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COMMENTARY
Year : 2022  |  Volume : 8  |  Issue : 3  |  Page : 163-164

Guillain-Barré syndrome, from the search for Zika to the discovery of asymptomatic campylobacteriosis as a risk factor for neurological syndromes in Veracruz, Mexico


Department of Internal Medicine, General Hospital 71, Instituto Mexicano del Seguro Social, Veracruz, Mexico

Date of Submission24-May-2022
Date of Decision26-Jul-2022
Date of Acceptance27-Jul-2022
Date of Web Publication21-Sep-2022

Correspondence Address:
Luis Del Carpio-Orantes
Department of Internal Medicine, General Hospital 71, Instituto Mexicano del Seguro Social, Veracruz
Mexico
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bc.bc_24_22

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How to cite this article:
Carpio-Orantes LD. Guillain-Barré syndrome, from the search for Zika to the discovery of asymptomatic campylobacteriosis as a risk factor for neurological syndromes in Veracruz, Mexico. Brain Circ 2022;8:163-4

How to cite this URL:
Carpio-Orantes LD. Guillain-Barré syndrome, from the search for Zika to the discovery of asymptomatic campylobacteriosis as a risk factor for neurological syndromes in Veracruz, Mexico. Brain Circ [serial online] 2022 [cited 2022 Oct 7];8:163-4. Available from: http://www.braincirculation.org/text.asp?2022/8/3/163/356528



In Mexico, as well as in the rest of America, moments of uncertainty were also experienced when the Chikungunya and Zika viruses arrived from Polynesia in 2014 to 2015, mainly Zika due to its great neurotropic potential, conditioning microcephaly, and Guillain-Barré syndrome. Alerting us from the initial experiences of Oceania and South America and taking time to prepare protocol studies when the viruses arrived in Mexican lands, a situation that took place in 2015.[1]

Guillain–Barré syndrome was modified by the Zika pandemic, mainly the incidence of cases associated with said virus up to 42%, as well as in the neuroconduction pattern that in the pre-Zika era AMAN predominated, while in Zika it was the acute inflammatory demyelinating polyneuropathy (AIDP) pattern, similarly, the less severe character of the disease in terms of recovery and sequelae was more evident in the Zika pandemic era.[2]

By 2016, we had had the first reports of cases in the Mexican southeast, where we studied eight patients with the syndrome, however, none were positive for Zika; for 2017, we studied seven patients of which none reported positivity for Zika, but for dengue and Chikungunya, the presence of Campylobacter being even more noticeable with five patients. In that same year, we made synergy with another hospital in the city and managed to combine 34 patients, of which two were positive for Zika, four for dengue, two for herpes, one for enterovirus, and one for Chikungunya; however, he highlighted again the presence of Campylobacter in 12 cases. The predominance of the AIDP pattern is also highlighted. Following up on the Zika pandemic and in its third year, we had documented a total of 39 cases of Guillain–Barré syndrome, of which only two cases had been associated with Zika, while 13 were with Campylobacter.[3],[4],[5],[6]

Based on this evidence, we decided to look for cases of asymptomatic campylobacteriosis, since most of the previous cases had not presented digestive manifestations. In 2019, a Campylobacter search protocol was carried out in healthy and immunocompetent subjects, 200 volunteers were studied and the presence of the bacteria in a fecal sample was analyzed, six positives were found with a rapid test, and these samples were cultured (campy-BAP medium) finding the development of five cases, four corresponding to Campylobacter jejuni and one to Campylobacter coli, which revealed the neurotropic potential of asymptomatic campylobacteriosis in this population that has previously suffered outbreaks of the syndrome that had not had an adequate epidemiological and in ecological analysis.[7],[8]

Finally, we consider that in the event of an outbreak of Guillain–Barré syndrome, whether in a pandemic context or not, viruses and bacteria with neurotropic potential must be taken into consideration, always highlighting the search for Campylobacter and even its asymptomatic forms that could at some point disrupt the intestinal microbiota and condition various nosological entities.



 
  References Top

1.
Del Carpio-Orantes L. Zika, a neurotropic virus? Rev Med Inst Mex Seguro Soc 2016;54:540-3.  Back to cited text no. 1
    
2.
Del Carpio-Orantes L, Sánchez-Díaz JS. Guillain-Barré syndrome, before and after Zika. J Neurosci Rural Pract 2019;10:567-8.  Back to cited text no. 2
    
3.
Del Carpio Orantes L, Juárez Rangel FJ, García-Méndez S. Incidence of Guillain-Barré syndrome at a secondary centre during the 2016 zika outbreak. Neurologia (Engl Ed) 2020;35:160-4.  Back to cited text no. 3
    
4.
Del Carpio-Orantes L, Pola-Ramirez MR, Garcia-Mendez S, Mata-Miranda MP, Perfecto-Arroyo MA, Solis-Sanchez I, et al. The most frequent causative agents of Guillain-Barre syndrome in a Mexican general hospital. Rev Neurol 2018;67:203-9.  Back to cited text no. 4
    
5.
Del Carpio-Orantes L, Peniche Moguel KG, Sánchez Díaz JS, Pola-Ramirez MD, Mata Miranda MD, García-Méndez S, et al. Guillain-Barré syndrome associated with Zika virus infection: Analysis of a cohort from the region of northern Veracruz in 2016-2017. Neurologia (Engl Ed) 2020;35:429-31.  Back to cited text no. 5
    
6.
Del Carpio-Orantes L, Salvador Sánchez-Díaz J, Gabriela Peniche Moguel K, García-Méndez S, Perfecto-Arroyo MA, Solis-Sánchez I, et al. 1680. Guillain Barré syndrome in arbovirus outbreak in Veracruz, Mexico: The follow-up to 3 years of the pandemic. Open Forum Infect Dis 2019;6 Suppl 2:S615.  Back to cited text no. 6
    
7.
Del Carpio-Orantes L, Sánchez-Díaz JS, Peniche Moguel KG, Perfecto-Arroyo MA, Solis-Sánchez I, García-Méndez S, et al. 718. Asymptomatic campylobacteriosis as a risk factor for developing acute neurological syndromes in Veracruz, Mexico. Open Forum Infect Dis 2020;7 Suppl 1:S410.  Back to cited text no. 7
    
8.
Del Carpio-Orantes L, Da Silva IR, Moguel KG, Díaz JS, Del Pilar Mata Miranda M, García-Méndez S, et al. Guillain Barré syndrome in arbovirus outbreak, Campylobacter claims his throne. J Neurol Sci 2019;396:254-5.  Back to cited text no. 8
    




 

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