↓ Skip to main content

Guillain-Barré Syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study

Overview of attention for article published in The Lancet, February 2016
Altmetric Badge

About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#19 of 25,296)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Readers on

666 Mendeley
Guillain-Barré Syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study
Published in
The Lancet, February 2016
DOI 10.1016/s0140-6736(16)00562-6
Pubmed ID

Van-Mai Cao-Lormeau, Alexandre Blake, Sandrine Mons, Stéphane Lastère, Claudine Roche, Jessica Vanhomwegen, Timothée Dub, Laure Baudouin, Anita Teissier, Philippe Larre, Anne-Laure Vial, Christophe Decam, Valérie Choumet, Susan K Halstead, Hugh J Willison, Lucile Musset, Jean-Claude Manuguerra, Philippe Despres, Emmanuel Fournier, Henri-Pierre Mallet, Didier Musso, Arnaud Fontanet, Jean Neil, Frédéric Ghawché, Cao-Lormeau, Van-Mai, Blake, Alexandre, Mons, Sandrine, Lastère, Stéphane, Roche, Claudine, Vanhomwegen, Jessica, Dub, Timothée, Baudouin, Laure, Teissier, Anita, Larre, Philippe, Vial, Anne-Laure, Decam, Christophe, Choumet, Valérie, Halstead, Susan K, Willison, Hugh J, Musset, Lucile, Manuguerra, Jean-Claude, Despres, Philippe, Fournier, Emmanuel, Mallet, Henri-Pierre, Musso, Didier, Fontanet, Arnaud, Neil, Jean, Ghawché, Frédéric, VM Cao-Lormeau, A Blake, S Mons, S Lastere, C Roche, J Vanhomwegen, T Dub, L Baudouin, A Teissier, P Larre, AL Vial, C Decam, V Choumet, SK Halstead, Prof HJ Willison, L Musset, JC Manuguerra, Prof P Despres, Prof E Fournier, HP Mallet, D Musso, Prof A Fontanet, J Neil, F Ghawché


Between October, 2013, and April, 2014, French Polynesia experienced the largest Zika virus outbreak ever described at that time. During the same period, an increase in Guillain-Barré syndrome was reported, suggesting a possible association between Zika virus and Guillain-Barré syndrome. We aimed to assess the role of Zika virus and dengue virus infection in developing Guillain-Barré syndrome. In this case-control study, cases were patients with Guillain-Barré syndrome diagnosed at the Centre Hospitalier de Polynésie Française (Papeete, Tahiti, French Polynesia) during the outbreak period. Controls were age-matched, sex-matched, and residence-matched patients who presented at the hospital with a non-febrile illness (control group 1; n=98) and age-matched patients with acute Zika virus disease and no neurological symptoms (control group 2; n=70). Virological investigations included RT-PCR for Zika virus, and both microsphere immunofluorescent and seroneutralisation assays for Zika virus and dengue virus. Anti-glycolipid reactivity was studied in patients with Guillain-Barré syndrome using both ELISA and combinatorial microarrays. 42 patients were diagnosed with Guillain-Barré syndrome during the study period. 41 (98%) patients with Guillain-Barré syndrome had anti-Zika virus IgM or IgG, and all (100%) had neutralising antibodies against Zika virus compared with 54 (56%) of 98 in control group 1 (p<0·0001). 39 (93%) patients with Guillain-Barré syndrome had Zika virus IgM and 37 (88%) had experienced a transient illness in a median of 6 days (IQR 4-10) before the onset of neurological symptoms, suggesting recent Zika virus infection. Patients with Guillain-Barré syndrome had electrophysiological findings compatible with acute motor axonal neuropathy (AMAN) type, and had rapid evolution of disease (median duration of the installation and plateau phases was 6 [IQR 4-9] and 4 days [3-10], respectively). 12 (29%) patients required respiratory assistance. No patients died. Anti-glycolipid antibody activity was found in 13 (31%) patients, and notably against GA1 in eight (19%) patients, by ELISA and 19 (46%) of 41 by glycoarray at admission. The typical AMAN-associated anti-ganglioside antibodies were rarely present. Past dengue virus history did not differ significantly between patients with Guillain-Barré syndrome and those in the two control groups (95%, 89%, and 83%, respectively). This is the first study providing evidence for Zika virus infection causing Guillain-Barré syndrome. Because Zika virus is spreading rapidly across the Americas, at risk countries need to prepare for adequate intensive care beds capacity to manage patients with Guillain-Barré syndrome. Labex Integrative Biology of Emerging Infectious Diseases, EU 7th framework program PREDEMICS. and Wellcome Trust.

Twitter Demographics

The data shown below were collected from the profiles of 583 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 666 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 16 2%
United States 13 2%
United Kingdom 4 <1%
Germany 3 <1%
Spain 3 <1%
France 2 <1%
Netherlands 2 <1%
Mexico 1 <1%
Denmark 1 <1%
Other 6 <1%
Unknown 615 92%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 131 20%
Student > Master 130 20%
Researcher 94 14%
Student > Ph. D. Student 91 14%
Other 50 8%
Other 170 26%
Readers by discipline Count As %
Medicine and Dentistry 220 33%
Agricultural and Biological Sciences 162 24%
Biochemistry, Genetics and Molecular Biology 72 11%
Immunology and Microbiology 46 7%
Unspecified 25 4%
Other 141 21%

Attention Score in Context

This research output has an Altmetric Attention Score of 2198. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 September 2017.
All research outputs
of 8,951,214 outputs
Outputs from The Lancet
of 25,296 outputs
Outputs of similar age
of 290,706 outputs
Outputs of similar age from The Lancet
of 564 outputs
Altmetric has tracked 8,951,214 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 25,296 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 29.6. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 290,706 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 564 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.