The Zika outbreak that swept through the Americas in 2015 and 2016
showed the virus could, in rare cases, cause Guillain-Barre, an
autoimmune disorder in which the body attacks itself in the
aftermath of an infection.
Since the Zika virus attacks nerve cells, scientists were not sure
whether the Guillain-Barre cases they had seen in Zika patients were
caused by an autoimmune response to the Zika infection or a direct
attack by the virus on nerve cells.
In pregnant women, the virus infects fetal brain cells, resulting in
the birth defect known as microcephaly.
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To study the nerve disorder, Dr. Tyler Sharp of the U.S. Centers for
Disease Control and Prevention's Dengue Branch in San Juan and
colleagues in Puerto Rico examined the rare case of a 78-year-old
man from San Juan who had been infected with Zika in 2016, developed
Guillain-Barre and subsequently died.
An autopsy showed inflammation and erosion of the protective sheath
known as myelin in two nerves, but no evidence of the Zika virus in
nerve cells.
"In this case, it looks like it was antibodies that led to
destruction of that myelin sheath," said Sharp, whose study was
published in Emerging Infectious Diseases, the CDC's public health
journal.
Although it was just a single case, Sharp said it suggested the
mechanism that causes Guillain-Barre after a Zika infection was the
same as in other cases of the nerve disorder.
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Sharp said the study raised a caution flag, however, for companies
testing experimental Zika vaccines. Although Guillain-Barre
typically occurs in the aftermath of an infection, it has been known
to occur in response to a vaccine.
"Vaccine manufacturers do need to be thinking about Guillain-Barre
as a potential outcome of vaccination against Zika," he said.
Several companies are developing Zika vaccines, including Takeda
Pharmaceutical Co, which said earlier this month it had begun an
early stage safety trial. Results are expected next year.
Dr. Rajeev Venkayya, president of Takeda's Global Vaccine Business
Unit, had not seen the study, but said in a telephone interview that
the company "would be looking for any safety issues, including
Guillain-Barre syndrome," in its clinical trials.
(Reporting by Julie Steenhuysen; Editing by Peter Cooney)
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