title: Influenza, Campylobacter and Mycoplasma infections, and hospital admissions for Guillain-Barré syndrome, England.
abstract: Guillain-Barré syndrome (GBS) is the most common cause of acute flaccid paralysis in polio-free regions. Considerable evidence links Campylobacter infection with GBS, but evidence that implicates other pathogens as triggers remains scarce. We conducted a time-series analysis to investigate short-term correlations between weekly laboratory-confirmed reports of putative triggering pathogens and weekly hospitalizations for GBS in England from 1993 through 2002. We found a positive association between the numbers of reports of laboratory-confirmed influenza A in any given week and GBS hospitalizations in the same week. Different pathogens may trigger GBS in persons of different ages; among those <35 years, numbers of weekly GBS hospitalizations were associated with weekly Campylobacter and Mycoplasma pneumoniae reports, whereas among those >35 years, positive associations were with influenza. Further studies should estimate the relative contribution of different pathogens to GBS incidence, overall and by age group, and determine whether influenza is a real trigger for GBS or a marker for influenza vaccination.
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom. clarence.tam@lshtm.ac.uk
authors.forename: Clarence C
authors.initials: CC
authors.lastname: Tam
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: O'Brien
authors.forename: Laura C
authors.initials: LC
authors.lastname: Rodrigues
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002167:Campylobacter / Q000302:isolation & purification; D002169:Campylobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D004739:England / Q000453:epidemiology; D005260:Female; D020275:Guillain-Barre Syndrome / Q000453:epidemiology* / Q000382:microbiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification; D009975:Orthomyxoviridae / Q000302:isolation & purification; D011019:Pneumonia, Mycoplasma / Q000453:epidemiology* / Q000382:microbiology; D012044:Regression Analysis; D012621:Seasons