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Binational outbreak of Guillain–Barré syndrome associated with Campylobacter jejuni infection, Mexico and USA, 2011

  • B. R. JACKSON (a1), J. ALOMÍA ZEGARRA (a2), H. LÓPEZ-GATELL (a3), J. SEJVAR (a1), F. ARZATE (a4), S. WATERMAN (a1), A. SÁNCHEZ NÚÑEZ (a5), B. LÓPEZ (a6), J. WEISS (a7), R. QUINTERO CRUZ (a2), D. Y. LÓPEZ MURRIETA (a4), R. LUNA-GIERKE (a1) (a8), K. HEIMAN (a1) (a8), A. R. VIEIRA (a1), C. FITZGERALD (a1), P. KWAN (a1), M. ZÁRATE-BERMÚDEZ (a1), D. TALKINGTON (a1), V. R. HILL (a1) and B. MAHON (a1)...

In June 2011, a cluster of suspected cases of Guillain–Barré syndrome (GBS), which can follow Campylobacter jejuni infection, was identified in San Luis Río Colorado (SLRC), Sonora, Mexico and Yuma County, Arizona, USA. An outbreak investigation identified 26 patients (18 from Sonora, eight from Arizona) with onset of GBS 4 May–21 July 2011, exceeding the expected number of cases (n = 1–2). Twenty-one (81%) patients reported antecedent diarrhoea, and 61% of 18 patients tested were seropositive for C. jejuni IgM antibodies. In a case-control study matched on age group, sex, ethnicity, and neighbourhood of residence, all Arizona GBS patients travelled to SLRC during the exposure period vs. 45% of matched controls (matched odds ratio 8·1, 95% confidence interval 1·5–∞). Exposure information and an environmental assessment suggested that GBS cases resulted from a large outbreak of C. jejuni infection from inadequately disinfected tap water in SLRC. Binational collaboration was essential in investigating this cross-border GBS outbreak, the first in mainland North America since 1976.

Corresponding author
*Author for correspondence: Dr B. R. Jackson, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS A38, Atlanta, GA 30333, USA. (Email:
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1. JJ Sejvar , Population incidence of Guillain-Barré syndrome: a systematic review and meta-analysis. Neuroepidemiology 2011; 36: 123133.

2. P Frenzen . Economic cost of Guillain-Barré syndrome in the United States. Neurology 2008; 71: 2127.

5. I Nachamkin , Patterns of Guillain-Barré syndrome in children. Neurology 2007; 69: 16651671.

6. J Drenthen , Guillain–Barré syndrome subtypes related to Campylobacter infection. Journal of Neurology, Neurosurgery & Psychiatry 2011; 82: 300305.

7. BC Jacobs , Serum anti-GQ1b IgG antibodies recognize surface epitopes on Campylobacter jejuni from patients with Miller Fisher syndrome. Annals of Neurology 1995; 37: 260264.

9. J Calva , Cohort study of intestinal infection with Campylobacter in Mexican children. The Lancet 1988; 331: 503506.

11. ML Hanninen , Detection and typing of Campylobacter jejuni and Campylobacter coli and analysis of indicator organisms in three waterborne outbreaks in Finland. Applied and Environmental Microbiology 2003; 69: 13911396.

14. JE Kaplan , Simultaneous outbreaks of Guillain-Barré syndrome and Bell's palsy in Hawaii in 1981. Journal of the American Medical Association 1983; 250: 26352640.

17. KS Kohl , Assessment of public health events through International Health Regulations, United States, 2007–2011. Emerging Infectious Diseases 2012; 18: 10471053.

18. JJ Sejvar , Guillain-Barré syndrome and Fisher syndrome: Case definitions and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine 2011; 29: 599612.

21. TJ Barrett , CM Patton , GK Morris . Differentiation of Campylobacter species using phenotypic characterization. Laboratory Medicine 1988; 19: 96102.

22. D Linton , R Owen , J Stanley . Rapid identification by PCR of the genus Campylobacter and of five Campylobacter species enteropathogenic for man and animals. Research in Microbiology 1996; 147: 707718.

25. KE Dingle , Multilocus sequence typing system for Campylobacter jejuni . Journal of Clinical Microbiology 2001; 39: 1423.

29. M Takahashi , Epidemiology of Campylobacter jejuni isolated from patients with Guillain-Barré and Fisher syndromes in Japan. Journal of Clinical Microbiology 2005; 43: 335339.

34. K Stanley , R Cunningham , K Jones . Isolation of Campylobacter jejuni from groundwater. Journal of Applied Microbiology 1998; 85: 187191.

36. BG Weniger , An outbreak of waterborne giardiasis associated with heavy water runoff due to warm weather and volcanic ashfall. American Journal of Public Health 1983; 73: 868872.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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