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. 1997 May;62(5):447–453. doi: 10.1136/jnnp.62.5.447

Epidemiological features of Guillain-Barré syndrome in Sweden, 1978-93.

G X Jiang 1, Q Cheng 1, H Link 1, J de Pedro-Cuesta 1
PMCID: PMC486845  PMID: 9153599

Abstract

OBJECTIVES: To describe the incidence of Guillain-Barré syndrome in Sweden during the period 1978-93 and its temporal and geographical variations. METHODS: Stratified and Poisson regression analyses and tests for detection of small epidemics were applied to population based hospital discharge data from 2257 incident cases of Guillain-Barré syndrome in Sweden during the study period. RESULTS: The incidence of Guillain-Barré syndrome was (1) 1.77 per 100000 person-years when age adjusted to the European population; (2) higher in males; and (3) stable across time, although occasional increases of annual incidence rates were found-namely, in 1978 (relative risk (RR) 1.30 (95% CI 1.10-1.54)), and in 1983 (RR 1.24 (95% CI 1.06-1.40)). The incidence increased with age and was bimodal, with peaks at 20-24 and 70-74 years. There was a moderate but significant seasonality with a peak in August, particularly among the young age groups. The age adjusted incidence by county varied from 1.11 to 2.57 per 100000 person-years. Neither temporal nor spatial clustering was significant, except during the period July-September in 1983 at ages below 40 years. CONCLUSIONS: The incidence of Guillain-Barré syndrome in Sweden during the period 1978-93 had a magnitude similar to those described in other surveys, a bimodal distribution by age, and modest geographical and temporal variations with significantly high rates in 1978 and 1983 and in autumn. Minor outbreaks might have passed unnoticed up to the present. Whereas reported drug induced cases of Guillain-Barré syndrome may in part explain the high incidence in 1983, the cause of the aberrant incidence in 1978 remains unknown. Epidemiological surveillance of Guillain-Barré syndrome in Sweden might have been useful.

