id,group,shortref,primrecyn,researchtype,studytype,region,country,adm1,country_return,studypop,studypop_line,studyyear,summary,aim,meth_expcasemeth_list,meth_outcasemeth_list,meth_altcaserange_list,meth_altcaseinfect_list,n_total,res_expcase_symp,res_expcase_any,res_expcase_igm,res_expcase_igg,res_expcase_prnt,res_expcase_pcrser,res_expcase_pcrur,res_altcase_denv,res_tlagcase,res_effmeas,res_pval,qual_strength,qual_weakn,qual_extvalid,qual_selectbias_cc,qual_selectbias_cs,qual_obsbias,qual_repbias,qual_confound,qual_power,causdim_temp,causdim_biol,causdim_ass,causdim_alt,causdim_cess,causdim_dose,causdim_exp,causdim_ana,causdim_spec,causdim_cons,caus_temp1,caus_temp3,caus_temp2,caus_biol1,caus_biol2,caus_biol3,caus_ass1,caus_ass2,caus_alt1,caus_alt2,caus_alt3,caus_alt4,caus_cess1,caus_cess2,caus_cess3,caus_dose1,caus_exp1,caus_exp2,caus_ana1,caus_ana2,caus_ana3,caus_spec1,caus_cons1,caus_cons2,caus_cons3,caus_cons4
348,7,"Thomas, MMWR Morb Mortal Wkly Rep, 2016",Yes,Clinical/epidemiological research,Case report,Americas,Puerto Rico,,,Humans,,2015-2016,"30 cases were identified with confirmed ZIKV infection through passive surveillance. Among these, 3 cases were hospitalized. One case was a male with rash, hospitalized for ascending paralysis, diagnosed with demyelinating polyneuropathy. Day 15, serum positive for Zika IgM, negative for dengue IgM, RT-PCR ZIKV, DENV and CHIKV. Day 19, urine negative for ZIKV by RT-PCR. Reported in a surveillance summary of 155 cases of suspected Zika virus infection.","To describe characteristics of the three laboratory-confirmed ZIKV cases who were hospitalized during November 23, 2015-January 28, 2016 in Puerto Rico, of which one had GBS","symptoms, ELISA IgM (serum), RT-PCR (serum), RT-PCR (urine)","symptoms/medical history, electrodiagnostics, CSF analyses",other infections,"CHIKV, DENV",1,1 of 1,1 of 1,1 of 1,,,0 of 1,0 of 1,0 of 0,3,,,Laboratory confirmed ZIKV infection  ,"Few other infections investigated (DENV, CHIKV)",,,,,,,,Yes,No,No,Yes,No,No,No,No,No,No,Evidence in favour,,Evidence in favour,,,,,,Evidence in favour,,,,,,,,,,,,,,,,,
425,8,"Reyna-Villasmil, Med Clin (Barc), 2016",Yes,Clinical/epidemiological research,Case report,Americas,Venezuela,"Maracaibo, Zulia State.",,Humans,,,"A case of pregnant 28 year old woman (gw 26) with ascending limb weakness and impaired speech and swallowing. She had myalgias, fever, rash and conjunctivitis 10 days before onset of the neurological symptoms. Electromyography showed diffuse demyelinating disorder with high distal motor latency, conduction block, acute denervation without axonal abnormalities. Serological tests were negative for common agents and positive for anti ganglioside GQ1b antibodies and ZIKV. She was treated in ICU with intravenous gamma globulins. The patient delivered a healthy baby at week 39. ",To describe a case of pregnant woman with Guillain-Barré Syndrome by ZIKV infection.  ,"symptoms, other","symptoms/medical history, electrodiagnostics, serum/plasma analyses, CSF analyses",other infections,,1,1 of 1,1 of 1,,,,,,,10,,,"Electromyography, Cerebrospinal fluid (CSF) analyses. Serological tests for ganglioside GQ1b and ZIKV were positive. Serological tests for common agents were negative, however there is no information about specific agents.",ZIKV infection was diagnostic with serological tests.,,,,,,,,Yes,Yes,No,No,No,No,No,No,No,No,Evidence in favour,,Evidence in favour,,Evidence in favour,,,,,,,,,,,,,,,,,,,,,
157,9,"Oehler, Eurosurveillance, 2014",No,Clinical/epidemiological research,Case report,Pacific,French Polynesia,,,Humans,,2013,"Woman with myalgia, rash and conjunctivitis. Hospitalized 7 days later with GBS‐like symptoms. Day 8, serum negative for dengue NS1 antigen by ELISA and DENV by RT‐PCR; day 8 and 28, serum positive for ZIKV IgM and ZIKV/DENV IgG. Day 28, serum positive for neutralising antibodies against DENV1‐4 and ZIKV. Serum negative for acute HIV, hepatitis B and C, Campylobacter jejuni, Leptospira, CMV, EBV, and HSV1/2.","To describe the first case of Guillain-Barré syndrome (GBS) occurring immediately after a Zika virus infec- tion, during the current Zika and type 1 and 3 dengue fever co-epidemics in French Polynesia.","symptoms, ELISA IgM (serum), ELISA IgG (serum), PRNT (serum), RT-PCR (serum)","symptoms/medical history, electrodiagnostics, CSF analyses",other infections,"Campylobacter jejuni, CMV, DENV, EBV, Hepatitis B, Hepatitis C, HIV, HSV, Leptospira",1,1 of 1,,1 of 1,1 of 1,1 of 1,0 of 1,,1 of 1,7,,,"Laboratory confirmed ZIKV infection  Partial exclusion of other infections (HIV, hepatitis B and C, Campylobacter jejuni, Leptospira, CMV, EBV, and HSV type 1 and 2)",Presumed date of infection based on clinical symptoms,,,,,,,,Yes,No,No,Yes,No,No,No,No,No,No,Evidence in favour,,Evidence in favour,,,,,,Evidence in favour,,,,,,,,,,,,,,,,,
