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(searched for: doi:10.1001/archneurpsyc.1959.02340180033005)
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, Robert S. Hagan, Frederick G. Hayden, William A. Fischer
Influenza and Other Respiratory Viruses, Volume 11, pp 372-393; https://doi.org/10.1111/irv.12470

The publisher has not yet granted permission to display this abstract.
, Fredrick Koster, Andrew Cawthon
Published: 9 July 2014
The publisher has not yet granted permission to display this abstract.
, B. Keller-Stanislawski, R.A. Hughes,
Published: 14 April 2012
Der Nervenarzt, Volume 83, pp 714-730; https://doi.org/10.1007/s00115-012-3479-8

Abstract:
Das Guillain-Barré-Syndrom (GBS) ist eine sporadisch auftretende, autoimmun-vermittelte akute Polyradikuloneuritis, die häufig nach Infektionen auftritt. Ein Zusammenhang wird auch seit Jahren mit verschiedenen Impfungen, insbesondere der Influenzaschutzimpfung diskutiert. Die vorliegende Arbeit fasst die Diskussion eines Zusammenhanges zwischen GBS und vorangegangener Infektion oder Impfung mit Influenza einschließlich der Impfung gegen das Influenzavirus A/H1N1/2009 zusammen. Nach der derzeitigen Datenlage erscheint das Risiko der Impfungen, sofern es überhaupt vorhanden ist, mit einem geschätzten Fall eines GBS innerhalb von 6 Wochen nach Impfung bei 1 Mio. verimpfter Dosen sehr gering zu sein. Aktuelle Studien weisen darauf hin, dass auch Infektionen mit Influenza eine Rolle bei der Entstehung des GBS spielen könnten. Guillain-Barré Syndrome (GBS) is an acquired, monophasic inflammatory polyradiculoneuritis of autoimmune origin, which occurs after infection and occasionally also after vaccination. Seasonal and pandemic influenza vaccines have in particular been implicated as triggers for GBS. However, a number of recent studies indicate that infection with influenza virus may also cause GBS. This review summarizes the epidemiological and experimental data of the association of GBS with exposure to influenza antigens by immunization (including vaccines against A/H1N1/2009) and infection. Vaccination against influenza is associated with a very low risk for the occurrence of GBS. In contrast infection with influenza may play a more important role as a triggering factor for GBS than previously assumed.
Ketan K Patel, , Shalin Shah, Rajiv Ranjan, Sudhir V Shah
Published: 1 January 2012
Journal of Global Infectious Diseases, Volume 4, pp 178-81; https://doi.org/10.4103/0974-777X.100581

Abstract:
Neurological complications of influenza are well known. Influenza A is commonly associated with neurological complications. Neurological complications especially encephalitis is described in the pediatric age group of patients with current pandemic novel H1N1 infection. We are describing a case of novel H1N1 infection presenting with multi-system involvement (encephalitis, bilateral pneumonia, severe rhabdomyolysis leading to renal failure and polyneuropathy) in adult patient.
Helmar C Lehmann, , Bernd C Kieseier, Richard Ac Hughes
Published: 1 September 2010
The Lancet Infectious Diseases, Volume 10, pp 643-651; https://doi.org/10.1016/s1473-3099(10)70140-7

Abstract:
Summary Guillain-Barré syndrome (GBS) is an acute, acquired, monophasic autoimmune disorder of peripheral nerves that develops in susceptible individuals after infection and, in rare cases, after immunisation. Exposure to influenza via infection or vaccination has been associated with GBS. We review the relation between GBS and these routes of exposure. Epidemiological studies have shown that, except for the 1976 US national immunisation programme against swine-origin influenza A H1N1 subtype A/NJ/76, influenza vaccine has probably not caused GBS or, if it has, rates have been extremely low (less than one case per million vaccine recipients). By contrast, influenza-like illnesses seem to be relevant triggering events for GBS. The concerns about the risk of inducing GBS in mass immunisation programmes against H1N1 2009 do not, therefore, seem justified by the available epidemiological data. However, the experiences from the 1976 swine flu vaccination programme emphasise the importance for active and passive surveillance to monitor vaccine safety.
, , Cm Drapeau, E Grilli
Published: 1 January 2009
Annals of Thoracic Medicine, Volume 4, pp 163-172; https://doi.org/10.4103/1817-1737.56008

