Brazilian scientists find new Zika-linked brain disorder in adults

New evidence links Zika virus to neurological disorders

CHICAGO (Reuters) -- 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.

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Zika has already been linked with the autoimmune disorder Guillain-Barre syndrome, which attacks peripheral nerves outside the brain and spinal cord, causing temporary paralysis that can in some cases require patients to rely on respirators for breathing.

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

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

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Zika, health agents trying to eradicate Zika mosquitoes in South America, Central America
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Brazilian scientists find new Zika-linked brain disorder in adults
RECIFE, BRAZIL - FEBRUARY 01: David Henrique Ferreira, 5 months, who was born with microcephaly, is examined by a doctor on February 1, 2016 in Recife, Pernambuco state, Brazil. Ferreira's mother says she spends up to eight hours per day in transit on buses, three days per week, to visit a litany of doctors with David. In the last four months, authorities have recorded thousands of cases in Brazil in which the mosquito-borne Zika virus may have led to microcephaly in infants. The ailment results in an abnormally small head in newborns and is associated with various disorders including decreased brain development. The World Health Organization (WHO) declared the Zika virus a 'public health emergency of international concern' today. (Photo by Mario Tama/Getty Images)
Health ministry personnel fumigate a classroom against the Aedes aegypti mosquito, vector of the dengue, Chikungunya and Zika viruses in Tegucigalpa, , on February 1, 2016. Honduran President Juan Orlando Hernandez on Friday declared the country on a preventive state of alert due to the Zika virus which in the last 44 days killed a person and infected some 1000. AFP PHOTO/Orlando SIERRA. / AFP / ORLANDO SIERRA (Photo credit should read ORLANDO SIERRA/AFP/Getty Images)
Members of the Migente foundation check mosquito traps in the Paris neighborhood, Bello municipality, Antioquia department, Colombia on January 26, 2016. The Study and Control of Tropical Diseases Program (PECET) of Antioquia's University released one year ago Aedes aegypti mosquitos carrying the Wolbachia pipientis bacteria, which prevents them from transmitting the Zika and dengue viruses, as part of project to fight dengue. The Zika virus, a mosquito-borne disease suspected of causing serious birth defects, is expected to spread to all countries in the Americas except Canada and Chile, the World Health Organization said. AFP PHOTO /Raul ARBOLEDA / AFP / -- / RAUL ARBOLEDA (Photo credit should read RAUL ARBOLEDA/AFP/Getty Images)
A photographer walks through the fumes as Health Ministry employee fumigate against the Aedes aegypti mosquito to prevent the spread of the Zika virus in Soyapango, six km east of San Salvador, on January 21, 2016. Health authorities have issued a national alert against the Aedes Aegypti mosquito, because of the link between the Zika virus and microcephaly and Guillain-Barré Syndrome in fetuses. AFP PHOTO/Marvin RECINOS / AFP / Marvin RECINOS (Photo credit should read MARVIN RECINOS/AFP/Getty Images)
Army soldiers check for Aedes aegypti mosquito larvae during a clean-up operation against the insect, which transmits the Zika virus, in Sao Paulo, Brazil on January 22, 2016. AFP PHOTO/Miguel SCHINCARIOL / AFP / Miguel Schincariol (Photo credit should read MIGUEL SCHINCARIOL/AFP/Getty Images)
Army soldiers check for Aedes aegypti mosquito larvae during a clean-up operation against the insect, which transmits the Zika virus, in Sao Paulo, Brazil on January 22, 2016. AFP PHOTO/Miguel SCHINCARIOL / AFP / Miguel Schincariol (Photo credit should read MIGUEL SCHINCARIOL/AFP/Getty Images)
Army soldiers check for Aedes aegypti mosquito larvae during a clean-up operation against the insect, which transmits the Zika virus, in Sao Paulo, Brazil on January 22, 2016. AFP PHOTO/Miguel SCHINCARIOL / AFP / Miguel Schincariol (Photo credit should read MIGUEL SCHINCARIOL/AFP/Getty Images)
A health agent from the Sao Paulo secretariat of public health and army soldiers check for Aedes aegypti mosquito larvae during a clean-up operation against the insect, which transmits the Zika virus, in Sao Paulo, Brazil on January 22, 2016. AFP PHOTO/Miguel SCHINCARIOL / AFP / Miguel Schincariol (Photo credit should read MIGUEL SCHINCARIOL/AFP/Getty Images)
A Health Ministry employee fumigates a home against the Aedes aegypti mosquito to prevent the spread of the Zika virus in Soyapango, six km east of San Salvador, on January 21, 2016. Health authorities have issued a national alert against the Aedes Aegypti mosquito, because of the link between the Zika virus and microcephaly and Guillain-Barré Syndrome in fetuses. AFP PHOTO/Marvin RECINOS / AFP / Marvin RECINOS (Photo credit should read MARVIN RECINOS/AFP/Getty Images)
A Health Ministry employee fumigates a home against the Aedes aegypti mosquito to prevent the spread of the Zika virus in Soyapango, six km east of San Salvador, on January 21, 2016. Health authorities have issued a national alert against the Aedes Aegypti mosquito, because of the link between the Zika virus and microcephaly and Guillain-Barré Syndrome in fetuses. AFP PHOTO/Marvin RECINOS / AFP / Marvin RECINOS (Photo credit should read MARVIN RECINOS/AFP/Getty Images)
TOPSHOT - A Health Ministry employee fumigates a home against the Aedes aegypti mosquito to prevent the spread of the Zika virus in Soyapango, six km east of San Salvador, on January 21, 2016. Health authorities have issued a national alert against the Aedes Aegypti mosquito, because of the link between the Zika virus and microcephaly and Guillain-Barré Syndrome in fetuses. AFP PHOTO/Marvin RECINOS / AFP / Marvin RECINOS (Photo credit should read MARVIN RECINOS/AFP/Getty Images)
Health ministry employees spray to eliminate breeding sites of the Aedes Aegypti mosquito, which transmits diseases such as the dengue, chicunguna and Zica viruses, in a Tegucigalpa cemetery on January 21, 2016. The medical school at the National Autonomous University of Honduras (UNAH) recommended that women in the country avoid getting pregnant for the time being due to the presence of the Zika virus. If a pregnant woman is infected by the virus, the baby could be born with microcephaly. AFP PHOTO/Orlando SIERRA / AFP / ORLANDO SIERRA (Photo credit should read ORLANDO SIERRA/AFP/Getty Images)
A specialist fumigates the Nueva Esperanza graveyard in the outskirts of Lima on January 15, 2016. Health officials fumigated the largest cementery in Peru and second largest in the world to prevent Chikunguya and Zika virus, which affect several South American countries. AFP PHOTO/ERNESTO BENAVIDES / AFP / ERNESTO BENAVIDES (Photo credit should read ERNESTO BENAVIDES/AFP/Getty Images)
View of the Nueva Esperanza graveyard as it is fumigated in the outskirts of Lima on January 15, 2016. Health officials fumigated the largest cemetery in Peru and second largest in the world to prevent Chikunguya and Zika virus, which affect several South American countries. AFP PHOTO/ERNESTO BENAVIDES / AFP / ERNESTO BENAVIDES (Photo credit should read ERNESTO BENAVIDES/AFP/Getty Images)
A pregnant woman is attended at the Maternal and Children's Hospital in Tegucigalpa on January 21, 2016. The medical school at the National Autonomous University of Honduras (UNAH) recommended that women in the country avoid getting pregnant for the time being due to the presence of the Zika virus. If a pregnant woman is infected by the virus, the baby could be born with microcephaly. AFP PHOTO/Orlando SIERRA / AFP / ORLANDO SIERRA (Photo credit should read ORLANDO SIERRA/AFP/Getty Images)
A pregnant woman waits to be attended at the Maternal and Children's Hospital in Tegucigalpa on January 21, 2016. The medical school at the National Autonomous University of Honduras (UNAH) recommended that women in the country avoid getting pregnant for the time being due to the presence of the Zika virus. If a pregnant woman is infected by the virus, the baby could be born with microcephaly. AFP PHOTO/Orlando SIERRA / AFP / ORLANDO SIERRA (Photo credit should read ORLANDO SIERRA/AFP/Getty Images)
Aedes aegypti mosquitos are seen in containers at a lab of the Institute of Biomedical Sciences of the Sao Paulo University, on January 8, 2016 in Sao Paulo, Brazil. Researchers at the Pasteur Institute in Dakar, Senegal are in Brazil to train local researchers to combat the Zika virus epidemic. / AFP / NELSON ALMEIDA (Photo credit should read NELSON ALMEIDA/AFP/Getty Images)
Aedes aegypti mosquitos are seen in containers at a lab of the Institute of Biomedical Sciences of the Sao Paulo University, on January 8, 2016 in Sao Paulo, Brazil. Researchers at the Pasteur Institute in Dakar, Senegal are in Brazil to train local researchers to combat the Zika virus epidemic. / AFP / NELSON ALMEIDA (Photo credit should read NELSON ALMEIDA/AFP/Getty Images)
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According to the World Health Organization, there is a strong scientific consensus that, in addition to Guillain-Barre, Zika can cause the birth defect microcephaly, though conclusive proof may take months or years. Microcephaly is defined by unusually small heads that can result in developmental problems.