473,10,"Roze, Eurosurveillance, 2016",Yes,Clinical/epidemiological research,Case report,Americas,Martinique,,,,,2016,Two cases of Guillain-Barré syndrome (GBS) were diagnosed in January 2016 on Martinique. The ZIKV infection was diagnosed by urine RT-PCR at hospital admission. The ZIKV infection was asymptomatic.,To describe two cases of Guillain-Barré syndrome (GBS) that were diagnosed in January 2016 on Martinique. Both patients were found to have ZIKV in their urine at hospital admission. ,"RT-PCR (serum), RT-PCR (urine), RT-PCR (CSF)","symptoms/medical history, electrodiagnostics, serum/plasma analyses, CSF analyses, imaging (CT/MRI/Ultrasound)",other infections,"Campylobacter jejuni, CHIKV, DENV, EBV, HIV, HSV, Mycoplasma pneumoniae, Other",2,,2 of 2,,,,0 of 2,2 of 2,2 of 2,,,,Outcome diagnosis . Other infectious were discarded. ZIKV infection was diagnosed by RT-PCR,"Other causes non infectious were not discarded. Temporal order unclear: ZIKV infection and GBS were diagnosed concomitantly, no reported Zika symptoms. ",,,,,,,,No,No,No,Yes,No,No,No,No,No,No,,,,,,,,,Evidence in favour,,,,,,,,,,,,,,,,,
799,25,"Fontes, Neuroradiology, 2016",Yes,Clinical/epidemiological research,Case report,Americas,Brazil,,,Humans,,2016,"A 51-year old female patient presented to the ER with lower limb paresis and facial biplegia after having Zika-related symptoms for 12 days. Zika virus was found in serum and urine (test unknown). The diagnosis of polyneuropathy compatible with GBS was based on CSF laboratory findings (elevated albumin), electromyography and neuroimaging (MRI of spinal cord and brain). Imaging showed contrast enhancement in facial nerves and spinal cord compatible with findings in other GBS cases. The patient was negative for other infections such as CHIKV, DENV, HSV, CMV, syphilis, HIV, HTLV and hepatitis (tests unknown). ",To report on the neuroimaging findings in a zika case who developed a polyneuropathy,"symptoms, other","symptoms/medical history, electrodiagnostics, CSF analyses, imaging (CT/MRI/Ultrasound)",other infections,"CHIKV, CMV, DENV, Hepatitis B, Hepatitis C, HIV, HSV, Other",1,1 of 1,1 of 1,,,,,,,12,,,,tests for Zika unknown,,,,,,,,Yes,No,No,Yes,No,No,No,No,No,No,Evidence in favour,,Evidence in favour,,,,,,Evidence in favour,,,,,,,,,,,,,,,,,
881,26,"Brasil, Lancet, 2016",Yes,Clinical/epidemiological research,Case report,Americas,Brazil,Rio de Janeiro,,Humans,,2014,"A 24-year old female developed paraesthesia of hands and feet followed by headache, fever, and rash 5 days later, and difficulty walking and disseminated rash 9 days later. Clinical examinations revealed absent deep tendon reflexes and reduced sensation to touch, but no ataxia. Nerve conduction studies, EMG and MRI were normal on day 10 and 13 after onset. She tested negative for CHIKV and DENV by PCR and IgM ELISA in serum and CSF, but positive for ZIKV in serum (day 5), CSF (day 6), and urine (day 11). ",To describe a case of paraparetic GBS associated with Zika virus infection,"symptoms, RT-PCR (serum), RT-PCR (urine), RT-PCR (CSF)","symptoms/medical history, electrodiagnostics, CSF analyses, imaging (CT/MRI/Ultrasound)",other infections,"CHIKV, DENV",1,1 of 1,1 of 1,,,,1 of 1,1 of 1,,,,,,,,,,,,,,No,No,No,Yes,No,No,No,No,No,No,,,,,,,,,Evidence in favour,,,,,,,,,,,,,,,,,
948,29,"Kassavetis, Neurology, 2016",Yes,Clinical/epidemiological research,Case report,Americas,Haiti,,,Humans,,2016,"Case report of a 35-year old haitian resident who presented with bifacial weakness and paraesthesia in hands and feet, which was diagnosed as a variant of GBS. A week later he developed external ophthalmoplegia, upper limb ataxia and gait ataxia consistent with Miller Fisher syndrome. Cranial MRI was normal. Serum and CSF were positive for Zika IgM and by PRNT. Rapid Plasma Reagin (Syphilis) and HIV were negative. ",,"ELISA IgM (serum), PRNT (serum), other","symptoms/medical history, CSF analyses, imaging (CT/MRI/Ultrasound)",other infections,"HIV, Other",1,,1 of 1,1 of 1,,1 of 1,,,,,,,,,,,,,,,,No,No,No,Yes,No,No,No,No,No,No,,,,,,,,,Evidence in favour,,,,,,,,,,,,,,,,,
