Binational outbreak of Guillain-Barre syndrome associated with Campylobacter jejuni infection, Mexico and USA, 2011

被引:41
作者
Jackson, B. R. [1 ]
Alomia Zegarra, J. [2 ]
Lopez-Gatell, H. [3 ]
Sejvar, J. [1 ]
Arzate, F. [4 ]
Waterman, S. [1 ]
Sanchez Nunez, A. [5 ]
Lopez, B. [6 ]
Weiss, J. [7 ]
Quintero Cruz, R. [2 ]
Lopez Murrieta, D. Y. [4 ]
Luna-Gierke, R. [1 ,8 ]
Heiman, K. [1 ,8 ]
Vieira, A. R. [1 ]
Fitzgerald, C. [1 ]
Kwan, P. [1 ]
Zarate-Bermudez, M. [1 ]
Talkington, D. [1 ]
Hill, V. R. [1 ]
Mahon, B. [1 ]
机构
[1] Ctr Dis Control & Prevent, Atlanta, GA 30333 USA
[2] Unidad Vigilancia Epidemiol, Hermosillo, Sonora, Mexico
[3] Inst Nacl Salud Publ, Ctr Invest Enfermedades Infecciosas, Cuernavaca, Morelos, Mexico
[4] Direcc Gen Epidemiol, Mexico City, DF, Mexico
[5] Serv Salud, San Luis Rio Colorado, Sonora, Mexico
[6] Yuma Cty Hlth Dept, Yuma, AZ USA
[7] Arizona Dept Hlth Serv, Phoenix, AZ 85007 USA
[8] Atlanta Res & Educ Fdn, Decatur, GA USA
关键词
Campylobacter; Guillain-Barre syndrome; outbreaks; water (safe); UNITED-STATES; FISHER-SYNDROME; WATER; POPULATION; CHILDREN;
D O I
10.1017/S0950268813001908
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
In June 2011, a cluster of suspected cases of Guillain-Barre syndrome (GBS), which can follow Campylobacter jejuni infection, was identified in San Luis Rio 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-infinity). 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.
引用
收藏
页码:1089 / 1099
页数:11
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