EPIDEMIOLOGY OF GUILLAIN-BARRE-SYNDROME IN CHILDREN - RELATIONSHIP OF ORAL POLIO VACCINE ADMINISTRATION TO OCCURRENCE

Because a cluster of cases of Guillain-Barre syndrome followed a mass vaccination program using oral polio vaccine, a retrospective epidemiologic survey was carried out in southern California to examine the relationship between oral polio vaccine and Guillain-Barre syndrome. We also examined the yearly pattern of Guillain-Barre syndrome and compared rates of illness in different ethnic populations. The mean annual incidence of Guillain-Barre syndrome was 0.60 (95% confidence intervals 0.48 to 0.73) per 100,000 children under 15 years of age. There was no difference in incidence between boys and girls or between ethnic populations. The incidence was significantly higher in 2-year-old children than in any other age group (p<0.05). The onset of Guillain-Barre syndrome was preceded by an infection in 71 (76%) of 93 children. In five children (5%) a vaccination was given within 8 weeks before illness onset. Only two children received the oral polio vaccine; the duration from vaccine administration to the onset of Guillain-Barre syndrome was 41 and 52 days, whereas the mean incubation time associated with infectious illnesses was 10.3 days. Strong evidence against a causal relationship between oral polio vaccine administration and Guillain-Barre syndrome is provided by the failure to find a correlation between the usual age of immunization with oral polio vaccine and the incidence of Guillain-Barre syndrome by age and the failure to find any children with onset of Guillain-Barre syndrome within 1 month of immunization with oral polio vaccine.