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November 18, 1983, Vol 250, No. 19 >
ARTICLE | November 18, 1983

Simultaneous Outbreaks of Guillain-Barré Syndrome and Bell's Palsy in Hawaii in 1981 FREE

Jonathan E. Kaplan, MD; Joel R. Greenspan, MD; Mona Bomgaars, MD; Ned Wiebenga, MD; Robert D. Bart, Jr, MD; Kenneth Robbins, MD; Robert Wiebe, MD; Frank Tabrah, MD; John Stewart, MD; Lawrence B. Schonberger, MD
[+] Author Affiliations

Deceased.

Reprint requests to Division of Viral Diseases, Bldg 6, Room 127-B, Centers for Disease Control, Atlanta, GA 30333 (Dr Kaplan).


JAMA. 1983;250(19):2635-2640. doi:10.1001/jama.1983.03340190037028
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References

Simultaneous outbreaks of Guillain-Barré syndrome (GBS) and Bell's palsy occurred among residents of Hawaii during the three-month period June through August 1981. The outbreak of GBS (six cases) involved children, while the outbreak of Bell's palsy (22 cases) involved primarily adults. Four of the six patients with GBS had serological evidence of recent infection with cytomegalovirus (CMV) v none of 24 control subjects; no such association with CMV infection could be demonstrated for patients with Bell's palsy. The patients with GBS and Bell's palsy lived in widely scattered areas within the population centers of Hawaii, and no common exposures to specific places or events were identified. Testing for antibodies to respiratory pathogens suggested that a variety of antecedent viral infections, in addition to CMV infection, may have been associated with this unusual simultaneous cluster of illnesses.

(JAMA 1983;250:2635-2640)