1028,31,"Duijster, Infection, 2016",Yes,Clinical/epidemiological research,Case report,Americas,Suriname,,Netherlands,Humans,,2016,"Of a series 18 travellers returning from Suriname to the Netherlands, one female patient aged 60 developped GBS as a potential complication of Zika virus infection. The patient experienced fever and arthralgia. Six days later, she presented with diarrhoea, fever and an unsteady gait, followed later by muscle weakness, sensory disturbances, hyporeflexia in her limbs and facial diplegia. The diagnosis GBS was supported by spinal fluid investigation and electromyography. She tested positive for ZIKV by RT-PCR in serum and Urine, but IgG negative for CHIKV, DENV IgG positive and IgM negative and NS1 negative. The patient had an underlying morbidity. ",To describe 18 patients in the Netherlands who acquired Zika virus during a stay in Suriname or Dominican Republic,"symptoms, RT-PCR (serum), RT-PCR (urine)","electrodiagnostics, CSF analyses","other infections, systemic or neurodegenerative disease","CHIKV, DENV",1,1 of 1,1 of 1,,,,1 of 1,1 of 1,1 of 1,6,,,laboratory confirmed Zika virus infection,"few details, no exclusion of campylobacter jejuni",,,,,,,,Yes,No,No,Yes,No,No,No,No,No,Yes,Evidence in favour,,,,,,,,Evidence in favour,,,,,,,,,,,,,,,Evidence in favour,,
1067,31,"van den Berg, Ned Tijdschr Geneeskd, 2016",No,Clinical/epidemiological research,Case report,Americas,Suriname,,Netherlands,Humans,,2016,,,,,,,,,,,,,,,,,,,,,,,,,,,,No,No,No,No,No,No,No,No,No,No,,,,,,,,,,,,,,,,,,,,,,,,,,
241,5,"PAHO, Epidemiological update. Zika virus infection -17 March 2016, 2015",Yes,Clinical/epidemiological research,Case series,Americas,Multiple countries,,United States,Humans,,,"2 cases of returning travellers from countries with autochtonus transmission of ZIKV. 'The first case is an elderly male resident of the United States with recent travel to Central America. He developed an acute febrile illness shortly after returning to the U.S. and was subsequently hospitalized in January with progressive ascending weakness of the extremities and diminished reflexes. The patient tested positive for Zika virus infection by polymerase chain reaction (PCR). He improved following treatment and was ready to be discharged. However, he experienced a sudden subarachnoid hemorrhage due to a ruptured aneurysm and died. The second case is a resident of Haiti who had onset of facial weakness, difficulty swallowing and numbness of fingers in early January. He traveled to the U.S. for medical care after the numbness spread to his lower extremities, and lumbar puncture showed elevated protein and one white blood cell in the CSF. Zika virus IgM and neutralizing antibodies were identified in serum and CSF'",,"symptoms, RT-PCR (serum)","symptoms/medical history, other",,,2,1 of 1,2 of 2,,,,1 of 1,,,,,,,no more information,,,,,,,,Yes,No,No,No,No,No,No,No,No,Yes,Evidence in favour,,,,,,,,,,,,,,,,,,,,,,,Evidence in favour,,
245,6,"PAHO, Epidemiological update. Zika virus infection -17 March 2016, 2015",Yes,Clinical/epidemiological research,Case series,Americas,El Salvador,,,,,2015-2016,"'Between EW 48 of 2015 and EW 9 of 2016, El Salvador reported 136 cases of GBS in all 14 departments. On average El Salvador reported 169 cases annually. The cases range from 3 - 88 years old, with the highest concentration of GBS cases in the age range of 30-39. All 136 patients were hospitalized and treated with plasmapheresis or immunoglobulin. In 22 patients for whom information was available, 12 patients (54%) presented with a febrile rash illness between 7 and 15 days prior to the onset of GBS symptoms. Three patients died, including one patient who had multiple underlying chronic illnesses. None of the three deaths had history of febrile rash illness.'",,symptoms,,,,22,12 of 22,,,,,,,,7-15,,,,,,,,,,,,Yes,No,No,No,No,No,No,No,No,No,Evidence in favour,,Evidence in favour,,,,,,,,,,,,,,,,,,,,,,,
731,9,"Watrin, Medicine (Baltimore), 2016",No,Clinical/epidemiological research,Case series,Pacific,French Polynesia,,,Humans,,2013-2014,Electrophysiological and clinical characteristics of FP GBS cases. ,,,,,,,,,,,,,,,,,,,,,,,,,,,Yes,No,No,No,No,No,No,No,No,No,Evidence in favour,,Evidence in favour,,,,,,,,,,,,,,,,,,,,,,,
