Guillain-Barré Syndrome, Influenzalike Illnesses, and Influenza Vaccination During Seasons With and Without Circulating A/H1N1 Viruses (original) (raw)

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Lamiae Grimaldi-Bensouda*

*Correspondence to Dr. Lamiae Grimaldi-Bensouda, LA-SER and Institut Pasteur, 10 place de Catalogne, 75014 Paris, France (e-mail: lgrimaldi@pgrx.net).

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Lucien Abenhaim for the GBS-PGRx Study Group

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Received:

17 November 2010

Accepted:

22 February 2011

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Lamiae Grimaldi-Bensouda, Annick Alpérovitch, Gérard Besson, Christophe Vial, Jean-Marie Cuisset, Caroline Papeix, Olivier Lyon-Caen, Jacques Benichou, Michel Rossignol, Lucien Abenhaim for the GBS-PGRx Study Group, Guillain-Barré Syndrome, Influenzalike Illnesses, and Influenza Vaccination During Seasons With and Without Circulating A/H1N1 Viruses, American Journal of Epidemiology, Volume 174, Issue 3, 1 August 2011, Pages 326–335, https://doi.org/10.1093/aje/kwr072
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Abstract

The role of influenzalike illnesses and influenza vaccination in the development of Guillain-Barré syndrome (GBS), particularly the role of A/H1N1 epidemics and A/H1N1 vaccination, is debated. Data on all incident GBS cases meeting the Brighton Collaboration criteria that were diagnosed at 25 neurology centers in France were prospectively collected between March 2007 and June 2010, covering 3 influenzavirus seasons, including the 2009–2010 A/H1N1 outbreak. A total of 457 general practitioners provided a registry of patients from which 1,080 controls were matched by age, gender, index date (calendar month), and region to 145 cases. Causal relations were assessed by multivariate case-control analysis with adjustment for risk factors (personal and family history of autoimmune disorders, among others), while matching on age, gender, and calendar time. Influenza (seasonal or A/H1N1) or influenzalike symptoms in the 2 months preceding the index date was associated with GBS, with a matched odds ratio of 2.3 (95% confidence interval (CI): 0.7, 8.2). The difference in the rates of GBS occurring between influenza virus circulation periods and noncirculation periods was highly statistically significant (P = 0.004). Adjusted odds ratios for GBS occurrence within 6 weeks after seasonal and A/H1N1 vaccination were 1.3 (95% CI: 0.4, 4.1) and 0.9 (95% CI: 0.1, 7.6), respectively. Study results confirm that influenza virus is a likely risk factor for GBS. Conversely, no new concerns have arisen regarding influenza vaccination.

American Journal of Epidemiology © The Author 2011. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Topic:

• influenza
• guillain-barre syndrome
• autoimmune diseases
• influenza vaccines
• neurology
• orthomyxoviridae
• physicians, family
• vaccination
• gender
• viruses
• influenza a virus, h1n1 subtype
• swine influenza

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