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National surveillance for Guillain-Barré syndrome: January 1978-March 1979
Insights
Guillain-Barré syndrome (GBS) incidence increases with age and is higher in males. While antecedent illnesses are common, a direct link to surgery or vaccination is uncertain, and swine flu vaccine posed no increased risk.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Guillain-Barré syndrome (GBS) is a rare neurological disorder.
- Understanding GBS incidence and risk factors is crucial for public health.
- Previous studies suggested potential links between GBS and various triggers.
Purpose of the Study:
- To determine the incidence rates of GBS in the US population.
- To investigate demographic factors associated with GBS.
- To explore potential triggers for GBS, including antecedent illnesses, surgery, and vaccinations.
Main Methods:
- Analysis of 1,034 GBS cases reported to the CDC from 1978-1979.
- Utilized data from 1,813 American Academy of Neurology sentinel physicians.
- Calculated age-specific and age-adjusted incidence rates by sex and race.
- Examined the temporal relationship between GBS onset and antecedent events.
Main Results:
- GBS incidence showed a positive correlation with increasing age.
- Age-adjusted incidence rates were higher in males (0.52/100,000) than females (0.40/100,000).
- 67% of patients reported an antecedent illness within 8 weeks prior to GBS onset, peaking at week 2.
- No increased GBS risk was found in individuals who received the 1976 swine influenza vaccine.
Conclusions:
- GBS incidence is influenced by age and sex.
- Antecedent illnesses are frequently reported before GBS, but causal links to surgery or vaccination require further investigation.
- The 1976 swine influenza vaccination did not elevate GBS risk.
Abstract:
Between January 1, 1978, and March 31, 1979, 1,034 cases of Guillain-Barré syndrome (GBS) were reported to the Centers for Disease Control by the 1,813 American Academy of Neurology sentinel physicians who participated in the national GBS surveillance program. A direct correlation was observed between increasing age and the age-specific attack (incidence) rates. Based on the cases observed and the total US population, age-adjusted attack rates were statistically higher in males (0.52 per 100,000) than in females (0.40). Rates for whites were 0.44 and those for blacks 0.28 per 100,000; although the difference is statistically significant, uncertainties as to the true denominators by race preclude acceptance of these differences as valid. Sixty-seven percent, or 682 of the patients, reported that they had had an antecedent illness within 8 weeks before onset of GBS, and among them the peak period of onset of GBS was in the second week after the onset of the prior illness. There were also 52 patients (5%) who had undergone surgery and 45 (4.5%) who had received vaccinations, both within the 8 weeks before onset of GBS. However, the high proportions of antecedent illness in these groups (45% of those operated and 53% of those vaccinated) made attribution of GBS to the procedures tenuous. Risk of GBS in patients who reported receiving a swine influenza vaccination in 1976 was no greater than in those who reported that they did not receive this vaccine.