Binational outbreak of Guillain-Barré syndrome associated with Campylobacter jejuni infection, Mexico and USA, 2011.
In June 2011, a cluster of suspected cases of Guillain-Barré syndrome (GBS), which can follow Campylobacter jejuni infection, was identified in San Luis Río Colorado (SLRC), Sonora, Mexico and Yuma County, Arizona, USA. An outbreak investigation identified 26 patients (18 from Sonora, eight from Arizona) with onset of GBS 4 May-21 July 2011, exceeding the expected number of cases (n = 1-2). Twenty-one (81%) patients reported antecedent diarrhoea, and 61% of 18 patients tested were seropositive for C. jejuni IgM antibodies. In a case-control study matched on age group, sex, ethnicity, and neighbourhood of residence, all Arizona GBS patients travelled to SLRC during the exposure period vs. 45% of matched controls (matched odds ratio 8·1, 95% confidence interval 1·5-∞). Exposure information and an environmental assessment suggested that GBS cases resulted from a large outbreak of C. jejuni infection from inadequately disinfected tap water in SLRC. Binational collaboration was essential in investigating this cross-border GBS outbreak, the first in mainland North America since 1976.
Centers for Disease Control and Prevention, Atlanta, GA, USA.
B R
BR
Jackson
Unidad de Vigilancia Epidemiologica, Hermosillo, Sonora, Mexico.
J Alomía
JA
Zegarra
Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
H
H
López-Gatell
Centers for Disease Control and Prevention, Atlanta, GA, USA.
J
J
Sejvar
Dirección General de Epidemiología, Mexico City, Mexico.
F
F
Arzate
Centers for Disease Control and Prevention, Atlanta, GA, USA.
S
S
Waterman
Servicios de Salud, San Luis Río Colorado, Sonora, Mexico.
A Sánchez
AS
Núñez
Yuma County Health Department, Yuma, AZ, USA.
B
B
López
Arizona Department of Health Services, Phoenix, AZ, USA.
J
J
Weiss
Unidad de Vigilancia Epidemiologica, Hermosillo, Sonora, Mexico.
R Quintero
RQ
Cruz
Dirección General de Epidemiología, Mexico City, Mexico.
D Y López
DY
Murrieta
Centers for Disease Control and Prevention, Atlanta, GA, USA.
R
R
Luna-Gierke
Centers for Disease Control and Prevention, Atlanta, GA, USA.
K
K
Heiman
Centers for Disease Control and Prevention, Atlanta, GA, USA.
A R
AR
Vieira
Centers for Disease Control and Prevention, Atlanta, GA, USA.
C
C
Fitzgerald
Centers for Disease Control and Prevention, Atlanta, GA, USA.
P
P
Kwan
Centers for Disease Control and Prevention, Atlanta, GA, USA.
M
M
Zárate-Bermúdez
Centers for Disease Control and Prevention, Atlanta, GA, USA.
D
D
Talkington
Centers for Disease Control and Prevention, Atlanta, GA, USA.
V R
VR
Hill
Centers for Disease Control and Prevention, Atlanta, GA, USA.
B
B
Mahon
D000907:Antibodies, Bacterial / Q000097:blood; D001130:Arizona / Q000453:epidemiology; D002169:Campylobacter Infections / Q000150:complications* / Q000453:epidemiology* / Q000635:transmission; D016123:Campylobacter jejuni / Q000302:isolation & purification*; D016022:Case-Control Studies; D004196:Disease Outbreaks; D005516:Food Microbiology; D020275:Guillain-Barre Syndrome / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D062486:Public Health Surveillance; D012189:Retrospective Studies; D014871:Water Microbiology
D000907:Antibodies, Bacterial