Abstract:
In the 4 months since it was first recognized, the pandemic strain of a novel influenza A (H1N1) virus has spread to all continents and, after documentation of human-to-human transmission of the virus in at least three countries in two separate World Health Organization (WHO) regions, the pandemic alert was raised to level 6. The agent responsible for this pandemic, a swine-origin influenza A (H1N1) virus (S-OIV), is characterized by a unique combination of gene segments that has not previously been identified among human or swine influenza A viruses. As of 31th July 2009, 168 countries and overseas territories/communities have each reported at least one laboratory-confirmed case of pandemic H1N1 infection. There have been a total of 162,380 reported cases and 1154 associated deaths. Influenza epidemics usually take off in autumn, and it is important to prepare for an earlier start this season. Estimates from Europe indicate that 230 millions Europe inhabitants will have clinical signs and symptoms of S-OIV this autumn, and 7– 35% of the clinical cases will have a fatal outcome, which means that there will be 160,000– 750,000 H1N1-related deaths. A vaccine against H1N1 is expected to be the most effective tool for controlling influenza A (H1N1) infection in terms of reducing morbidity and mortality and limiting diffusion. However, there are several issues with regard to vaccine manufacture and approval, as well as production capacity, that remain unsettled. We searched the literature indexed in PubMed as well as the websites of major international health agencies to obtain the material presented in this update on the current S-OIV pandemic.
Published: 4 April 2007
Abstract:
A number of infectious agents have previously been suggested as risk factors for the development of Guillain-Barré syndrome (GBS), but robust epidemiologic evidence for these associations is lacking. We conducted a nested case-control study using data from the United Kingdom General Practice Research Database between 1991 and 2001. Controls were matched to cases on general practice clinic, sex, year of birth and date of outcome diagnosis in their matched case. We found positive associations between GBS and infection with Campylobacter, Epstein-Barr virus and influenza-like illness in the previous two months, as well as evidence of a protective effect of influenza vaccination. After correction for under-ascertainment of Campylobacter infection, the excess risk of GBS following Campylobacter enteritis was 60-fold and 20% of GBS cases were attributable to this pathogen. Our findings indicate a far greater excess risk of GBS among Campylobacter enteritis patients than previously reported by retrospective serological studies. In addition, they confirm previously suggested associations between infection due to Epstein-Barr virus infection and influenza-like illness and GBS. Finally, we report evidence of a protective effect of influenza vaccination on GBS risk, which may be mediated through protection against influenza disease, or result from a lower likelihood of vaccination among those with recent infection. Cohort studies of GBS incidence in this population would help to clarify the burden of GBS due to influenza, and any potential protective effect of influenza vaccination.
, Kate Clezy, Richard Lindley, Rod Pearce
Published: 20 November 2006
by AMPCo
Medical Journal of Australia, Volume 185; https://doi.org/10.5694/j.1326-5377.2006.tb00706.x

Abstract:
Influenza is an acute febrile illness caused by influenza A or B viruses. It occurs mainly in winter in temperate climates, and throughout the year in tropical Australia. It is highly contagious and of considerable public health concern because of the rapidity with which epidemics evolve and the associated morbidity and mortality. Most influenza illnesses resolve over about 1 week without specific medical intervention. People at particular risk for complicated infection are those > 65 or < 5 years old, those with chronic medical comorbidities, residents of chronic care facilities (including nursing homes), and women in the second or third trimester of pregnancy. Complicated influenza infection most commonly manifests as primary viral pneumonia, combined viral and bacterial pneumonia, and secondary bacterial pneumonia. Rare but serious complications of influenza include central nervous system involvement (eg, encephalitis, transverse myelitis, aseptic meningitis, and Guillain–Barré syndrome). The recent emergence of avian influenza A/H5N1 and confirmation of sporadic cases of human H5N1 infection have heightened concern about an impending human influenza pandemic, either from a human form of H5N1 or a primary new human influenza strain. H5N1 infection in humans has been associated with severe illness and a > 50% mortality rate, with high mortality in people aged 10–39 years.
Richard A. C. Hughes
Published: 1 January 1990
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Peter C. Dowling, Stuart D. Cook
Published: 1 January 1981
Annals of Neurology, Volume 9, pp 44-55; https://doi.org/10.1002/ana.410090709

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H. Abou-Donia, R. Jennings, C. W. Potter
Published: 1 January 1981
Journal of Medical Virology, Volume 7, pp 251-262; https://doi.org/10.1002/jmv.1890070402

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S R Jones
Published: 1 November 1976
Western Journal of Medicine, Volume 125, pp 341-6

C. E. C. Wells
Published: 13 February 1971
by BMJ
BMJ, Volume 1, pp 369-373; https://doi.org/10.1136/bmj.1.5745.369

Abstract:
Acute neurological disorder followed an upper respiratory infection in 19 patients in south-east Wales during the winter of 1969-70. Spinal and radicular syndromes predominated and included seven cases of transverse myelopathy. Serological tests suggested that the preceding infection was due to influenza A virus in eight cases, to other viruses in six, and were negative in five.
C. H. Stuart-Harris
Published: 1 October 1963
by BMJ
Postgraduate Medical Journal, Volume 39, pp 578-581; https://doi.org/10.1136/pgmj.39.456.578

Patrick Keelan
Irish Journal of Medical Science (1971 -), Volume 37, pp 272-275; https://doi.org/10.1007/bf02957017

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