“It’s pretty obvious that in all seven sites there is a clear relationship,” said Dr. Marcos A. Espinal, the study’s lead author and the director of communicable diseases at the Pan American Health Organization, which collected data on confirmed and suspected cases of Zika infection and on the incidence of Guillain-Barré. “Something is going on.” 
 
 In Venezuela, officials expected roughly 70 cases of Guillain-Barré from December 2015 to the end of March 2016, as mosquitoes were spreading the virus. Instead, there were 684 cases. 
 
 Similarly, during five months in which the Zika virus was circulating in Colombia, officials recorded 320 cases of Guillain-Barré when there should have been about 100. From September 2015 to March 2016, while Zika infections peaked in El Salvador, cases of Guillain-Barré doubled to 184 from 92. 
 
 The researchers included patients with both suspected and confirmed Zika infections, as reported by national health officials. 
 
 Newsletter Sign Up Continue reading the main story Please verify you're not a robot by clicking the box. Invalid email address. Please re-enter. You must select a newsletter to subscribe to. Sign Up You agree to receive occasional updates and special offers for The New York Times's products and services. Thank you for subscribing. An error has occurred. Please try again later. View all New York Times newsletters. 
 
 Dr. Kenneth C. Gorson, professor of neurology at Tufts University School of Medicine, who was not involved with the new analysis, called it compelling. 
 
 “This is a substantial public health burden for countries that may not have well-developed health systems in place,” he said. “They have to have enough ventilators and I.C.U. beds.” About one-third of patients with Guillain-Barré require breathing assistance, he said. 
 
 Over all, Dr. Espinal and his authors found increases in Guillain-Barré that were two to 10 times what would normally be expected. Roughly 500 million people in Latin America and the Caribbean are at risk for Zika virus infection, so even modest increases in the incidence of Guillain-Barré are worrisome. 
 
 The nations in the study included the Dominican Republic, El Salvador, Honduras, Suriname, Venezuela and Colombia, along with the state of Bahia in Brazil. (National data from Brazil was not available until February 2016.) 
 
 Advertisement Continue reading the main story 
 
 Collectively, they reported a total of nearly 1,500 cases of temporary paralysis. The reported incidence was 28 percent higher for men and increased with age for both sexes, in line with previous research. 
 
 Temporary paralysis is a potential neurological complication of dengue infection, too. But Dr. Espinal and his colleagues looked for a similar link to dengue and found none. 
 
 Dr. Gorson noted that the continental United States has no formal monitoring system for Guillain-Barré. As the number of Zika cases in Florida and elsewhere increases, he said, “you won’t know if a Guillain-Barré case is related to Zika infection.” 
 
 “We can do it,” he said of such surveillance. But “there’s no funding from Congress to do it.” ||||| SAN JUAN, Puerto Rico (AP) — Puerto Rico on Friday reported its first death from a paralysis condition that developed from a Zika infection as the U.S. territory fights an epidemic of the mosquito-borne virus. 
 
 The victim was a man between 35 and 45 years old from the San Juan metro area who died from Guillain-Barre, according to state epidemiologist Brenda Rivera. The condition can cause temporary paralysis and in rare instances, death. 
 
 Rivera noted that it's unusual for the victim to be so young. 
 
 "What does this tell us? That all of us are susceptible," Rivera said as she urged Puerto Ricans to protect themselves from the mosquito-borne virus. 
 
 The man, who died last month, was obese but did not have any other health conditions, she said. No further details about the victim were provided. 
 
 The U.S. territory has a total of 13,186 confirmed Zika cases, with a total of 102 hospitalizations and 34 cases of Guillain-Barre. The number of Zika cases is believed to be much higher because eight of 10 people have no symptoms and many do not go to the doctor. Those infected include 1,106 pregnant women, which is a concern because Zika has been linked to severe birth defects. 
 
 "We are not going to see the effects of Zika today," Rivera said. "We are going to see them in the next couple of months, in the next several years." 
 
 Puerto Rico reported the first Zika-related microcephaly case acquired on U.S. soil in May, involving a dead fetus that a woman turned over to health authorities. Since then no microcephaly cases have been reported, but federal officials say it is only a matter of time. A study published Friday in JAMA Pediatrics estimates that up to 10,300 pregnant women in Puerto Rico could be infected with Zika and that between 100 to 270 babies could be born with microcephaly through mid-2017. 
 