REFERENCES

1 +
Schonberger LB, Hurwitz ES, Katona P, et al:  Guillain-Barré syndrome: Its epidemiology and associations with influenza vaccination . Ann Neurol 1981;;9( (suppl) ):31-38.
2 +
Kurtzke JF, Kurland LT:  Other specific neurologic disorders , in Kurland LT, Kurtzke JF, Goldberg ID (eds): Epidemiology of Neurologic and Sense Organ Disorders . Cambridge, Mass, Harvard University Press, 1973;, pp 215-217.
3 +
Lopez F, Lopez JH, Holguin J, et al:  An outbreak of acute polyradiculoneuropathy in Colombia in 1968 . Am J Epidemiol 1973;;98:226-230.
4 +
Sliman NA:  Outbreak of Guillain-Barré syndrome associated with water pollution . Br Med J 1978;;1:751-752.
5 +
Schonberger LB, Bregman DJ, Sullivan-Bolyai JZ, et al:  Guillain-Barré syndrome following vaccination in the National Influenza Immunization Program, United States, 1976-1977 . Am J Epidemiol 1979;;110:105-123.
6 +
Wegner EL: The Computation of Socioeconomic Status Scores for Census Tracts in Hawaii and Suggestions for Their Use in Health Research , population report 12. Honolulu, Hawaii State Department of Health, 1980;.
7 +
Waner JL, Weller TH, Stewart JA:  Cytomegalovirus , in Rose NR, Friedman H (eds): Manual of Clinical Immunology . Washington, DC, American Society for Microbiology, 1976;, pp 423-427.
8 +
Stewart JA, Herrmann KL:  Herpes simplex virus , in Rose NR, Friedman H (eds): Manual of Clinical Immunology . Washington, DC, American Society for Microbiology, 1976;, pp 416-420.
9 +
Asbury AK:  Diagnostic considerations in Guillain-Barré syndrome . Ann Neurol 1981;; 9( (suppl) ):1-5.
10 +
Leibowitz U:  Epidemic incidence of Bell's palsy . Brain 1969;;92:109-114.
11 +
Dowling PC, Cook SD:  Role of infection in Guillain-Barré syndrome: Laboratory confirmation of herpesviruses in 41 cases . Ann Neurol 1981;;9( (suppl) ):44-55.
12 +
Schmitz H, Enders G:  Cytomegalovirus as a frequent cause of Guillain-Barré syndrome . J Med Virol 1977;;1:21-27.
13 +
Soffer D, Feldman S, Alter M:  Epidemiology of Guillain-Barré syndrome . Neurology 1978;; 28:686-690.
14 +
Jordan MC, Rousseau WE, Stewart JA, et al:  Spontaneous cytomegalovirus mononucleosis . Ann Intern Med 1973;;79:153-160.
15 +
Kennedy RH, Danielson MA, Mulder DW, et al:  Guillain-Barré syndrome: A 42-year epidemiologic and clinical study . Mayo Clin Proc 1978;;53:93-99.
16 +
Melnick SC, Flewett TH:  Role of infection in the Guillain-Barré syndrome . J Neurol Neurosurg Psychiatry 1964;;27:385-407.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Schonberger LB, Hurwitz ES, Katona P, et al:  Guillain-Barré syndrome: Its epidemiology and associations with influenza vaccination . Ann Neurol 1981;;9( (suppl) ):31-38.
2 +
Kurtzke JF, Kurland LT:  Other specific neurologic disorders , in Kurland LT, Kurtzke JF, Goldberg ID (eds): Epidemiology of Neurologic and Sense Organ Disorders . Cambridge, Mass, Harvard University Press, 1973;, pp 215-217.
3 +
Lopez F, Lopez JH, Holguin J, et al:  An outbreak of acute polyradiculoneuropathy in Colombia in 1968 . Am J Epidemiol 1973;;98:226-230.
4 +
Sliman NA:  Outbreak of Guillain-Barré syndrome associated with water pollution . Br Med J 1978;;1:751-752.
5 +
Schonberger LB, Bregman DJ, Sullivan-Bolyai JZ, et al:  Guillain-Barré syndrome following vaccination in the National Influenza Immunization Program, United States, 1976-1977 . Am J Epidemiol 1979;;110:105-123.
6 +
Wegner EL: The Computation of Socioeconomic Status Scores for Census Tracts in Hawaii and Suggestions for Their Use in Health Research , population report 12. Honolulu, Hawaii State Department of Health, 1980;.
7 +
Waner JL, Weller TH, Stewart JA:  Cytomegalovirus , in Rose NR, Friedman H (eds): Manual of Clinical Immunology . Washington, DC, American Society for Microbiology, 1976;, pp 423-427.
8 +
Stewart JA, Herrmann KL:  Herpes simplex virus , in Rose NR, Friedman H (eds): Manual of Clinical Immunology . Washington, DC, American Society for Microbiology, 1976;, pp 416-420.
9 +
Asbury AK:  Diagnostic considerations in Guillain-Barré syndrome . Ann Neurol 1981;; 9( (suppl) ):1-5.
10 +
Leibowitz U:  Epidemic incidence of Bell's palsy . Brain 1969;;92:109-114.
11 +
Dowling PC, Cook SD:  Role of infection in Guillain-Barré syndrome: Laboratory confirmation of herpesviruses in 41 cases . Ann Neurol 1981;;9( (suppl) ):44-55.
12 +
Schmitz H, Enders G:  Cytomegalovirus as a frequent cause of Guillain-Barré syndrome . J Med Virol 1977;;1:21-27.
13 +
Soffer D, Feldman S, Alter M:  Epidemiology of Guillain-Barré syndrome . Neurology 1978;; 28:686-690.
14 +
Jordan MC, Rousseau WE, Stewart JA, et al:  Spontaneous cytomegalovirus mononucleosis . Ann Intern Med 1973;;79:153-160.
15 +
Kennedy RH, Danielson MA, Mulder DW, et al:  Guillain-Barré syndrome: A 42-year epidemiologic and clinical study . Mayo Clin Proc 1978;;53:93-99.
16 +
Melnick SC, Flewett TH:  Role of infection in the Guillain-Barré syndrome . J Neurol Neurosurg Psychiatry 1964;;27:385-407.

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