565,13,"PAHO, Epidemiological Update. Neurological syndrome, congenital anomalies, and Zika virus infection - 17 January 2016. , 2016",Yes,Clinical/epidemiological research,Case series,Americas,Brazil,,,,,,"PAHO epi alert 17.01.2016: In July 2015, 76 patients with neurological syndromes of which 42 were GBS. Among GBS, 26 had zika symptoms history. In november 2015, 7 patients with neurological syndromes were ZIKV positive (???)",,symptoms,,,,42,26 of 42,,,,,,,,,,,,"No more information, based on medical history only, no laboratory confirmed cases",,,,,,,,Yes,No,No,No,No,No,No,No,No,No,Evidence in favour,,,,,,,,,,,,,,,,,,,,,,,,,
567,15,"PAHO, Epidemiological update. Zika virus infection - 3 March 2016 and 17 March 2016, 2016",Yes,Clinical/epidemiological research,Case series,Americas,Panama,,,,,,"Panama reported 2 GBS cases, 1 ZIKV positive in blood and urine, the other a 13 year old girl, ZIKV positive in CSF and urine. The girl had onset of fever on 19 February 2016 and weakness on lower extremities on 29 February. Lumbar puncture showed elevated protein in the CSF, and Zika virus was detected in CSF and urine.",,"symptoms, RT-PCR (serum), RT-PCR (urine), RT-PCR (CSF)",,,,2,1 of 1,2 of 2,,,,1 of 2,2 of 2,,10,,,,,,,,,,,,Yes,No,No,No,No,No,No,No,No,No,Evidence in favour,,Evidence in favour,,,,,,,,,,,,,,,,,,,,,,,
430,9,"Cao-Lormeau, Lancet, 2016",Yes,Clinical/epidemiological research,Case-control study,Pacific,French Polynesia,"Papeete, Tahiti",,Humans,,2013-2014,"Case-control study, cases were patients with GBS (French Polynesia), 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). Cases with GBS had an OR 59.7 (10.4-infinite) of being Zika positive (IgM or IgG) compared to hospital controls. Past dengue virus history did not differ significantly between patients with GBS and those in the two control groups (95%, 89%, and 83%, respectively). However, GBS cases had an OR of 6.0 (0.8-269.5) of being also Dengue IgG compared to Zika infected hospital controls without GBS. ",To assess the role of Zika virus and dengue virus infection in developing Guillain-Barré syndrome.,"symptoms, ELISA IgM (serum), ELISA IgG (serum), PRNT (serum), RT-PCR (serum)","symptoms/medical history, electrodiagnostics, serum/plasma analyses, CSF analyses",other infections,"Campylobacter jejuni, CMV, DENV, EBV, Hepatitis B, Hepatitis C, HIV, HSV, Leptospira, Mycoplasma pneumoniae, Other",42,39 of 42,42 of 42,39 of 42,29 of 42,42 of 42,0 of 42,,40 of 42,Median 6 (IQR 4-10),"vs Control 1: for IgG and or IgM OR 59.7 (95% IC 10.4-infinite), for seroenutralisation OR 34.1 (5.8-infinite), dengue IgG OR 2(0.4-19.9). Control 2: OR 6 (0.8-269.5)", p<0.0001,Zika infection diagnostic. Electrophysiological assessment. Evaluation of DENV antibodies as a cofactor ,Viral RNA was not detected in control group 1.  It is not clear if the control group 2 had enough time after Zika infection to develop GBS.,Yes,Yes,,Yes,No,Yes,Yes,Yes,Yes,Yes,Yes,No,No,No,No,No,No,Evidence in favour,,Evidence in favour,Evidence in favour,,,Evidence in favour,,Evidence in favour,,,,,,,,,,,,,,,,,
120,1,"Duffy, N Engl J Med, 2009",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Pacific,Micronesia,Yap,,Humans,,,"The review of hospital and health center records identified 185 caes of suspected Zika infection. The reconstructed epidemic curve showed two peaks on May 27, 2007 and June 24, 2007. The calculated attack rate was 14.6 per 1000 residents. The sex-specific attack rates were 17.9 per 1000 females and 11.4 per 1000 males. No deaths, hospitalisations, or hemorrhagic complications were associated with Zika during this outbreak. The household survey yielded a seroprevalence of Zika IgM of 74%. Among the positive respondents, 19% reported a clinical illness. After accounting for non-response and sampling errors, the calculated infection risk was 73% (95% CI 68-77%). Male participants were more likely than female participants to have IgM antibodies (RR 1.1, 95% CI 1.0-1.2). ",To estimate the proportion of Yap residents with IgM antibodies against Zika,,,,,,,,,,,,,,,,,Yap is a small island which minimizes the risk of bias for the population at risk and the attack rates. The population at risk is well defined and there is a low risk of missing cases due to small number of health centres. Random sampling of household allows for an unbiased estimation of the seroprevalence. The estimates are thus considered reliable. ,"The neurological sequelae were unknown at the time point of this publication. Specific review of medical records for the outcomes of interest were not undertaken and cases with any of the outcomes may have been missing, despite the authors claiming that no hospitalizations associated with Zika occurred during the outbreak. ",,,,,,,,Yes,No,No,No,No,No,No,No,No,Yes,,Evidence not in favour,,,,,,,,,,,,,,,,,,,,,Evidence not in favour,,,