 In addition, some babies infected with Zika may present other type of problems such as eye abnormalities, hearing loss and inflexible joints, said Dr. Peggy Honein, chief of the birth defects branch at the U.S. Centers for Disease Control and Prevention. 
 
 "We are very concerned about these often devastating outcomes," she said in a phone interview. 
 
 Honein, who was involved in the study, said that one of the major challenges of the Zika outbreak is the time delay in babies being born with severe defects. 
 
 "It doesn't mean that it's not happening because we don't see the effects yet," she warned. 
 
 The U.S. government last week declared a public health emergency in Puerto Rico because of Zika, and federal officials have warned that up to 25 percent of Puerto Rico's nearly 3.5 million people could become infected. 
 
 The CDC recently urged Puerto Rico fight Zika with the insecticide naled through aerial spraying, but the governor rejected that proposal and instead authorized the use of Bti, an organic larvicide. ||||| Fears over the Zika virus have intensified after El Salvador warned women not to get pregnant for the next two years, as the mosquito-borne virus could cause birth defects among newborns. 
 
 The virus is thought to cause severe brain damage in new-born babies and may also be behind rising instances of a separate potentially fatal illness that can leave patients paralysed, doctors say. 
 
 It is already suspected of being responsible for a dramatic increase in cases of microcephaly, where babies are born with abnormally small heads, in Latin America. 
 
 Zika Virus is associated with a 20x increase of Guillain-Barré in Brazil. @nytimes https://t.co/cQJCQLuR3e 
 
 Nearly 4,000 cases have been recorded in Brazil since October , a trend specialists are attributing to Zika, although they concede the link is not 100 per cent certain. 
 
 Now doctors in the country believe the virus - which was previously virtually unknown on the American continent - may also be causing a sudden surge in a potentially fatal condition known as Guillain-Barre. 
 
 Brazil now fears #Zika may be causing rise in Guillain-Barré (also observed after 2013 outbreak in French Polynesia) https://t.co/CGS6ILaWtz — Jennifer Yang (@jyangstar) January 21, 2016 
 
 North-eastern Brazil, the area hardest hit by the Zika virus, recorded 554 cases of Guillain-Barre last year, leading doctors to suspect a link, although that too is still unproven. 
 
 Guillain-Barre syndrome, also known as Landry's Paralysis, is defined as a rapid onset of muscle weakness caused by damage to the peripheral nervous system. 
 
 It can be life-threatening in its acute phase and leaves sufferers unable to move and dependent on life support. 
 
 @CMichaelGibson That"s correct! Three patients with Guillain Barre syndrome have appeared in Venezuela where the Zika cases are high. — Monica Cedeno (@CedenoMonica) January 21, 2016 
 
 The United States Centres for Disease Control and Prevention (CDC) is helping authrorities in Brazil to conduct studies aimed at establishing if Guillain-Barre is connected to Zika, the New York Times reported. 
 
 The CDC last week advised pregnant women against travelling to 13 Latin American countries, as well as Puerto Rico, where Zika has become prevalent. 
 
 More than half-a-dozen Zika cases have been reported in the US, most recently a woman in Texas who had returned from a trip to El Salvador 
 
 America's first case of a baby born with an unusually small head and brain was recorded last week in Hawaii. The mother had visited Brazil while pregnant. Although the CDC says the link between Zika and microcephaly is not definite, no other explanation has been offered. 
 
 First discovered in Uganda's Zika forest in 1947, the virus is said to be related to dengue, yellow fever and the West Nile virus. While common in Africa and Asia, it only started spreading in the Western hemisphere last May following an outbreak in Brazil. 
 
 Increased foreign travel and rising temperatures caused by global warming are two common theories given to explain its sudden spread. 
 
 There is no separate test for the infection and symptoms can be relatively mild, with only 20 per cent of sufferers reporting signs such as rashes, fever, joint pain and red eyes. 
 
 It is thought to be most commonly spread by mosquitoes, which breed in or near stagnant water pools. ||||| There’s more evidence that Zika virus infection can cause a paralyzing side effect called Guillain-Barré syndrome. 
 
