Mosquito-borne Viruses Linked to Causing Strokes

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Research published in The Lancet Neurology has found mosquito-borne viruses may be a trigger for stroke in some patients. 

Researchers from across Brazil and the University of Liverpool collaborated for the observational study.

They aimed to investigate the neurological features of two mosquito-borne viruses, Zika and Chikungunya. Moreover, whether a dual infection increases the risk of developing stroke in patients. 

1410 patients screened for mosquito-borne viruses

Over the past 5 years, Brazil has seen a huge increase in the cases of mosquito-borne viruses.

Along with a dengue epidemic, there have been multiple outbreaks of Zika and Chikungunya virus in the region. All three are mosquito-borne viruses transmitted by Aedes aegypti mosquitoes. 

Between December 2014 and December 2016, 1410 patients with a history of suspected arboviral infection were admitted at Hospital da Restauração in Recife, Brazil.

The patients had presented to the hospital’s neurology department with symptoms of a suspected neurological disease. Only 201 of these patients had sufficient samples for diagnostic testing and therefore, were included in the study.

Zika infection most often causes a syndrome of rash and fever without many long-term consequences, but these neurological complications—although rare—can require intensive care support in hospital, often result in disability, and may cause death.

Dr. Maria Lúcia Brito Ferreira

Laboratory investigations confirmed 148 of them with an arbovirus infection. Out of the 148 patients, 41 had Zika, 55 had Chikungunya, and 46 had a dual infection of both Zika and Chikungunya.

The most common symptoms among the patient were fever, rash, and muscle pains. 

What are Arbovirus Infections?

Arbovirus infections are those transmitted by the bite of an arthropod such as mosquitoes or ticks. 

Between 2015 and 2016, Brazil suffered a Zika and Chikungunya virus epidemic. Both viruses can cause a wide range of neurological symptoms in individuals. 

Two-Third of Stroke Patients Had a Dual Infection

17% of patients with a dual infection had a stroke or transient ischemic attack (TIA) compared to only 6% of those with a single infection. 

Additionally, both Zika and Chikungunya virus caused Guillain-Barre syndrome (GBS) in the patients. However, those suffering from GBS and a dual infection required more intensive care and support. 

Our study highlights the potential effects of viral infection on the brain, with complications like stroke. This is relevant to Zika and chikungunya, but also to our understanding of other viruses, such as COVID-19, which is increasingly being linked to neurological complications.

Dr. Suzannah Lant

Professor Tom Solomon, at the University of Liverpool, believes that while we continue to battle the COVID-19 pandemic it is important to understand why certain viruses can trigger a stroke to prevent complications in the future.


 Maria Lúcia Brito Ferreira et al, Neurological disease in adults with Zika and chikungunya virus infection in Northeast Brazil: a prospective observational study, The Lancet Neurology (2020).  DOI: 10.1016/S1474-4422(20)30232-5


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