167,2,"Ioos, Med Mal Infect, 2014",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Pacific,French Polynesia,,,Humans,,,"Description of the Yap Islands and French Polynesia outbreaks. Causality assesses for FP part. Epidemiologic curves of the number of reported zika consultation (out of the sentinel surveillance) and number of total estimated zika consultation, linked with the number of GBS, ITP and ME cases, between the 30th oct 13 and 14 feb 2014. Total population (2016): 268'270, suspected case reported: 8510, suspected case estimated: 29`000, sample collected: 746, sample zika positive:396. 72 cases with severe neurological  symptoms: 42 GBS in three months compared with 5 usually diagnosed during that period. 4 cases of ITP. 13 cases with meningoencephalitis, 2 with opthalmological problems, 11 other neurological presentations","General review of the two epidemics, with ecological data about FP: epidemic curve of zika cases and GBS, ITP and ME outcomes. ",,,,,,,,,,,,,,,8.4; 3.3; 21.2,,"The show the epidemic curve for different outcomes: GBS, ITP, ME, ophtalmological symptoms, other neurological presentations","No measure of association done by itself. Comparison of expected number of cases only for GBS and not the other outcomes (ITP, ME, ...), and even for GBS, no source is given. They reported data until the 14th of Feb 2014 but the epidemic stopped a little bit later (week 8, 23th Feb14) and in other epidemic reports about this outbreak, GBS cases are reported until the end of Feb (where 2 more GBS cases occurred) ",,,,,,,,Yes,No,No,No,Yes,No,No,No,No,No,,Evidence in favour,,,,,,,,,,,,,Evidence in favour,,,,,,,,,,,
1055,2,"Yung, Clin Infect Dis, 2016",No,Clinical/epidemiological research,Ecological study/outbreak report,Pacific,French Polynesia,,,,,,"Using the case numbers of the case-control study by Cao et al, the authors calculated a 21 times increased risk of GBS during the Zika epidemic compared to the pre-Zika period of 2009 to 2012 (GBS incidence 0.41 per 1000 py, 95% CI 0.29 to 0.55 vs. 0.02 per 1000 py, 95% CI 0.01 to 0.03). This corresponds to an attributable risk of 0.39 per 1000 py. ",,,,,,,,,,,,,,,,,,,,,,,,,,,No,No,Yes,No,No,No,No,No,No,No,,,,,,,,Evidence in favour,,,,,,,,,,,,,,,,,,
190,2,"InVS, Point Epidemiologique International. Virus Zika Polynésie 2013-2014, Ile de Yap, Micronésie 2007 - Janvier 2014, 2014",No,Clinical/epidemiological research,Ecological study/outbreak report,Pacific,French Polynesia,,,Humans,,,"From 1. November 2013 - 12. January 2014, 59 cases with neurological problems were admitted to the hospital. Of those, 10 had meningo-encephalitis, 33 had GBS, 10 had other neurological problems, 2 had ophthalmological problems, 4 had ITP, 1 had other problems. ",Summarise outbreak data for ZIka cases and neurological disorders,,,,,,,,,,,,,,,,,"Hospital-based diagnoses are likely to be reliable, low risk of misclassification. ","No background risks available for the conditions under study, risk of selection bias. ",,,,,,,,Yes,No,No,No,No,No,No,No,No,No,,Evidence in favour,,,,,,,,,,,,,,,,,,,,,,,,
239,3,"PAHO, Epidemiological update. Zika virus infection 31 March 2016, 2015",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,French Guiana,,,,,,"PAHO epi alert 31.03.2016: Reported at least one case of zika positive GBS case, but no general GBS increase in the population  ",,,,,,,,,,,,,,,,,,,"No more information, no reference or baseline data",,,,,,,,Yes,No,No,No,No,No,No,No,No,No,,Evidence not in favour,,,,,,,,,,,,,,,,,,,,,,,,
240,4,"PAHO, Epidemiological update - 10 March 2016, 2015",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,Venezuela,,,,,,"Temporal relationship between GBS cases and Zika cases. Between EW49 2015 and EW6 2016: 278 GBS cases reported, from which 235 have history of zika-like symptoms. 1st confirmed GBS case with RT-PCR was in Nov 2015. In 2016 (EW1 to 6): 27 samples from GBS patients were tested, 6 (22.2%) were positive for zikv. From previous report when there were only 252 cases: of the 66 cases for which information was available: Associated comorbidity in 65% of the cases, 61%male. ",,,,,,,,,,,,,,,,,,,,,,,,,,,Yes,No,No,No,No,No,No,No,No,No,,Evidence in favour,,,,,,,,,,,,,,,,,,,,,,,,
