Zika Virus: Mimicking Stroke Symptoms, Understanding The Connection

can zika virus mimic a stroke

The Zika virus, transmitted by mosquitoes, is known to cause brain damage in babies born to infected mothers. However, new research has found that the virus can also cause nervous system disease in adults. A study of 201 adults with neurological disease treated in Brazil during the 2015 Zika and 2016 Chikungunya epidemics found that Zika was especially likely to cause Guillain-Barré syndrome, while Chikungunya was more likely to cause inflammation and swelling in the brain and spinal cord. Importantly, the research also showed that infection with both viruses together increased the risk of stroke, which occurs when an artery supplying blood to the brain becomes blocked. While the risk of stroke is known to increase after some viral infections, the link between Zika and Chikungunya co-infection and stroke is a novel finding with important implications for patient management and our understanding of disease mechanisms.

Characteristics Values
Zika Virus Can cause brain damage in babies following infection in pregnancy
Zika Virus Can cause nervous system disease in adults
Zika Virus Can cause Guillain-Barré syndrome
Chikungunya Virus Can cause inflammation and swelling in the brain (encephalitis)
Chikungunya Virus Can cause inflammation and swelling in the spinal cord (myelitis)
Zika and Chikungunya Viruses Can increase the risk of stroke

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Zika and Chikungunya viruses are mosquito-borne and can cause stroke

The Zika virus is primarily transmitted by Aedes mosquitoes, which bite mostly during the day. The virus was first identified in Uganda in 1947 in a Rhesus macaque monkey, and evidence of infection in humans was found in other African countries in the 1950s. Since 2007, outbreaks of the Zika virus have been recorded in Africa, the Americas, Asia, and the Pacific. The virus gained significant attention during a large epidemic in Brazil in 2015, where it was linked to an increased incidence of Guillain-Barré syndrome and microcephaly in infants born to infected mothers.

Zika is known to cause brain damage in babies following infection during pregnancy, and this has been classified as a congenital Zika syndrome by the World Health Organization (WHO). However, new research from the University of Liverpool and Brazilian collaborators has revealed that the Zika virus can also cause nervous system disease in adults. The study, published in The Lancet Neurology, investigated the link between neurological disease and infection with the Zika and chikungunya viruses, which are both mosquito-borne and circulate mainly in tropical regions.

The research found that each virus can cause a range of neurological problems. Zika was particularly associated with Guillain-Barré syndrome, while chikungunya was more likely to cause inflammation and swelling in the brain (encephalitis) and spinal cord (myelitis). Importantly, the study also showed that stroke could be caused by either virus alone but was more likely to occur in patients infected with both viruses simultaneously. The risk of stroke is known to increase after some viral infections, and the presence of additional stroke risk factors, such as high blood pressure, further elevates this risk.

The implications of these findings are significant for the investigation and management of patients with viral infections, as well as for understanding the mechanisms of disease. The research highlights the potential effects of viral infections on the brain and underscores the need to understand why certain viruses trigger strokes so that preventative measures can be developed.

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Zika can cause brain damage in babies following infection in pregnancy

Zika virus infection during pregnancy can cause severe congenital malformations in babies, including brain damage. The virus can be transmitted from a pregnant woman to the fetus, and this has been linked to a range of adverse outcomes, including brain abnormalities and congenital Zika syndrome (CZS).

CZS is characterised by five distinctive features that affect brain development, such as microcephaly, brain calcifications, retinal issues, and defects in the extremities, including congenital contractures and hypertonia. Microcephaly is a serious condition where the baby's head is smaller than expected, and it is often associated with smaller brains that do not develop properly.

Studies have found that Zika infection during pregnancy increases the risk of miscarriage, stillbirth, preterm delivery, and fetal growth problems. In some cases, babies may appear healthy at birth but develop postnatal microcephaly or other neurological issues later on.

The causal relationship between Zika infection during pregnancy and microcephaly, as well as other severe brain anomalies, has been confirmed by organisations like the World Health Organization (WHO). The risk of congenital malformations following Zika infection during pregnancy varies, with estimates ranging from 5% to 15% of infants born to infected women.

To prevent Zika infection during pregnancy, pregnant women are advised to avoid travelling to Zika-affected areas unless necessary and to take precautions such as using insect repellent and protective clothing to prevent mosquito bites.

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Zika can cause nervous system disease in adults

Zika virus, transmitted primarily by Aedes mosquitoes, has been linked to nervous system disease in adults. While the virus is known to cause brain damage in babies following infection during pregnancy, new research has shown that it can also cause nervous system disease in adults.

A study of 201 adults with new-onset neurological disease treated in Brazil during the 2015 Zika and 2016 Chikungunya epidemics found that Zika was especially likely to cause Guillain-Barré syndrome, in which the nerves in the arms and legs are damaged. The study also found that Zika infection was more often associated with peripheral nervous system disease, particularly Guillain-Barré syndrome.

In addition to Guillain-Barré syndrome, Zika has been associated with other neurological complications in adults, including meningoencephalitis, myelitis, and neuropathy. Zika has also been linked to a rare syndrome known as congenital Zika syndrome, which can cause microcephaly, eye abnormalities, and hearing loss in infants born to women infected during pregnancy.

