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Zika-linked brain disorder in adults identified by Brazilian scientists

Scientists in Brazil have uncovered a new brain disorder associated with Zika infections in adults: an autoimmune syndrome called acute disseminated encephalomyelitis, or ADEM, that attacks the brain and spinal cord.

Zika virus may provoke an immune attack on the central nervous system

Scientists in Brazil haveuncovered a new brain disorder associated with Zika infectionsin adults: an autoimmune syndrome called acute disseminatedencephalomyelitis, or ADEM, that attacks the brain and spinalcord.

Zika has already been linked with the autoimmune disorderGuillain-Barrsyndrome, which attacks peripheral nerves outsidethe brain and spinal cord, causing temporary paralysis that canin some cases require patients to rely on respirators forbreathing.

The new discovery now shows Zika may provoke an immuneattack on the central nervous system as well.

The findings add to the growing list of neurological damageassociated with Zika.

According to the World Health Organization, there is astrong scientific consensus that, in addition to Guillain-Barr,
Zika can cause the birth defect microcephaly, though conclusiveproof may take months or years. Microcephaly is defined byunusually small heads that can result in developmental problems.

Brazil said it has confirmed more than 940 cases to berelated to Zika infections in the mothers. Brazil isinvestigating nearly 4,300 additional suspected cases ofmicrocephaly.

In addition to autoimmune disease, some researchers alsohave reported patients with Zika infections developingencephalitis and myelitis nerve disorders typically caused bydirect infections in nerve cells.

"Though our study is small, it may provide evidence that inthis case, the virus has different effects on the brain thanthose identified in current studies," Dr. Maria Lucia Brito, aneurologist at Restoration Hospital in Recife, Brazil, said in astatement.

ADEM typically occurs in the aftermath of an infection,causing intense swelling in the brain and spinal cord thatdamages myelin, the white protective coating surrounding nervefibers. It results in weakness, numbness and loss of balance andvision, symptoms similar to multiple sclerosis.

Brito presented her findings on Sunday at the AmericanAcademy of Neurology meeting in Vancouver. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

The study involved 151 patients who visited her hospital between December 2014 andJune 2015. All had been infected with arboviruses, the family ofviruses that includes Zika, dengue and chikungunya.

Six of these patients developed symptoms consistent withautoimmune disorders. Of these six, four had Guillain-Barrandtwo had ADEM. In both ADEM cases, brain scans showed damage towhite matter. ADEM symptoms typically last about six months.

All six patients tested positive for Zika, and all hadlingering effects after being discharged from the hospital, withfive patients reporting motor dysfunction, one with visionproblems, and one with cognitive decline.

Why does Zikavirus appear to be strongly associated with disease of nervous system?

At least 13 countries have reported cases of Guillain-Barrlinked with outbreaks of Zika, according to the World Health
Organization, and WHO believes that Zika likely is the cause.

Dr. James Sejvar, a neuroepidemiologist for the U.S. Centersfor Disease Control and Prevention, said the ADEM cases linkedwith Zika do not appear to be occurring at the same acceleratedrate as cases of Guillain-Barr, but said doctors should be onthe lookout for ADEM and other central nervous system illnesses.

"Of course, the remaining question is 'Why?'" Sejvar said."Why does Zika virus appear to have the strong association withGBS and potential other immune/inflammatory diseases of thenervous system?"

Sejvar, who has studied Guillain-BarrSyndrome (GBS) inBrazil and is involved in a major clinical trial ofGuillain-Barrin Puerto Rico, said he hopes future studies willshed more light on such questions.

InGuillain-Barr, the immune system attacks the nervous system, resulting in muscle weakness and sometimes paralysis, according to the U.S.Centersfor Disease Control and Prevention.

Zika, which is prevalent in Latin America and the Caribbean, is mainly transmitted through the bite of infectedAedesaegyptimosquitoes. Most healthy people infected with the virus experience no symptoms, but babies whose mothers were exposed to the virus in pregnancy appear to be at special risk formicrocephaly.

With files from HealthDay News