566,14,"PAHO, Epidemiological update. Zika virus infection - 31 March 2016, 2016",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,Dominican Republic,,,,,,"PAHO Epi Alert 31.03.2016: Increase in GBS cases with zika virus lab confirmation in at least one case of GBS. Temporal correlation with zika cases, concurrent dengue epidemic. (plot). In EW15 2016: 9 new cases with history of suspected zikv disease. Total of 48 cases from EW1 to 15 2016. ʺOf the total number of cases, 67% (32 cases) were reported in the last four weeks. This corresponds to the increase of Zika cases reported in EW 15.",,,,,,,,,,,,,,,,,,,,,,,,,,,Yes,No,No,No,No,No,No,No,No,No,,Evidence in favour,,,,,,,,,,,,,,,,,,,,,,,,
569,16,"PAHO, Epidemiological update 21 April 2016, 2016",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,Haiti,,,,,,"At least one case of zika positive GBS case, but no general GBS increase in the population",,,,,,,,,,,,,,,,,,,,,,,,,,,Yes,No,No,No,No,No,No,No,No,No,,Evidence not in favour,,,,,,,,,,,,,,,,,,,,,,,,
571,17,"PAHO, Epidemiological update 21 April 2016, 2016",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,Honduras,,,,,,"Between EW1 and EW14 2016, Honduras reported 74 GBS cases. On average 112 GBS/year between 2010-2015 according to the hospital discharge records. Temporal correlation between GBS and zika cases. (although sporadic fluctuaction in GBS cases are shown; they are probably due tu delays in notification, see plot). Furthermore: in 2015: increase in AFP cases coincinding with introduction of zika virus in Honduras. in 2016, AFP rate from first 14 EW has already reached similar levels as AFP for whole year in 2013 and 2014. ʺIf this trend continues, a greater than average rate of AFP can be expected for 2016 coinciding with the increased cases of GBS and Zika virus casesʺ (see plot, difficult to say as it varies between 1.5 and 2 AFP rate/100'000 <15y.o ).",,,,,,,,,,,,,,,,,,,,,,,,,,,Yes,No,No,No,Yes,No,No,No,No,No,,Evidence in favour,,,,,,,,,,,,,Evidence in favour,,,,,,,,,,,
580,18,"PAHO, Epidemiological Update 24 March 2016, 2016",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,Panama,,,,,,PAHO Epi Alert 24.03.2016: No population level increase in GBS although at least 1 was tested positive for ZIKV (2 cases),,,,,,,,,,,,,,,,,,,,,,,,,,,Yes,No,No,No,No,No,No,No,No,No,,Evidence not in favour,,,,,,,,,,,,,,,,,,,,,,,,
631,19,"Craig, Bull World Health Organ, 2016",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Pacific,Multiple countries,,,Humans,,,"Retrospective review, surveillance (from 2000 to 2015) of acute flaccid paralysis (AFP)  in children <15 years. No overall spatial-temporal correlation with  ZIKV emergence in previously unaffected Pacific islands. Statistically significant excess cases of AFP were found in the pacific islands in 2000 (p<0.004), in 2006 (p<0.001), in 2009 (p<0.008) and 2014 (p<0.04) and on the Salomon Islands in 2015 (p<0.001). ",To identify published and unpublished information on human Zika cases and outbreaks in the Pacific island from 2007 to February 2016. To review routinely reported AFP data for Pacific island countries and areas from 2000 to 2015 and compared unexpected surveillance exceedances with ZIKV emergence in the islands to identify any correlation.,,,,,,,,,,,,,,,,,Covers multiple countries. Calculated observed vs. expected number of cases,Yearly data aggregated; AFP surveillance only in children (proxy measure for GBS); Small numbers of total populations and reported AFP,,,,,,,,Yes,No,No,No,No,No,No,No,No,No,,Evidence not in favour,,,,,,,,,,,,,,,,,,,,,,,,
638,20,"WHO, Zika situation report. Neurological syndrome and congenital anomalies - 5 February 2016, 2016",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,Brazil,,,,,,"Between EW13 and EW20 2015, there was an increase in GBS cases. On average there are 94 GBS cases/year and in 2015 there were 130 cases in Pernambuco. In Brazil, there were 1708 GBS cases registered nationwide, representing a 19% increase from the previous year (1439 cases).",,,,,,,,,,,,,,,,19% (1.4 times),,,,,,,,,,,Yes,No,Yes,No,No,No,No,No,No,No,,Evidence in favour,,,,,,Evidence in favour,,,,,,,,,,,,,,,,,,
