Guillain-Barre syndrome and Zika virus: Estimating attributable risk to inform intensive care capacity preparedness

Abstract

On 1 February 2016, Zika virus (ZIKV) was declared a public health emergency of international concern by the World Health Organization [1]. This relatively unknown flavivirus from the Flaviviridae family of viruses such as dengue and yellow fever is now linked to 2 main neurological complications: microcephaly and Guillain-Barré syndrome (GBS). A large number of ZIKV-associated microcephaly cases have been reported. Of note, a significant number of affected countries and territories (n = 13) also reported either an increase in the incidence of GBS cases or GBS cases with confirmed ZIKV infection [2]. GBS can present as an acute medical emergency where the availability of intensive care support could be critical in determining survival outcomes. As the threat of ZIKV epidemics looms over many countries and regions, it would be useful to have data to inform capacity planning of intensive care beds as part of preparedness plans for a potential increase in GBS cases.