Brazil said it has confirmed more than 940 cases to be related to Zika infections in the mothers. Brazil is investigating nearly 4,300 additional suspected cases of microcephaly.

In addition to autoimmune disease, some researchers also have reported patients with Zika infections developing encephalitis and myelitis -- nerve disorders typically caused by direct infections in nerve cells.

"Though our study is small, it may provide evidence that in this case, the virus has different effects on the brain than those identified in current studies," Dr. Maria Lucia Brito, a neurologist at Restoration Hospital in Recife, Brazil, said in a statement.

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

Brito presented her findings on Sunday at the American Academy of Neurology meeting in Vancouver. The study involved 151 patients who visited her hospital between December 2014 and June 2015. All had been infected with arboviruses, the family of viruses that includes Zika, dengue and chikungunya.

Six of these patients developed symptoms consistent with autoimmune disorders. Of these six, four had Guillain-Barre and two had ADEM. In both ADEM cases, brain scans showed damage to white matter. ADEM symptoms typically last about six months.

All six patients tested positive for Zika, and all had lingering effects after being discharged from the hospital, with five patients reporting motor dysfunction, one with vision problems, and one with cognitive decline.

At least 13 countries have reported cases of Guillain-Barre linked 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. Centers for Disease Control and Prevention, said the ADEM cases linked with Zika do not appear to be occurring at the same accelerated rate as cases of Guillain-Barre, but said doctors should be on the 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 with GBS and potential other immune/inflammatory diseases of the nervous system?"

Sejvar, who has studied Guillain-Barre Syndrome (GBS) in Brazil and is involved in a major clinical trial of Guillain-Barre in Puerto Rico, said he hopes future studies will shed more light on such questions.

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Brazil reporting more microcephaly cases, defect cause by Zika
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