720,21,"PAHO, Epidemiological update 8 April 2016, 2016",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,Colombia,,,,,,"Compared to 2013, Colombia experienced a large outbreak of dengue which started in August 2014 and peaked in April 2015. An outbreak of Chikungunya (55,000 cases) also began at the same time in 2014 mirroring the dengue epidemic curve (65,000 cases). In August 2015, after Zika introduction, the trends of both stared increasing simultaneously. There is a temporal correlation between the monthly reported cases of accute flaccid paralysis (AFP) and the beginning of zika outbreak when comparing the 3 arboviruses dynamics. There was also an increase in suspected measles and rubella cases from Sept15 to Nov15 (after the confirmation of an imported measles case). (of note, there were previous peaks of suspected measles-rubella cases cases in Sept13 and 14, but measles and rubella were ruled out in all these cases. Dengue also ruled out in few reported cases). (plot) During the enhenced surveillance for neurological syndrome from Dec15 to EW13 2016, Colombia detected 416 cases of neurological syndrome with history of zika virus symptoms, including 227 GBS cases and other similar neurological conditions as ascending polyneuropathy. Large number of cases reported from Norte Santander, were there is the highest number of GBS cases and highest number of zika cases in the country. There is also a temporal association between number of GBS and neurological syndrome cases with history of zika virus symptoms and the epidemic curve of reported zika virus cases in Colombia since 2015. Concurrent DENV epidemic and end (but still cases) of CHIKV.",,,,,,,,,,,,,,,,,,,,,,,,,,,Yes,No,No,No,Yes,No,No,No,No,No,,Evidence in favour,,,,,,,,,,,,,Evidence in favour,,,,,,,,,,,
780,22,"PAHO, Epidemiological update 21 April 2016, 2016",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,Martinique,,,,,,No increase in GBS cases since the zika epidemic although there was at least 1 confirmed zika positive GBS case (11 in total according to InVS16),,,,,,,,,,,,,,,,,,,"They don't indicate the baseline GBS incidence in Martinique. In the beginning they said there was an increase compared to previous weeks (because they had no info about baseline incidence), but then the PAHO report said there was no increase...",,,,,,,,Yes,No,No,No,No,No,No,No,No,No,,Evidence not in favour,,,,,,,,,,,,,,,,,,,,,,,,
781,23,"PAHO, Epidemiological update. Zika virus infection - 21 April 2016, 2016",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,El Salvador,,,,,,"Between EW48 2015 and EW14 2016, El Salvador reported 141 GBS cases (including 5 deaths from which, at leat 1 had multiple undelying chronic illness and at least 3 didn't had febrile rash illness). On average, there are 169 GBS cases/year. Temporal correlation is observed between Zika virus dynamics and GBS incidence.",,,,,,,,,,,,,,,,,,,No other information,,,,,,,,Yes,No,No,No,Yes,No,No,No,No,No,,Evidence in favour,,,,,,,,,,,,,Evidence in favour,,,,,,,,,,,
782,24,"PAHO, Epidemiological update. Zika virus infection - 28 April 2016, 2016",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,Paraguay,,,,,,PAHO Epi Update 28.04.2016: Increase in GBS cases in Paraguay in the first 3 months of 2016: 21 cases reported. As compared to previous years: from 2005-2011: average of 32 cases/year. No zika virus lab confirmation yet.  ,,,,,,,,,,,,,,,,,,,,,,,,,,,Yes,No,No,No,No,No,No,No,No,No,,Evidence in favour,,,,,,,,,,,,,,,,,,,,,,,,
909,27,"PAHO, Epidemiological update. Zika virus infection - 28 April 2016, 2016",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,Suriname,,,,,,"Between EW39 2015 and EW 15 2015, Suriname reported 14 cases of GBS, 9 of which were reported between EW1 and 15 2016. Annual average number: 5 cases/year, 2-fold increase in the 1st four months of 2016. Temporal relationship can be observed by simultaneous trends of Zika and GBS cases.",,,,,,,,,,,,,,,,,,,,,,,,,,,Yes,No,No,No,Yes,No,No,No,No,No,,Evidence in favour,,,,,,,,,,,,,Evidence in favour,,,,,,,,,,,
912,28,"Paploski, Emerg Infect Dis, 2016",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,Brazil,Salvador,,,,,"Using data on suspected cases of Zika (as assessed by acute exanthemous illness AEI), GBS and microcephaly from the Centers for Information and Epidemiologic Surveillance of Salvador (CIES), epidemiological curves for Zika, GBS and microcephaly were reconstructed. Temporal associations between the time series were assessed by lagged time-series cross-correlations to identify the most likely time lags between Zika exposure and sequelae. The analyses showed a strong positive correlation between temporally lagged time series of Zika cases and cases with GBS or microcephaly. The time interval between Zika infection peaks and GBS peaks was 5-9 weeks. Since the GBS cases were recorded on the date of hospitalisation rather than the date when symptoms began, the authors conclude that the actual time lag between Zika infection and onset of GBS might be shorter, as observed in other outbreaks. The number of microcephaly cases peaked 30-33 weeks after the peak of AEI cases. ",To investigate the temporal associations and the time lags between the epidemiological curves and reported cases of GBS and microcephaly,,,,,,,,,,,,,,,,,,,Yes,,,,,No,No,Yes,No,No,No,Yes,No,No,No,No,No,,,Evidence in favour,,,,,,,,,,,,Evidence in favour,,,,,,,,,,,