 Instances of Guillain-Barré skyrocketed in countries hit by Zika virus epidemics — by as much as 877 percent in Venezuela, health officials and researchers from Latin America reported. At the very least, rates doubled, the officials said in a letter to the New England Journal of Medicine. 
 
 A specialist at Harris County Public Health and Environmental Services holds a box that contains captured mosquitoes. Jennifer Weiss / NBC News 
 
 “During the weeks of Zika virus transmission, there were significant increases in the incidence of the Guillain–Barré syndrome, as compared with the pre-Zika virus baseline incidence, in (Brazil’s) Bahia State (an increase of 172 percent), Colombia (211 percent), the Dominican Republic (150 percent), El Salvador (100 percent), Honduras (144 percent), Suriname (400 percent), and Venezuela (877 percent),” they wrote. “When the incidence of Zika virus disease increased, so did the incidence of the Guillain–Barré syndrome.” 
 
 Doctors are fairly certain that Zika can cause Guillain-Barré syndrome, a little understood reaction in which the immune system attacks the nerves. It can cause temporary but often severe paralysis. In extreme cases, patients must be put on ventilators to help them breathe until they recover. 
 
 Related: Rare Zika Complication Hits 30 in Puerto Rico 
 
 It can be fatal — Guillain-Barré caused by Zika killed a man in Puerto Rico last month. It's usually seen in about every 5,000 to 10,000 infections like Zika. Other infections also can cause Guillain-Barré. 
 
 “When the incidence of Zika virus disease increased, so did the incidence of the Guillain–Barré syndrome.” 
 
 Zika’s worst effect is the brain and nerve damage it causes in developing fetuses. It can devastate the growing brain and there is no way to prevent or reverse the effects. 
 
 Pregnant women in Zika-affected zones are warned to avoid mosquito bites if they possibly can by using repellents, covering up with clothing and staying inside behind screens and air conditioning. But these facilities are often not available in some of the worst-hit places. 
 
 The researchers found more women than men reported Zika infections, but said that might be because women are more aware of the risks because of the pregnancy link. However, men were more likely to develop Guillain-Barré. 
 
 “From April 1, 2015, to March 31, 2016, a total of 164,237 confirmed and suspected cases of Zika virus disease and 1,474 cases of the Guillain–Barré syndrome were reported in Bahia, Brazil; Colombia; the Dominican Republic; El Salvador; Honduras; Suriname; and Venezuela,” they wrote. “The reported incidence of the Guillain–Barré syndrome was 28 percent higher among males than among females and consistently increased with age, findings that are in line with previous reports.” 
 
 “The reported incidence of the Guillain–Barré syndrome was 28 percent higher among males than among females.” 
 
 Zika has often circulated quietly, in part because it doesn’t cause symptoms in most people and in part because it looks like so many other mosquito-borne diseases, such as dengue virus. 
 
 The health officials suggested that watching for Guillain-Barré cases might be one way to spot Zika outbreaks. 
 
 Related: Zika Link to Birth Defects, Guillain-Barré 'Alarming' 
 
 “Approximately 500 million people in Latin America and the Caribbean are at risk for Zika virus infection,” they wrote. 
 
 “It is clear that increases in the incidence of the Guillain–Barré syndrome to a level that is 2 and 9.8 times as high as baseline, as we have reported here, impose a substantial burden on populations and health services in this region.” ||||| The Aedes aegypti mosquito carries the Zika virus, which has been linked to suspected brain damage in thousands of Brazilian newborns. (AFP/Getty Images) 
 
 This post has been updated. 
 
 U.S. and Brazilian health officials are investigating whether there may be an association between the mosquito-borne Zika virus that is spreading in the South American country and an increase in cases of a rare syndrome that causes paralysis. 
 
 The Centers for Disease Control and Prevention has sent a four-member team to Brazil to help the health ministry in its investigation of the growing number of cases of Guillain-Barré syndrome and a potential connection to the Zika outbreak there. 
 
 Spokeswoman Christine Pearson said Thursday that the CDC team, dispatched at Brazil’s request, has been on the ground for less than a week. It includes a neuroepidemiologist and a medical epidemiologist. 
 