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Selected References

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  1. Beghi E., Kurland L. T., Mulder D. W., Wiederholt W. C. Guillain-Barré syndrome. Clinicoepidemiologic features and effect of influenza vaccine. Arch Neurol. 1985 Nov;42(11):1053–1057. doi: 10.1001/archneur.1985.04060100035016. [DOI] [PubMed] [Google Scholar]
  2. Congia S., Melis M., Carboni M. A. Epidemiologic and clinical features of the Guillain-Barre' syndrome in Sardinia in the 1961-1980 period. Acta Neurol (Napoli) 1989 Feb;11(1):15–20. [PubMed] [Google Scholar]
  3. D'Ambrosio G., De Angelis G., Vizioli R. Epidemiology of Guillain-Barré syndrome in Campania (south Italy). Preliminary results. Acta Neurol (Napoli) 1983 Aug;5(4):245–252. [PubMed] [Google Scholar]
  4. Fagius J., Osterman P. O., Sidén A., Wiholm B. E. Guillain-Barré syndrome following zimeldine treatment. J Neurol Neurosurg Psychiatry. 1985 Jan;48(1):65–69. doi: 10.1136/jnnp.48.1.65. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hankey G. J. Guillain-Barré syndrome in Western Australia, 1980-1985. Med J Aust. 1987 Feb 2;146(3):130–133. doi: 10.5694/j.1326-5377.1987.tb120153.x. [DOI] [PubMed] [Google Scholar]
  6. Ho T. W., Mishu B., Li C. Y., Gao C. Y., Cornblath D. R., Griffin J. W., Asbury A. K., Blaser M. J., McKhann G. M. Guillain-Barré syndrome in northern China. Relationship to Campylobacter jejuni infection and anti-glycolipid antibodies. Brain. 1995 Jun;118(Pt 3):597–605. doi: 10.1093/brain/118.3.597. [DOI] [PubMed] [Google Scholar]
  7. Jiang G. X., Cheng Q., Ehrnst A., Link H., de Pedro-Cuesta J. Guillain-Barré syndrome in Stockholm County, 1973-1991. Eur J Epidemiol. 1997 Jan;13(1):25–32. doi: 10.1023/a:1007312112285. [DOI] [PubMed] [Google Scholar]
  8. Jiang G. X., de Pedro-Cuesta J., Fredrikson S. Guillain-Barré syndrome in south-west Stockholm, 1973-1991, 1. Quality of registered hospital diagnoses and incidence. Acta Neurol Scand. 1995 Feb;91(2):109–117. doi: 10.1111/j.1600-0404.1995.tb00416.x. [DOI] [PubMed] [Google Scholar]
  9. Kaplan J. E., Poduska P. J., McIntosh G. C., Hopkins R. S., Ferguson S. W., Schonberger L. B. Guillain-Barré syndrome in Larimer County, Colorado: a high-incidence area. Neurology. 1985 Apr;35(4):581–584. doi: 10.1212/wnl.35.4.581. [DOI] [PubMed] [Google Scholar]
  10. Kaplan J. E., Schonberger L. B., Hurwitz E. S., Katona P. Guillain-Barré syndrome in the United States, 1978-1981: additional observations from the national surveillance system. Neurology. 1983 May;33(5):633–637. doi: 10.1212/wnl.33.5.633. [DOI] [PubMed] [Google Scholar]
  11. Koobatian T. J., Birkhead G. S., Schramm M. M., Vogt R. L. The use of hospital discharge data for public health surveillance of Guillain-Barré syndrome. Ann Neurol. 1991 Oct;30(4):618–621. doi: 10.1002/ana.410300418. [DOI] [PubMed] [Google Scholar]
  12. Larsen J. P., Kvåle G., Nyland H. Epidemiology of the Guillain-Barré syndrome in the county of Hordaland, Western Norway. Acta Neurol Scand. 1985 Jan;71(1):43–47. doi: 10.1111/j.1600-0404.1985.tb03165.x. [DOI] [PubMed] [Google Scholar]
  13. MANTEL N., HAENSZEL W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959 Apr;22(4):719–748. [PubMed] [Google Scholar]
  14. McLean M., Duclos P., Jacob P., Humphreys P. Incidence of Guillain-Barré syndrome in Ontario and Quebec, 1983-1989, using hospital service databases. Epidemiology. 1994 Jul;5(4):443–448. doi: 10.1097/00001648-199407000-00011. [DOI] [PubMed] [Google Scholar]
  15. Ohno Y., Aoki K., Aoki N. A test of significance for geographic clusters of disease. Int J Epidemiol. 1979 Sep;8(3):273–280. doi: 10.1093/ije/8.3.273. [DOI] [PubMed] [Google Scholar]
  16. Pettersson B., Coleman M. P., Ron E., Adami H. O. Iodine supplementation in Sweden and regional trends in thyroid cancer incidence by histopathologic type. Int J Cancer. 1996 Jan 3;65(1):13–19. doi: 10.1002/(SICI)1097-0215(19960103)65:1<13::AID-IJC3>3.0.CO;2-4. [DOI] [PubMed] [Google Scholar]
  17. Radhakrishnan K., el-Mangoush M. A., Gerryo S. E. Descriptive epidemiology of selected neuromuscular disorders in Benghazi, Libya. Acta Neurol Scand. 1987 Feb;75(2):95–100. doi: 10.1111/j.1600-0404.1987.tb07901.x. [DOI] [PubMed] [Google Scholar]
  18. Rees J. H., Soudain S. E., Gregson N. A., Hughes R. A. Campylobacter jejuni infection and Guillain-Barré syndrome. N Engl J Med. 1995 Nov 23;333(21):1374–1379. doi: 10.1056/NEJM199511233332102. [DOI] [PubMed] [Google Scholar]
  19. Robins J., Greenland S., Breslow N. E. A general estimator for the variance of the Mantel-Haenszel odds ratio. Am J Epidemiol. 1986 Nov;124(5):719–723. doi: 10.1093/oxfordjournals.aje.a114447. [DOI] [PubMed] [Google Scholar]
  20. Visser L. H., Van der Meché F. G., Van Doorn P. A., Meulstee J., Jacobs B. C., Oomes P. G., Kleyweg R. P., Meulstee J. Guillain-Barré syndrome without sensory loss (acute motor neuropathy). A subgroup with specific clinical, electrodiagnostic and laboratory features. Dutch Guillain-Barré Study Group. Brain. 1995 Aug;118(Pt 4):841–847. doi: 10.1093/brain/118.4.841. [DOI] [PubMed] [Google Scholar]
  21. Walder M. Epidemiology of campylobacter enteritis. Scand J Infect Dis. 1982;14(1):27–33. doi: 10.3109/inf.1982.14.issue-1.06. [DOI] [PubMed] [Google Scholar]
  22. Wallenstein S. A test for detection of clustering over time. Am J Epidemiol. 1980 Mar;111(3):367–372. doi: 10.1093/oxfordjournals.aje.a112908. [DOI] [PubMed] [Google Scholar]
  23. Yuki N., Yoshino H., Sato S., Miyatake T. Acute axonal polyneuropathy associated with anti-GM1 antibodies following Campylobacter enteritis. Neurology. 1990 Dec;40(12):1900–1902. doi: 10.1212/wnl.40.12.1900. [DOI] [PubMed] [Google Scholar]
  24. de Pedro-Cuesta J., Abraira V., Jiang G. X., Solders G., Fredrikson S. Guillain-Barré syndrome in South-West Stockholm, 1973-1991, 3. Clinicoepidemiological subgroups. Acta Neurol Scand. 1996 Feb-Mar;93(2-3):175–183. doi: 10.1111/j.1600-0404.1996.tb00195.x. [DOI] [PubMed] [Google Scholar]

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