Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
Records 1-1 (of 1 Records) |
Query Trace: Fonseco-Ford M [original query] |
---|
Clinical, epidemiologic, and laboratory features of an outbreak of campylobacter-associated guillain-barre syndrome along the United States/Mexico Border
Sejvar JJ , Zegarra JA , Jackson BR , Lopez-Gatell H , Philen R , Fonseco-Ford M , Mahon B , Arzate F , Lopez B , Weiss J , Kamatsu K , Muley S , Lahda S , Talkington D , Waterman S . J Peripher Nerv Syst 2013 18 S104 Outbreaks of Guillain-Barre syndrome (GBS) are rare. In June 2011, a cluster of cases of acute flaccid paralysis with features consistent with GBS was identified along the international border in the town of San Luis Rio Colorado (SLRC) in Sonora, Mexico, and in Yuma County, Arizona. A binational investigation involving United States and Mexican state and federal officials identified additional cases, and epidemiologic information suggested an association of GBS cases with a concomitant outbreak of Campylobacter jejuni .We describe the clinical, laboratory, and epidemiologic features of this outbreak. We identified cases of AFP in Mexico from national reporting data, and suspected GBS cases in Arizona through active casefinding and physician outreach at local hospitals. We categorized cases using standardized diagnostic criteria (Brighton International Criteria) for GBS through physical and neurological examination, medical record review, laboratory testing, and electrodiagnostic studies. Of 31 identified AFP cases, we classified 26 (18 from Sonora, 8 from Arizona) as GBS. All cases had weakness onset between May 4-July 21, 2011; 21 (81%) cases were male. One GBS case (4%) reached Brighton Level 1 (most diagnostically certain), 14 (54%) Level 2, and 11 (42%) Level 3. Estimated incidence was 26/100,000 persons/year, over 26 times the typical expected rate in this area. Clinical phenotype suggested acute motor axonal neuropathy (AMAN) or Fisher syndrome in all; electrodiagnostic studies in 14 of 16 cases tested also suggested AMAN. Twenty-one cases (81%) reported antecedent diarrhea a median of 11 days before weakness 11/18 cases tested (61%) had C. jejuni -specific serum IgM antibodies and 16/18 (89%) were seropositive for one or more antiganglioside antibodies. Although the exact source of exposure to C. jejuni in the cluster could not be determined with certainty, epidemiologic evidence suggested contaminated ground water in SLRC. In conclusion, in addition to epidemiologic evidence, the clinical and laboratory features of this unprecedented outbreak of GBS clustered in geographical location and time suggested C. jejuni infection as the precipitant. The reason for this outbreak is unknown, but may be related to specific host, pathogen, or environmental factors. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Sep 23, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure