Title |
Guillain-Barré syndrome following the 2009 pandemic monovalent and seasonal trivalent influenza vaccination campaigns in Spain from 2009 to 2011: outcomes from active surveillance by a neurologist network, and records from a country-wide hospital discharge database
|
---|---|
Published in |
BMC Neurology, May 2016
|
DOI | 10.1186/s12883-016-0598-z |
Pubmed ID | |
Authors |
Enrique Alcalde-Cabero, Javier Almazán-Isla, Fernando J. García López, José Ramón Ara-Callizo, Fuencisla Avellanal, Carlos Casasnovas, Carlos Cemillán, José Ignacio Cuadrado, Jacinto Duarte, María Dolores Fernández-Pérez, Óscar Fernández, Juan Antonio García Merino, Rosa García Montero, Dolores Montero, Julio Pardo, Francisco Javier Rodríguez-Rivera, María Ruiz-Tovar, Jesús de Pedro-Cuesta, Spanish GBS Epidemiology Study Group |
Abstract |
Studies have shown a slight excess risk in Guillain-Barré syndrome (GBS) incidence associated with A(H1N1)pdm09 vaccination campaign and seasonal trivalent influenza vaccine immunisations in 2009-2010. We aimed to assess the incidence of GBS as a potential adverse effect of A(H1N1)pdm09 vaccination. A neurologist-led network, active at the neurology departments of ten general hospitals serving an adult population of 4.68 million, conducted GBS surveillance in Spain in 2009-2011. The network, established in 1996, carried out a retrospective and a prospective study to estimate monthly alarm thresholds in GBS incidence and tested them in 1998-1999 in a pilot study. Such incidence thresholds additionally to observation of GBS cases with immunisation antecedent in the 42 days prior to clinical onset were taken as alarm signals for 2009-2011, since November 2009 onwards. For purpose of surveillance, in 2009 we updated both the available centres and the populations served by the network. We also did a retrospective countrywide review of hospital-discharged patients having ICD-9-CM code 357.0 (acute infective polyneuritis) as their principal diagnosis from January 2009 to December 2011. Among 141 confirmed of 148 notified cases of GBS or Miller-Fisher syndrome, Brighton 1-2 criteria in 96 %, not a single patient was identified with clinical onset during the 42-day time interval following A(H1N1)pdm09 vaccination. In contrast, seven cases were seen during a similar period after seasonal campaigns. Monthly incidence figures did not, however, exceed the upper 95 % CI limit of expected incidence. A retrospective countrywide review of the registry of hospital-discharged patients having ICD-9-CM code 357.0 (acute infective polyneuritis) as their principal diagnosis did not suggest higher admission rates in critical months across the period December 2009-February 2010. Despite limited power and underlying reporting bias in 2010-2011, an increase in GBS incidence over background GBS, associated with A(H1N1)pdm09 monovalent or trivalent influenza immunisations, appears unlikely. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 2 | 50% |
Unknown | 2 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 3 | 75% |
Scientists | 1 | 25% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Canada | 1 | 2% |
Unknown | 64 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 14 | 22% |
Student > Master | 9 | 14% |
Student > Postgraduate | 5 | 8% |
Student > Ph. D. Student | 5 | 8% |
Other | 4 | 6% |
Other | 16 | 25% |
Unknown | 12 | 18% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 23 | 35% |
Nursing and Health Professions | 7 | 11% |
Pharmacology, Toxicology and Pharmaceutical Science | 3 | 5% |
Neuroscience | 3 | 5% |
Agricultural and Biological Sciences | 3 | 5% |
Other | 10 | 15% |
Unknown | 16 | 25% |