 [Zika's alarming spread: More than a million infected with virus globally] 
 
 Guillain-Barré syndrome occurs when individuals’ own immune system damages their nerve cells, causing muscle weakness and sometimes paralysis. Symptoms usually last for a few weeks. Most people recover fully from it, but some have long-term nerve damage. In rare cases, people have died, usually from difficulty breathing. 
 
 Brazilian officials have identified hundreds of cases of Guillain-Barré syndrome. A number of states have reported significant increases. Rio Grande do Norte state had reported 33 by August, compared to 23 in the whole of 2014, TV Globo said last month. 
 
 Brazil’s Ministry of Health said in December that it was investigating whether the syndrome could be caused by Zika. The ministry said the symptoms being seen start in the legs, before radiating through the trunk, arms and face. The condition is most dangerous when it involves respiratory muscles. “In this case, the syndrome can cause death if respiratory support measures are not adopted,” the ministry said. 
 
 ["I could move my fingers but within days I'd probably be totally paralyzed"] 
 
 Earlier this week, the Pan American Health Organization and World Health Organization announced an “increase of congenital anomalies, Guillain-Barré syndrome, and other neurological and autoimmune syndromes in areas where Zika virus is circulating.” PAHO warned member states to step up detection, prepare for a possible increase in neurological cases and reduce mosquito transmission. 
 
 Zika is carried by mosquitoes and typically causes only mild symptoms, but health officials globally have recently been alarmed because of a possible link between the virus and nearly 3,900 children born with suspected microcephaly in Brazil since October. The rare condition, marked by an abnormally small head, is associated with incomplete brain development. 
 
 (This video was updated on Feb. 2, 2016.) Authorities have confirmed more than 30 cases of Zika virus in the United States. Here's what you need to know. (Gillian Brockell/The Washington Post) 
 
 Last week, CDC issued an advisory warning pregnant women against travel to Brazil or more than a dozen other countries and territories in South America, Central America and the Caribbean where local transmission of the virus has been confirmed. 
 
 The agency then followed up with guidelines for doctors who care for pregnant women, advising that they be tested for Zika infection if they show symptoms after visiting any of those areas. The guidelines note: “Guillain-Barré syndrome has been reported in patients following suspected Zika virus infection.” 
 
 [How climate change could help the spread of Zika virus and other infectious diseases] 
 
 In recent days, several countries have taken drastic measures to try to combat the Zika virus, with Brazil, Colombia, El Salvador and Jamaica all calling on women to consider delaying becoming pregnant. 
 
 In the United States, Florida, Illinois, New Jersey, Texas and Hawaii have confirmed Zika infections involving returning travelers who were likely bitten by mosquitoes while abroad. The CDC said there have been at least “a dozen or so” cases. 
 
 Ariana Eunjung Cha and Dom Phillips in Rio de Janeiro contributed to this report. 
 
 Read more: 
 
 CDC: 'Dozens or so' cases of Zika virus among U.S. residents 
 
 Brazilians panic as mosquito-borne virus is linked to brain damage in thousands of babies
– Earlier this month, Puerto Rico announced its first death from Guillain-Barre syndrome, a condition causing temporary paralysis that, in this case, was linked to the Zika virus. Now incidences of Guillain-Barre are said to have risen in seven countries in tandem with outbreaks of Zika, per a study in the New England Journal of Medicine. The New York Times notes that while the CDC remains wary of saying Zika can cause GBS (it simply says GBS is "strongly associated" with Zika), this research offers further evidence that Zika may indeed be responsible—worrisome news, as about 500 million people in Latin America and the Caribbean are vulnerable to becoming infected with it. "It's pretty obvious that in all seven sites there is a clear relationship," says lead author Dr. Marcos A. Espinal of the Pan American Health Organization. The study found nearly 165,000 cases of Zika virus (some confirmed, some suspected) between April 2015 and March 2016, as well as almost 1,500 cases of GBS, reported in the Brazilian state of Bahia, Colombia, the Dominican Republic, El Salvador, Honduras, Suriname, and Venezuela. During the weeks of Zika outbreaks in these areas, the incidence of GBS cases spiked compared to pre-Zika baseline numbers—jumping as much as 877% in Venezuela. Women had a 75% higher reported incidence rate of Zika than men, but men had a GBS incidence rate 28% higher than women's, and incidence rates also climbed with age, NBC News reports. (The CDC's Zika funds are almost gone.)