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Surveillance and outbreak report Open Access
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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.

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/content/10.2807/1560-7917.ES.2016.21.4.30119
2016-01-28
2024-11-08
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2016.21.4.30119
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References

  1. Wakerley BR, Uncini A, Yuki N, Attarian S, Barreira AA, Chan Y-C, et al. Guillain-Barré and Miller Fisher syndromes--new diagnostic classification. Nat Rev Neurol. 2014;10(9):537-44.  https://doi.org/10.1038/nrneurol.2014.138  PMID: 25072194 
  2. Ye Y, Zhu D, Wang K, Wu J, Feng J, Ma D, et al. Clinical and electrophysiological features of the 2007 Guillain-Barré syndrome epidemic in northeast China. Muscle Nerve. 2010;42(3):311-4.  https://doi.org/10.1002/mus.21701  PMID: 20589890 
  3. Ho TW, Mishu B, Li CY, Gao CY, Cornblath DR, Griffin JW, et al. Guillain-Barré syndrome in northern China. Relationship to Campylobacter jejuni infection and anti-glycolipid antibodies. Brain. 1995;118(Pt 3):597-605.  https://doi.org/10.1093/brain/118.3.597  PMID: 7600081 
  4. Kutleša M, Santini M, Krajinović V, Raffanelli D, Barsić B. Acute motor axonal neuropathy associated with pandemic H1N1 influenza A infection. Neurocrit Care. 2010;13(1):98-100.  https://doi.org/10.1007/s12028-010-9365-y  PMID: 20428968 
  5. Chitambar SD, Fadnis RS, Joshi MS, Habbu A, Bhatia SG. Case report: Hepatitis A preceding Guillain-Barré syndrome. J Med Virol. 2006;78(8):1011-4.  https://doi.org/10.1002/jmv.20656  PMID: 16789022 
  6. Susuki K, Odaka M, Mori M, Hirata K, Yuki N. Acute motor axonal neuropathy after Mycoplasma infection: Evidence of molecular mimicry. Neurology. 2004;62(6):949-56.  https://doi.org/10.1212/01.WNL.0000115123.42929.FD  PMID: 15037698 
  7. Toscani L, Guarducci D, Matà S, Furlan T, Ballo P. Association between acute motor axonal neuropathy and septic shock due to Acinetobacter baumannii. Infez Med. 2015;23(4):349-52. PMID: 26700086 
  8. Orlikowski D, Porcher R, Sivadon-Tardy V, Quincampoix JC, Raphaël JC, Durand MC, et al. Guillain-Barré syndrome following primary cytomegalovirus infection: a prospective cohort study. Clin Infect Dis. 2011;52(7):837-44.  https://doi.org/10.1093/cid/cir074  PMID: 21427390 
  9. Masajtis-Zagajewska A, Muras K, Mochecka-Thoelke A, Kurnatowska I, Nowicki M. Guillain-Barré syndrome in the course of EBV infection after kidney transplantation--a case report. Ann Transplant. 2012;17(3):133-7.  https://doi.org/10.12659/AOT.883468  PMID: 23018266 
  10. Dalton HR, Kamar N, van Eijk JJ, Mclean BN, Cintas P, Bendall RP, et al. Hepatitis E virus and neurological injury. Nat Rev Neurol. 2015.
  11. Oehler E, Watrin L, Larre P, Leparc-Goffart I, Lastere S, Valour F, et al. Zika virus infection complicated by Guillain-Barre syndrome--case report, French Polynesia, December 2013. Euro Surveill. 2014;19(9):20720.  https://doi.org/10.2807/1560-7917.ES2014.19.9.20720  PMID: 24626205 
  12. Sejvar JJ, Bode AV, Marfin AA, Campbell GL, Ewing D, Mazowiecki M, et al. West Nile virus-associated flaccid paralysis. Emerg Infect Dis. 2005;11(7):1021-7.  https://doi.org/10.3201/eid1107.040991  PMID: 16022775 
  13. Marx A, Glass JD, Sutter RW. Differential diagnosis of acute flaccid paralysis and its role in poliomyelitis surveillance. Epidemiol Rev. 2000;22(2):298-316.  https://doi.org/10.1093/oxfordjournals.epirev.a018041  PMID: 11218380 
  14. Van Haren K, Ayscue P, Waubant E, Clayton A, Sheriff H, Yagi S, et al. Acute Flaccid Myelitis of Unknown Etiology in California, 2012-2015. JAMA. 2015;314(24):2663-71.  https://doi.org/10.1001/jama.2015.17275  PMID: 26720027 
  15. Welsh Government. Chief Medical Officer for Wales. Annual Report 2014-15. Cardiff: Welsh Government. 2015. Available from: http://gov.wales/docs/phhs/publications/151014cmoreporten.pdf
  16. Welsh Government. StatsWales. 2014 mid-year population estimates. Cardiff: Welsh Government. [Accessed: 25 Jan 2016]. Available from: https://statswales.wales.gov.uk/Catalogue
  17. Poelman R, Schuffenecker I, Van Leer-Buter C, Josset L, Niesters HG, Lina B,, et al. European surveillance for enterovirus D68 during the emerging North-American outbreak in 2014. J Clin Virol. 2015;71:1-9.  https://doi.org/10.1016/j.jcv.2015.07.296  PMID: 26364237 
  18. World Health Organization (WHO). International Statistical Classification of Diseases and Related Health Problems. 10th Revision (ICD-10). Geneva: WHO. [Accessed 25 Jan 2016]. Available from: http://www.who.int/classifications/icd/ICD10Volume2_en_2010.pdf
  19. Hughes RAC, Cornblath DR. Guillain-Barré syndrome. Lancet. 2005;366(9497):1653-66.  https://doi.org/10.1016/S0140-6736(05)67665-9  PMID: 16271648 
  20. Messacar K, Schreiner TL, Maloney JA, Wallace A, Ludke J, Oberste MS, et al. A cluster of acute flaccid paralysis and cranial nerve dysfunction temporally associated with an outbreak of enterovirus D68 in children in Colorado, USA. Lancet. 2015;385(9978):1662-71.  https://doi.org/10.1016/S0140-6736(14)62457-0  PMID: 25638662 
  21. Public Health Wales. Weekly influenza activity in Wales report. Cardiff: Public Health Wales. 20 Jan 2016. Available from http://www.wales.nhs.uk/sites3/page.cfm?orgid=457&pid=34338
  22. Public Health England (PHE). Risk assessment of Enterovirus D-68 (EV-D68). London: PHE. Jan 2015. Available from www.gov.uk/government/uploads/system/uploads/attachment_data/file/399590/EV-D68_RA_v4__3_.pdf
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