Declining Guillain-Barre Syndrome after Campylobacteriosis Control, New Zealand, 1988-2010

University of Otago, Wellington, New Zealand.
Emerging Infectious Diseases (Impact Factor: 6.75). 02/2012; 18(2):226-33. DOI: 10.3201/eid1802.111126
Source: PubMed

ABSTRACT Infection with Campylobacter spp. commonly precedes Guillain-Barré syndrome (GBS). We therefore hypothesized that GBS incidence may have followed a marked rise and then decline in campylobacteriosis rates in New Zealand. We reviewed records for 1988-2010: hospitalization records for GBS case-patients and campylobacteriosis case-patients plus notifications of campylobacteriosis. We identified 2,056 first hospitalizations for GBS, an average rate of 2.32 hospitalizations/100,000 population/year. Annual rates of hospitalization for GBS were significantly correlated with rates of notifications of campylobacteriosis. For patients hospitalized for campylobacteriosis, risk of being hospitalized for GBS during the next month was greatly increased. Three years after successful interventions to lower Campylobacter spp. contamination of fresh poultry meat, notifications of campylobacteriosis had declined by 52% and hospitalizations for GBS by 13%. Therefore, regulatory measures to prevent foodborne campylobacteriosis probably have an additional health and economic benefit of preventing GBS.

20 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Molecular-based surveillance of campylobacteriosis in New Zealand contributed to the implementation of interventions that led to a 50% reduction in notified and hospitalised cases of the country's most important zoonosis. From a pre-intervention high of 384 per 100,000 population in 2006, incidence dropped by 50% in 2008; a reduction that has been sustained since. This article illustrates many aspects of the successful use of molecular-based surveillance, including the distinction between control-focused and strategyfocused surveillance and advances in source attribution. We discuss how microbial genetic data can enhance the understanding of epidemiological explanatory and response variables and thereby enrich the epidemiological analysis. Sequence data can be fitted to evolutionary and epidemiological models to gain new insights into pathogen evolution, the nature of associations between strains of pathogens and host species, and aspects of between-host transmission. With the advent of newer sequencing technologies and the availability of rapid, high-coverage genome sequence data, such techniques may be extended and refined within the emerging discipline of genomic epidemiology. The aim of this article is to summarise the experience gained in New Zealand with molecular- based surveillance of campylobacteriosis and to discuss how this experience could be used to further advance the use of molecular tools in surveillance.
    Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 01/2013; 18(3). · 5.72 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Understanding of Guillain-Barré syndrome (GBS) has progressed substantially since the seminal 1916 report by Guillain et al. Although Guillain, Barré, and Strohl summarised the syndrome based on observations of two French infantrymen, 2012 saw the beginning of an ambitious collaborative study designed to collect detailed data from at least 1,000 patients worldwide (IGOS, Progress has been made in many areas even since GBS was last reviewed in this journal in 2009. GBS subsequently received prominent attention in light of concerns regarding H1N1 influenza vaccinations, and several large-scale surveillance studies resulted. Despite these developments, and promising pre-clinical studies, disease-modifying therapies for GBS have not substantially altered since intravenous immunoglobulin was introduced over 20 years ago. In other areas, management has improved. Antibiotic prophylaxis in ventilated patients reduces respiratory tract infection, thromboprophylaxis has reduced the risk of venous thromboembolism, and there is increasing awareness of the benefit of high-intensity rehabilitation. This article highlights some of the interesting and thought-provoking developments of the last 3 years, and is based on a plenary lecture given at the 2012 Peripheral Nerve Society (PNS) meeting.
    Journal of the Peripheral Nervous System 06/2013; 18(2):99-112. DOI:10.1111/jns5.12020 · 2.76 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Campylobacteriosis in humans, caused by Campylobacter jejuni and C. coli, is the most common recognized bacterial zoonosis in the EU and US. The acute phase is characterized by gastro intestinal symptoms. The long-term sequelae (Guillain-Barré Syndrome, reactive arthritis and post-infectious irritable bowel syndrome) contribute considerably to the disease burden. Attribution studies identified poultry as the reservoir responsible for up to 80% of the human Campylobacter infections. In the EU, an estimated 30% of the human infections is associated with consumption and preparation of poultry meat. Until now, interventions in the poultry meat production chain have not been effectively introduced except for targeted interventions in Iceland and New Zealand. Intervention measures (e.g. biosecurity) have limited effect or are hampered by economic aspects or consumer acceptance. In the future a multi-level approach should be followed, aiming at reducing the level of contamination of consumer products rather than complete absence of Campylobacter.
    Clinical Infectious Diseases 09/2013; 57(11). DOI:10.1093/cid/cit555 · 8.89 Impact Factor
Show more


20 Reads
Available from