Dr Peter Barlow 

British Society for Immunology spokesperson, and Reader in Immunology & Infection, Edinburgh Napier University

本研究では、フランス領ポリネシアで流行したジカウイルス感染とギラン・バレー症候群（GBS）とに因果関係があるとする証拠を提示しています。しかし、今回、分析した患者数は比較的少なく、GBS発症と関連していると考えられるデング熱ウイルスの感染について考慮されていないため、この結果が南米でのジカウイルス流行に同じように当てはまるかどうかについては、まだ多くの調査が必要でしょう。

原文

“This study provides evidence to suggest a causal link between Zika virus infection and Guillain-Barreì syndrome in French Polynesia.  However, there is still a significant amount of work to be undertaken before the same conclusions can be extended to the Zika outbreak in South America, where local population factors may also play a role.

“Because the patient group that was analysed in this study is relatively small, the exact link between Zika and Guillain-Barreì syndrome remains inconclusive.   The authors also had to consider their findings in the context of Dengue virus infection circulating in the local population, which is another viral infection associated with Guillain-Barreì.

“However, the evidence that links Zika virus with Guillain-Barreì syndrome is now substantially more compelling.”

Prof Jimmy Whitworth

Professor of International Public Health, London School of Hygiene & Tropical Medicine

本研究では、2013年にフランス領ポリネシアで流行したジカウイルス感染とGBSに関連があるとする証拠を提示しています。過去のケースからは、GBS発症に関連する感染症にかかった2,000～4,000人の患者のうち一人が、感染後、２～８週間目にGBSを発症すると言われています。

しかし、本研究では、ジカウイルス感染後の患者がGBSを発症したのは、他の感染症にかかった患者よりも平均1週間ほど早く、さらに回復も早かったとあります。研究者らは、デング熱感染とGBSの関連性については調査していないとのことです。

原文

“This paper provides compelling evidence of the link between Guillain-Barré syndrome and Zika virus infection during the outbreak in French Polynesia in 2013. Guillain-Barrésyndrome is a rare neurological complication seen after a variety of bacterial and viral infections (such as Campylobacter and cytomegalovirus) and occurs all around the world. From previous experience we know that one person in 2,000-4,000 of those who have had one of these infections will develop Guillain-Barré syndrome, which is an abnormal immune response to the infection. It usually occurs 2-8 weeks after an infection.

“In this paper, the authors calculate that Guillain-Barré syndrome occurred at about the same frequency after Zika virus infections as is seen with other infections. However, the condition seems to have developed sooner after infection, on average less than one week, than is seen with other infections. The affected patients are reported to have recovered quicker too. The authors found no signal that previous dengue infection was associated with the development of Guillain-Barré syndrome.

“If the experience of Zika virus infection in Latin America is similar to that seen in French Polynesia, we can expect to see about 2-5 cases of Guillain-Barré syndrome for every 10,000 people who get infected. This has implications for health care in countries with a Zika virus epidemic as a proportion of those affected with Guillain-Barrésyndrome will need breathing support on a ventilator for a while, and some cases do not recover fully from the syndrome and are left with disability.”