Could Zika paralyze hundreds of U.S. adults?

The U.S. Centers for Disease Control and Prevention (CDC) last week released numbers raising the possibility that the Zika virus could lead to hundreds of disability insurance claims, and even some long-term care insurance (LTCI) claims, involving non-pregnant adults in the continental United States.

See also: CDC reports 683 Zika cases, 1 death in Puerto Rico

CDC officials reported that public health authorities recorded 683 laboratory-confirmed Zika infections in Puerto during the period from Nov. 1, 2015, through April 14.

News coverage of a widespread Zika outbreak in Brazil has focused mainly on the effects of the virus on fetuses. Authorities at the Pan-American Health Organization (PAHO) and the World Health Organization (WHO) estimated last week that Zika appears to have caused at least 91,387 confirmed infections in Brazil and at least 1,198 cases of microcephaly, or malformed heads, involving babies born to mothers who were exposed to Zika.

See also: Zika virus does cause birth defects

Public health officials have also talked, often more generally, about a somewhat less common complication: Guillain-Barré syndrome (GBS) cases linked to Zika infections.

In a patient who has GBS, the immune system attacks nerve cells and the sheaths around nerve cells.

Many patients recover fully from GBS, but the condition kills some patients and paralyzes others. When Dutch researchers studied the cost of treating 397 patients with the syndrome identified at European hospitals, they had to exclude three patients from the study because those patients died within one week of being identified. Only about 40 percent of the patients in the study could walk without assistance more than 30 meters in an open space four weeks after they were identified.

The United States normally has about one or two cases of GBS per 100,000 residents per year.

When CDC officials released the new Zika data for Puerto Rico, they said they knew of five people in Puerto Rico who tested positive for Zika and had developed GBS.

In other reports, CDC officials have said that mosquitos capable of carrying the Zika virus are already present in at least 30 U.S. states, as well as in Puerto Rico.

One problem with knowing what those numbers mean for the GBS rate among adults living in the continental states is that it’s hard to know whether current or past Zika infection patterns will repeat themselves, or even what the full infection numbers really are, either in the United States or other countries.

For a look at some of the numbers that are available, read on. 

1. Guillain-Barré syndrome in French Polynesia, Brazil and other non-U.S. locations.

Physicians first noticed Zika virus in the 1940s. Most cases were “subclinical,” meaning that the patients had no noticeable symptoms, and most of the other cases were mild.

Starting around 2007, another, somewhat more noticeable wave of Zika virus infections appeared to coincide with a spike in GBS cases in French Polynesia. Public health authorities had a hard time proving that Zika was directly responsible for the GBS cases, and about 80 percent of the Zika cases in French Polynesia were subclinical. But Zika appeared to infect about 73 percent of all French Polynesian residents ages three and older. The country recorded 42 GBS cases. That’s the equivalent of about 16 GBS cases per 100,000 residents.

In Brazil, officials have talked about seeing a sharp increase in the number of people with GBS but have not published a national total.

In February, a reporter at the Independent, a United Kingdom news organization, talked to just four large hospitals and learned of 177 cases of GBS.

In another country, Suriname, PAHO figures suggest that about 1 percent of the patients with Zika known to public health officials are developing GBS.

See also: Zika mosquitoes: Already in 30 U.S. states

Image: Vitalii Tkachuk