Guillain-Barré syndrome and antecedent cytomegalovirus infection, United States 2009–2015

Details

• Alternative Title:
  Neurol Sci
• Personal Author:
  Leung, Jessica ; Sejvar, James J. ; Soares, Jesus ; Lanzieri, Tatiana M.
• Description:
  Objective:
  
  To describe incidence and clinical characteristics of cases of Guillain-Barré Syndrome (GBS) in the United States during 2009–2015, and characteristics of GBS cases with antecedent cytomegalovirus (CMV) infection among persons with employer-sponsored insurance.
  
  Methods:
  
  We analyzed medical claims from IBM Watson MarketScan® databases. GBS patients were defined as enrollees with an inpatient claim with GBS as the principal diagnosis code, based on ICD-9 or ICD-10, and ≥1 claim for lumbar puncture or EMG/nerve conduction study. We assessed intensive care unit (ICU) hospitalization, intubation, dysautonomia, and death. We also assessed selected infectious illness within 60 days prior to first GBS-coded inpatient claim.
  
  Results:
  
  We identified 3,486 GBS patients; annual incidence of 1.0–1.2/100,000 persons during 2009–2015. GBS incidence was higher in males (1.2/100,000) than females (0.9/100,000) (p=0.006) and increased with age, from 0.4/100,000 in persons 0–17 years old to 2.1/100,000 in persons ≥65 years old (p<0.001). Half of GBS patients were hospitalized in the ICU, 8% were intubated, 2% developed dysautonomia, and 1% died. Half had a claim for antecedent illness, but only 125 (3.5%) had a claim for specific infectious pathogens. The mean age among 18 GBS patients with antecedent CMV infection was 39 years versus 47 years among those without antecedent CMV infection (p=0.038).
  
  Conclusions:
  
  Incidence of GBS using a large national claims database was comparable to that reported in the literature, but cases appeared to be less severe. Half of GBS patients reported prior infectious illness, but only a minority had a specific pathogen identified.
  
  
• Subjects:
  Adolescent Adult Aged Aged, 80 And Over Child Child, Preschool Cytomegalovirus Infections Databases, Factual Female Guillain-Barre Syndrome Humans Incidence Infant Infections Insurance, Health Male Middle Aged Respiratory Tract Infections Severity Of Illness Index

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• Source:
  Neurol Sci. 41(4):885-891
• Pubmed ID:
  31828680
• Pubmed Central ID:
  PMC7501740
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  41
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:3dde3466943f47cb2425f272a423d4c451244fbd9fbd4d91f156d3afb4226d0e
• Download URL:
  https://stacks.cdc.gov/view/cdc/93865/cdc_93865_DS1.pdf
• File Type:
  [PDF - 443.17 KB ]