Stroke associated with superinfection with mosquito-borne virus

As if the general symptoms associated with mosquito-borne viral infections were not sufficient, a new study by researchers at the University of Liverpool found that double infection with Zika and chikungunya viruses could trigger stroke. I found. These viruses circulate primarily in the tropics and cause outbreaks of rashes and fever in Brazil and India. Zika is widely known to cause brain damage in babies following infection during pregnancy, but new studies show that it can also cause nervous system disorders in adults.

The results of the new study were recently published Lancet neurology “Adult neurological disorders infected with Zika and Chikungunya viruses in northeastern Brazil: prospective observational study.. “

“Our study highlights the potential effects of viral infections on the brain with complications such as stroke,” said collaborator Suzannah Lant, MBChB, a clinical research fellow at the University of Liverpool. Stated. “It’s related to Zika and Chikungunya, but it’s also related to our understanding of other viruses that are increasingly associated with nervous system complications, such as COVID-19.”

In the current study, 201 adults with new-onset neurological disorders treated in Brazil during the 2015 Zika and 2016 Chikungunya fever epidemics are neurologically infected with several arbovirus infections that circulate simultaneously. It is the largest of its kind to describe its features.

Interestingly, new findings show that each virus can cause a variety of neurological problems. Zika was particularly likely to cause Guillain-Barré syndrome, which damages nerves in the arms and legs. Chikungunya was more likely to cause inflammation and swelling in the brain (encephalitis) and spinal cord (myelitis). However, strokes could be caused by only one of the viruses and were more likely to occur in patients infected with the two viruses at the same time.

A stroke occurs when one of the arteries that supply blood to the brain is blocked. It is known that the risk of stroke increases after viral infections such as varicella-zoster virus and HIV that cause chickenpox and shingles. Stroke is increasingly recognized as a complication of COVID-19. This has important implications for the investigation and management of virally infected patients and for understanding the mechanism of the disease.

In total, 1,410 patients were screened and 201 were recruited for two years at the Hospital Dulles Taurason in Recife, Brazil. Comprehensive PCR and antibody testing of the virus was performed at the Fiocruz laboratory.

“We recruited adults over the age of 18 who were referred to a hospital, a secondary and tertiary level hospital with a history of suspected acute neurological disease and suspected arbovirus infection,” the authors wrote. There is. “We looked for evidence of Zika, chikungunya, or dengue infection with specific IgM antibodies in viral RNA or serum or CSF. Patients were grouped according to the diagnosis of the Arbovirus laboratory and demographically and We compared the clinical features. “

Surprisingly, about two-thirds of stroke patients, on average 67 years old, were infected with multiple viruses. Many people who have had a stroke have other stroke risk factors such as high blood pressure, and strokes following Zika and chikungunya virus infections can be most often seen in people who are already at high risk. is showing.

Currently, the world’s attention is focused on COVID-19, but other recently emerging viruses such as deer and chikungunya continue to circulate and cause problems, “said the co-research director at the National Institute. One Tom Solomon FRCP concluded that the University of Liverpool’s Health Research and Health Protection Research Unit on Emerging and Zoonotic Diseases. “We need to understand more about why some viruses cause strokes, so that we can prevent this from happening in the future.”