950,30,"PAHO, Epidemiological update. Zika virus infection - 28 April 2016, 2016",Yes,Clinical/epidemiological research,Ecological study/outbreak report,Americas,Puerto Rico,,,,,,"Puerto Rico reported at least one case of zika positive GBS case, but no general GBS increase in the population",,,,,,,,,,,,,,,,,,,,,,,,,,,Yes,No,No,No,No,No,No,No,No,No,,Evidence not in favour,,,,,,,,,,,,,,,,,,,,,,,,
537,11,"Lucchese, Autoimmun Rev, 2016",Yes,Basic and applied biomedical research,Sequence analysis and phylogenetics,,,,,,MR766,2016,"This study analyzed the peptide sharing between ZIKV polyprotein and human proteins using the Immune Epitope DataBase (IEDB). The polyprotein sequence was segmented in pentapeptides and each peptide was compared to sequence data of human proteins. The sequences were selected from UniProt by searching for 'microcephaly'. Sequences related to 'Down syndrome' were used as controls. The search revealed that 26 hexapeptides of 21 human microcephaly-related proteins overlapped with ZIKV pentaproteins, while no match was found for Down syndrome. The human protein matches included a range of proteins presumably involved in neurodevelopment. The same strategy was also applied for GBS by searching for protein keywords 'myelin', 'demyelination' and 'axonal neuropathy' as well as GBS autoantigens derived from literature. Of 140 proteins retrieved, 99 proteins (216 peptide sequences) showed matcheswith ZIKV polyprotein. The vast peptide sharing in this study supports an autoimmune component involved in Zika sequelae.  ",To investigate the immunological potential of the shared peptides,,,,,,,,,,,,,,,,,systematic approach to detect peptide sequence overlaps,"Keywords used in UniProt search may not adequately reflect the pathogenesis of the outcomes, the segmentation and alignment of peptides does not take into account the 3D structure of the protein (not all linear matches may also be matches in 3D), the hypothesis of microcephaly being a malformation due to an autoimmune reaction is not very sound (fetal immune system not well developed and not all maternal AB's cross the placenta). ",,,,,,,,No,Yes,No,No,No,No,No,No,No,No,,,,Evidence in favour,,,,,,,,,,,,,,,,,,,,,,
556,12,"Homan, bioRxiv, 2016",Yes,Basic and applied biomedical research,Sequence analysis and phylogenetics,,,,,,"SPH2015/ gi 969945757 (Brazilian strain), gi 592746966 (Senegal/Cote d'Ivoire)",2016,"In silico prediction of epitopes. Polyprotein sequences of ZIKV (Brazil and African lineage) as well as of DENV, YF, WNF, TBEV, JAEV were retrieved from GenBank and curated into polyproteins, which were then segmented into individual proteins. Human and viral protein epitopes were computationally predicted. Matches were additionally filtered by the use of keywords associated with the human proteome data to select candidate pentamers for potential Zika-proteome molecular mimicry. Among the 103 pentamers identified for ZIKV, the 5 matches with the highest probability among neurological mimics were the proteins Optineurin, Synaptogyrin-1, von Willenbrand factor A, Pro-Neuropeptide Y and Neuron Navigator 2. 3D modelling of the ZIKV Brazil lineage polyprotein confirmed the matches for pro-neuropeptide Y (proNPY) (ESTEN), synaptogyrin (TESTE), neurotrophin 4 (STENS), neural cell adhesion molecule (PVITE), and VWA (TENSK) for a ZIKV region adjacent to high affinity MHC II binding site suggesting B and T-cell co-presentation. The ZIKV Brazil but not African lineage showed a mimic match for optineurin. Most lineages of DENV-3 (Brazilian lineage) were shown to mimic the mature neuropeptid Y, while the Venezuelan DENV-3 lineage has no such matches. The authors hypothesise that antibodies to ZIKV may contribute to the pathogenesis of GBS, microcephaly and ocular lesions. ",To illuminate ZIKV pathogenesis using an in silico approach and by predicting antibody mediated epitope mimicry for the human proteome. ,,,,,,,,,,,,,,,,,"3D protein prediction analysis, set of filters to detect matches, comparison of Brazilian and African lineage as well as other Viruses",,,,,,,,,No,Yes,No,No,No,No,No,No,No,No,,,,Evidence in favour,,,,,,,,,,,,,,,,,,,,,,