title: Cluster of atypical adult Guillain-Barré syndrome temporally associated with neurological illness due to EV-D68 in children, South Wales, United Kingdom, October 2015 to January 2016.
abstract: We report a cluster of atypical Guillain-Barré syndrome in 10 adults temporally related to a cluster of four children with acute flaccid paralysis, over a 3-month period in South Wales, United Kingdom. All adult cases were male, aged between 24 and 77 years. Seven had prominent facial diplegia at onset. Available electrophysiological studies showed axonal involvement in five adults. Seven reported various forms of respiratory disease before onset of neurological symptoms. The ages of children ranged from one to 13 years, three of the four were two years old or younger. Enterovirus testing is available for three children; two had evidence of enterovirus D68 infection in stool or respiratory samples. We describe the clinical features, epidemiology and state of current investigations for these unusual clusters of illness.
authors: Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, United Kingdom.
authors: Christopher J
authors: CJ
authors: Williams
authors: Rhys H
authors: RH
authors: Thomas
authors: Trevor P
authors: TP
authors: Pickersgill
authors: Marion
authors: M
authors: Lyons
authors: Gwen
authors: G
authors: Lowe
authors: Rhianwen E
authors: RE
authors: Stiff
authors: Catherine
authors: C
authors: Moore
authors: Rachel
authors: R
authors: Jones
authors: Robin
authors: R
authors: Howe
authors: Huw
authors: H
authors: Brunt
authors: Anna
authors: A
authors: Ashman
authors: Brendan W
authors: BW
authors: Mason
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004196:Disease Outbreaks; D004770:Enterovirus / Q000145:classification / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000150:complications* / Q000453:epidemiology* / Q000209:etiology*; D017678:Sex Distribution; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D014852:Wales / Q000453:epidemiology
keywords: Acute flaccid paralysis; Guillain-Barré Syndrome; Miller Fisher syndrome; enterovirus