TURBO, Colombia — The Zika epidemic flaring across the Americas has produced several hot spots with large numbers of cases. But there is no place quite like Turbo.

The mosquito-borne virus has spread rapidly here and across lowland Colombia, but the city is unusual for the subsequent outbreak of a rare, debilitating disorder known as Guillain-Barre syndrome, whose precise link to the virus remains unclear.

Before Zika’s arrival in Turbo, a mostly Afro-Colombian town of 60,000 set amid vast banana plantations on the country’s north coast, doctors typically saw one case of Guillain-Barre a year, if that.

In the past six weeks, there have been five, all of them severe. Three patients have died. One is fighting for his life in an intensive care unit. The fifth, a 10-year-old girl, hasn’t been able to move her legs in a week.

The deaths, and the aggressiveness of the Guillain-Barre cases here, are among the first signs of a strange and worrisome pattern that is challenging the way doctors in Colombia and across Latin America are preparing for the spread of Zika.

Much of the global attention to the virus has zeroed in on a suspected link to microcephaly, a congenital defect that leaves babies with undersized heads and varying degrees of nerve damage. Brazilian officials say they may have hundreds or thousands of such cases related to Zika. But the photos of worried mothers and distressed infants may have given many people the impression that the virus poses no major risk to anyone else.

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That is not true, and certainly not here in Turbo, where rank, sewage-filled canals line the streets and more and more people are arriving at the crowded emergency room with bloodshot eyes and itchy, red pockmarks, the telltale signs of Zika. Something about the virus – and researchers still don’t know what it is – appears to significantly increase the incidence of Guillain-Barre.

The first resident here to get it was 41-year-old Eliana Uribe. She called in sick to her cousin’s dress shop one morning in mid-January, not long after missing several days of work with a strange rash and sore joints. Something was wrong with her feet, she said.

A few hours later, when Uribe tried to walk, she collapsed. Her legs felt “like rags.” The illness was creeping toward her torso.

Uribe’s family carried her to the emergency room. German Gomez, the internist at the small public hospital, thought it might be Guillain-Barre. But he wasn’t sure.

“I’d been here 15 months and hadn’t seen a single case,” he said.

Two days later, Uribe lost control of her tongue and facial muscles. She fell short of breath. Doctors rushed her to a bigger hospital.

Uribe died Feb. 2, her brain swamped in fluid – “severe hydrocephaly,” doctors told her family. “They never told us you could die from it,” said Katarina Lemus, Uribe’s cousin.

The disease has made an orphan of Uribe’s 12-year-old son, Marlon, whose father died of a heart attack last year. “Whenever anyone asks about his mother, he just crumples,” said Shirley Uribe, his aunt.

The day after Uribe’s death, another Turbo resident, Edelberto Padilla, 51, also died with Guillain-Barre, at a different hospital. He had the symptoms of Zika, too.


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