title: Guillain-Barré syndrome: background incidence rates in The Netherlands.
abstract: Guillain-Barré syndrome (GBS) is a (sub)acute polyradiculoneuropathy, which may occur following immunization. To interpret the occurrence of GBS after introduction of large-scale immunization programmes, it is important to define recent background incidence rates (IRs) of GBS. We used a general practitioner electronic medical record database to assess age-specific GBS IRs between 1996 and 2008 in The Netherlands. All possible GBS cases were manually reviewed. Validated incident cases were reviewed by a neurologist (B. J.) for diagnostic certainty using the GBS case definition of the Brighton Collaboration (BC). In a population of 638,891 persons, we identified 23 validated incident GBS cases (mean age 46 years). IR was 1.14 per 100,000 person years (95% confidence interval [CI] 0.67-1.61) and was lower for people under 50 years (0.76; 95%CI 0.41-1.32) compared with elderly of 50 years or older (1.80; 95%CI 0.98-3.05). Only six cases fulfilled level 1 or 2 of diagnostic certainty of the BC case definition. IR of GBS increases with age. As vaccinations are often targeted at specific age groups, age-specific rates should be used to monitor GBS observed versus expected rates after introduction of large-scale vaccination programmes.
authors: Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. nicoline.van.der.maas@rivm.nl
authors: Nicoline A T
authors: NA
authors: van der Maas
authors: Merlijn A
authors: MA
authors: Kramer
authors: Bart C
authors: BC
authors: Jacobs
authors: Eva M
authors: EM
authors: van Soest
authors: Jeanne P
authors: JP
authors: Dieleman
authors: Jeanet M
authors: JM
authors: Kemmeren
authors: Hester E
authors: HE
authors: de Melker
authors: Miriam C J M
authors: MC
authors: Sturkenboom
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D020275:Guillain-Barre Syndrome / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D055815:Young Adult