Guillain-Barré Syndrome Surveillance

Purpose

Beginning in October 2009, the Emerging Infections Program (EIP)conducted active surveillance statewide for all cases of Guillain-Barré Syndrome (GBS). GBS surveillance was a collaborative effort between the Connecticut EIP, the Centers for Disease Control and Prevention, Connecticut hospitals, and local neurologists. Similar surveillance was also carried out in the 9 other EIP sites across the country.

In 1976, about 40 million Americans were vaccinated against an influenza virus of swine origin, and subsequently, an increased risk of GBS associated with vaccination was found. It remains unclear what caused the increased risk of GBS associated with the swine-origin influenza vaccine in 1976. Since then, numerous studies have been conducted to evaluate the association between seasonal flu vaccine and GBS. Most studies showed no association, while two studies suggested that approximately 1 additional person out of 1 million vaccinated people may be at risk for GBS. There is no indication that the 2009 pandemic H1N1 vaccine will be associated with an increased risk of GBS. However, there is a need to be vigilant given the magnitude of the anticipated vaccination campaign. To facilitate GBS surveillance, the Commissioner of Health of the Connecticut Department of Public Health has added Guillain-Barré syndrome to the list of mandated reportable diseases and findings. (See link to CT Epidemiologist below).

Goals & Objectives

• Rapidly detect potential cases of Guillain-Barré Syndrome
• Produce regular surveillance reports on cases of GBS identified in the EIP area including descriptive data on vaccination history and presence or absence of established risk factors for GBS
• Determine whether vaccination with the influenza A (H1N1) 2009 monovalent vaccine is associated with increased risk of developing Guillain-Barré Syndrome

Related Links

• Preliminary results published in MMWR
• CT Epidemiologist Addition of GBS to list of reportable diseases and findings
• CDC Information about Influenza
• CDC Information about 2009 H1N1 Influenza Vaccine and GBS
• Wise ME, M Viray, JJ Sejvar, P Lewis, AL Baughman, W Connor, et al. Guillain-Barre Syndrome During the 2009-2010 H1N1 Influenza Vaccination Campaign: Population-Based Surveillance among 45 million Americans. American Journal of Epidemiology. 2012;175(11): 1110-9

Document Archive

• Guillain-Barré Syndrome Report Form
• Letter to CT Neurologists 24 September 2009
• CT Epidemiologist - Addition of GBS to list of reportable diseases and findings