The mechanisms underlying Zika-induced neuropathogenesis are still not fully understood, but studies in mice and guinea pigs have shown that the virus can replicate and affect central nervous system cells. The virus has also been found to be neuroinvasive, with the ability to cross the blood-brain barrier and infect neural stem cells, astrocytes, oligodendrocyte precursor cells, and microglia.

The link between Zika virus infection and nervous system disease in adults highlights the need for further research to understand the underlying pathogenic mechanisms and develop effective prevention and treatment strategies.

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Zika is associated with Guillain-Barré syndrome

Zika virus infection is associated with Guillain-Barré syndrome (GBS), a condition of acute muscle and limb weakness due to immune-mediated damage to the peripheral nerves. GBS is a rare but serious complication of Zika virus infection, and the exact mechanism by which the virus causes GBS is not yet fully understood. However, evidence suggests that GBS arises from autoimmune processes triggered by the infection.

Zika virus infection has been linked to an increased risk of GBS, with a higher incidence of GBS cases reported during Zika outbreaks. The risk of developing GBS following Zika virus infection is estimated to be around 2 cases per 10,000 Zika virus infections. This risk is higher than the baseline risk of GBS in the general population, which is estimated to be around 1 case per 100,000 people per year.

The temporal association between Zika virus infection and GBS has been observed in multiple countries, including Brazil, French Polynesia, El Salvador, and Venezuela. In these countries, an increase in GBS cases was reported following Zika outbreaks, and the onset of GBS symptoms typically occurred within a few days to two weeks after Zika virus infection.

The pathophysiology of Zika-associated GBS is still being investigated, but it is believed to involve a combination of direct neurotropic effects of the virus and immune-mediated mechanisms. In some cases, Zika virus RNA has been detected in the cerebrospinal fluid of patients with GBS, suggesting direct viral involvement in the central nervous system. Additionally, anti-ganglioside antibodies, which are associated with GBS, have been found in the serum of patients with Zika-associated GBS.

The clinical presentation of Zika-associated GBS is similar to that of GBS triggered by other infections, with patients experiencing progressive weakness, sensory loss, and, in severe cases, respiratory failure requiring intensive care. Treatment for Zika-associated GBS is similar to that for other forms of GBS and includes intravenous immunoglobulin and plasmapheresis. However, more research is needed to determine the optimal treatment approach for this condition.

In summary, Zika virus infection is a recognized trigger of Guillain-Barré syndrome, and the association between the two conditions has been observed in multiple countries. The exact mechanisms underlying this association are still being elucidated, and ongoing research aims to improve our understanding of the pathophysiology, clinical course, and optimal management of Zika-associated GBS.

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Zika can cause congenital Zika syndrome

Congenital Zika syndrome includes five birth defects:

  • Severe microcephaly with a partly collapsed skull. Microcephaly is a birth defect in which a baby's head is smaller than expected, compared to babies of the same sex and age.
  • Less brain tissue than normal, with a specific pattern of brain damage that includes calcium deposits in the deep tissues of the brain. This calcium can build up and affect the way a baby's brain works.
  • Damage to the back of the eye, including macular scarring. The retina is the nerve tissue that lines the back of the eye. It senses light and sends images to the brain. The macula gives the sharp, central vision you need for reading, driving, and seeing fine detail. Macular scarring happens when scar tissue forms on the macula.
  • Problems with limbs or joints, including birth defects like arthrogryposis, clubfoot, and congenital hip dysplasia. A joint is a part of the body where two or more bones come together, like the knee, hip, elbow, or shoulder. A baby with arthrogryposis is born with joint problems that make it hard for them to move their hands or legs.
  • Hypertonia that limits a baby's movement after birth. Hypertonia is when a baby has too much muscle tone, so their hands or legs may be stiff and hard to move.

In addition to these five defects, other health conditions linked to congenital Zika infection include:

  • Cerebral palsy
  • Low birth weight
  • Growth and development problems, including trouble swallowing, problems with balance and movement, trouble sitting up, and intellectual and developmental disabilities.
  • Hearing loss and other hearing problems.
  • Nervous system problems, including epilepsy, hypotonia, hyperreflexia, severe fussiness, and tremors.
  • Vision problems, including cataracts, coloboma, and congenital glaucoma.
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Frequently asked questions

The symptoms of Zika virus infection include rash, fever, conjunctivitis, muscle and joint pain, malaise and headache. However, most people with Zika virus infection do not develop symptoms.

Zika virus is transmitted primarily by Aedes mosquitoes, which bite mostly during the day. It can also be transmitted from mother to fetus during pregnancy, as well as through sexual contact, transfusion of blood and blood products, and possibly through organ transplantation.

Zika virus infection has been linked to a number of central and peripheral nervous system injuries such as Guillain-Barré syndrome, transverse myelitis, meningoencephalitis, ophthalmological manifestations, and other neurological complications. It is also associated with congenital brain abnormalities and Guillain-Barré syndrome in infants.

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