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R Melbourne-Chambers

Meningo-encephalo-myelitis in Children during the Zika Virus Epidemic in Grenada

Issue: 
DOI: 
10.7727/wimjopen.2017.227
Pages: 
43–6
Synopsis: 
Zika Virus is neurotropic. We report two children from the Caribbean Island of Grenada, a three-year-old with acute neuro-inflammation who had intractable seizures, meningo-encephalitis, CSF pleocytosis and Zika IgM positive acute serology and a four-year-old with acute demyelinating encephalomyelitis manifesting as generalized seizures, optic neuritis, diffuse cerebral dysfunction, encephalopathy, impaired speech and ataxia who also had CSF pleocytosis as well as Zika IgM and Dengue IgM positive acute serologies. Both cases occurred during the 2016 Zika and Dengue fever epidemic in Grenada. Both children recovered completely. The aetiologic role of the Zika and Dengue arboviruses is discussed.

Zika Virus is neurotropic. We report two children from the Caribbean Island of Grenada, a three-year-old with acute neuro-inflammation who had intractable seizures, meningo-enceph-alitis, cerebrospinal fluid (CSF) pleocytosis and Zika Immunoglobulin M (IgM) positive acute serology and a four-year-old with acute demyelinating encephalomyelitis manifesting as generalized seizures, optic neuritis, diffuse cerebral dysfunction, encephalopathy, impaired speech and ataxia who also had CSF pleocytosis as well as Zika IgM and Dengue IgM positive acute serologies.

Accepted: 
December 18, 2017
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Acute Paralysis and Neuro-inflammation in Jamaican Children during Zika virus and Dengue Epidemics of 2016

Issue: 
DOI: 
10.7727/wimjopen.2016.526
Pages: 
12-7
Synopsis: 
This case series suggests a unique clinical pattern of neuro-inflammation in Jamaican adolescents occurring during the ZIKV epidemic and questions the role of the three circulating arbo-viruses in the pathogenesis.

Dengue, Chikungunya fever (CHIKV) and Zika virus (ZIKV) are all transmitted by the Aedes aegypti mosquito and are currently circulating in Jamaica. Jamaica has been experiencing a ZIKV epidemic since February 2016. At the University Hospital of the West Indies (UHWI), Kingston, Jamaica, a cluster of five cases of paralysis attributed to neuro-inflammation was noted amongst adolescents admitted to the Institution. Three were diagnosed with acute myelitis and one each with acute disseminated encephalomyelitis (ADEM) and Guillain-Barre Syndrome (GBS).

Accepted: 
October 24, 2016
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Chikungunya in Jamaica – Public Health Effects and Clinical Features in Children

Issue: 
DOI: 
10.7727/wimjopen.2016.529
Pages: 
18-24
Synopsis: 
The Chikungunya fever epidemic had significant public health and economic impact in Jamaica. In children, there were characteristic presentations in neonates and young infants and in children six months to six years. Neurologic involvement was common but other organ dysfunction was rare.

Background: Chikungunya virus entered the Caribbean for the first time in 2013 and Jamaica experienced its maiden epidemic with Chikungunya fever in 2014. We aimed to describe the public health effects and describe the clinical features in children and adolescents in Jamaica.

Accepted: 
October 26, 2016
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Trends of Microcephaly and Severe Arthrogryposis in Three Urban Hospitals following the Zika, Chikungunya and Dengue Fever Epidemics of 2016 in Jamaica

Issue: 
DOI: 
10.7727/wimjopen.2017.124
Pages: 
33-42
Synopsis: 
Newborns with the characteristics of congenital syndrome associated with Zika virus (CSAZ) are being born in urban hospitals after the 2016 Zika virus epidemic in Jamaica. Phenotypic features include microcephaly, craniofacial disproportion, neuro-imaging and neuro-pathological findings and arthrogryposis. A trend towards babies being delivered with small head circumferences, but not yet in the range of microcephaly and others with normal head sizes who were born to women who were symptomatic in pregnancy is also being observed. While, most babies with probable CSAZ are being born to asymptomatic women who did not report any symptoms related to arbovirus illness in pregnancy. Diagnosis is challenged by serological cross-reactivity between circulating flaviviruses. Team management is multidisciplinary to maximize the neuro-developmental potential of this vulnerable patient population.
Introduction: Jamaica experienced its maiden Zika virus (ZIKV) epidemic in 2016, while Dengue (serotypes 3 and 4) and Chikungunya were also circulating.
 
Aim: We describe initial trends in microcephaly and arthrogryposis observed by the clinicians from three urban birthing facilities during late 2016 to early 2017.
 
Accepted: 
December 12, 2016
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Journal Sections: 
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