunity to combine data and biobanks from centers in the various geographical regions that are participating in IGOS, IGOS-Zika and other study groups operating in ZikaPLAN work packages, including the NEAS group in Colombia. By combining these data, we will be able to analyze the clinical features of GBS related to Zika and compare these to GBS followed by other infections.
With the new knowledge about ZIKV and GBS generated, we are also focusing on our dissemination plan. With the support of The Global Health Network (TGHN), we are collaborating with our large international network of GBS experts to create guidelines, practical recommendations and training materials to strengthen diagnostic capacity and improve management for GBS cases in Zika virus endemic regions.
Melissa R. Mandarakas, project manager, Erasmus MC, University Medical Center Rotterdam, The Netherlands
Dr. Sonja E. Leonhard, MD, Phd candidate, Erasmus MC, University Medical Center Rotterdam, The Netherlands
Prof. Bart C. Jacobs, Professor of Neurology and Immunology, Erasmus MC, University Medical Center Rotterdam, The Netherlands