The Lancet Neurology, October 1, 2020
Maria Lúcia Brito Ferreira, Maria de Fatima Pessoa Militão de Albuquerque, Carlos Alexandre Antunes de Brito, Rafael Freitas de Oliveira França, Álvaro José Porto Moreira, Maria Íris de Morais Machado, Roberta da Paz Melo, Raquel Medialdea-Carrera, Solange Dornelas Mesquita, Marcela Lopes Santos, Ravi Mehta, Rafael Ramos e Silva, Sonja E Leonhard, Mark Ellul, Anna Rosala-Hallas, Girvan Burnside, Lance Turtle, Michael J Griffiths, Bart C Jacobs, Maneesh Bhojak, Hugh J Willison, Lindomar José Pena, Carlos A Pardo, Ricardo A A Ximenes, Celina Maria Turchi Martelli, David W G Brown, Marli Tenório Cordeiro, Suzannah Lant, Tom Solomon
The authors report a prospective observational study done during epidemics of Zika and chikungunya viruses in Recife, Pernambuco, a dengue-endemic area of Brazil. Adults were recruited who had been referred to Hospital da Restauração with suspected acute neurological disease and a history of suspected arboviral infection.
The authors looked for evidence of Zika, chikungunya, or dengue infection by viral RNA or specific IgM antibodies in serum or CSF. Patients were grouped according to their arbovirus laboratory diagnosis and then compared demographic and clinical characteristics.
There is a wide and overlapping spectrum of neurological manifestations caused by Zika or chikungunya mono-infection and by dual infections. The possible increased risk of acute cerebrovascular disease in patients with dual infection merits further investigation.