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

Background: Studies have shown a slight excess risk in Guillain-Barre 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) pdm0...

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Detalles Bibliográficos
Autores: Alcalde Cabero, Enrique, Almazan Isla, Javier, García López, Fernando J., Ara Callizo, José Ramón, Avellanal, Fuencisla, Casasnovas Pons, Carlos, Cemillán, Carlos, Cuadrado, José Ignacio, Duarte, Jacinto, Fernández Pérez, María Dolores, Fernández, Óscar, García Merino, Juan Antonio, García Montero, Rosa, Montero, Dolores, Pardo, Julio, Rodríguez Rivera, Francisco Javier, Ruiz Tovar, María, Pedro Cuesta, Jesús de, Spanish GBS Epidemiology Study Group
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2016
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/126747
Acceso en línea:https://hdl.handle.net/2445/126747
Access Level:acceso abierto
Palabra clave:Malalties autoimmunitàries
Nervis perifèrics
Influenzavirus
Grip
Vacunes
Autoimmune diseases
Peripheral nerves
Influenza viruses
Influenza
Vaccines
Descripción
Sumario:Background: Studies have shown a slight excess risk in Guillain-Barre 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. Methods: 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. Results: 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. Conclusions: 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.

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